The Director-General of the Cancer Centre, Rwanda Military Hospital talked to RWANDA TODAY about the hospital launching a modern cancer treatment centre, with the capacity to receive 80 patients per day.

Below are excerpts

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Let’s talk about the inception of the project.

Since 2012, I have been involved in starting up a radiotherapy centre both at the national level through the Ministry of Health and at the Rwanda Military Hospital.

The few skills that we have in radiotherapy were mostly located at the Rwanda Military Hospital and that is why there is a plan in place to have this expanded.

The way we planned for this type of technology is by recognising that we don’t have enough skills first of all. We approached different manufacturers looking for a solution as opposed to just buying a linear accelerator because the specificity of these types of centres is that each type of equipment has different requirements in terms of construction and skills.

Why do you say that what we have so far is not enough?

There are different guidelines set by the World Health Organisation and from the International Atomic Energy Agency. There is also an estimate for a machine per number of population for both developed and developing countries.

Looking at our population, we need about 10 centres, so we definitely need more than one. This is in line with the cancer prevalence in Rwanda.

What is the cancer rate in Rwanda?

At a national level, we are at an important level of establishing a cancer registry. I was involved in setting up the cancer registry, and the staff were based at the Rwanda Military Hospital.

But, we also have international statistics, specifically from GLOBOCAN, which provides each country’s statistics on cancer. Hopefully in a few months we shall have initial reports from the new cancer registry. Cancer registrars are moving across the country collecting all the data.

What is the difficulty in having a cancer registry?

There is not just one hospital or one doctor that deals with cancer; particularly when you consider from the time of diagnosis, to treatment and follow up, more often than not, the patient will have gone to different hospitals and at different levels.

It is easy to get double reports that are misleading, that is why it is important to have a centralised registry which is specific.

There are two types of cancer registries; hospital-based and population-based.

Is your registry hospital-based or population-based?

We shall start with a hospital-based registry, but eventually implement a population-based registry.

What is Rwanda’s level of expertise in diagnosing cancer?

You need doctors and a lab that can conduct specific tests and detect cancer early, and you need a strong imaging facility.

At the moment we have all those, but not up to international standards, but I think we are at a very acceptable level. For example, for imaging, we only lack functional and metabolic imaging, which is called the PET/CAT scan, which is very helpful in accurately staging, making diagnosis and accurately following up treatment outcome.

In our case, our technology is able to use those type of images to accurately deliver radiation treatment in selected type of diseases.

Given the existing challenges in diagnosis; would you agree that being diagnosed with cancer in Rwanda is a death sentence?

The prognosis will always be the same whether you are in Rwanda or at the best cancer centre in Europe or USA. In the past, management of radiosensitive diseases was somewhat compromised if you were in Rwanda, but we now have radiotherapy machines.

It is estimated that 60 per cent of all cancer patients will need radiotherapy in the course of their treatment whether alone or in combination with surgery and chemotherapy. So you can imagine that this was a major missing link in Rwanda.