Radiotherapy stalled at National Cancer Institute as machines out of service

Radiotherapy services at the National Institute of Cancer Research and Hospital, the country's only full-fledged cancer treatment facility, remain stalled after the last two functioning machines broke down. This leaves cancer patients in distress, with no immediate solution in sight.

The state-run facility had six radiotherapy machines, but four were declared obsolete over the past few years. Until recently, two of the machines were still operational, treating around 200-220 patients daily, though demand far exceeded capacity. 

On 21 December, one of these machines malfunctioned during therapy, and the second went out of service the following day. Since then, radiotherapy services have ceased completely.

A technologist at Cancer Institute's radiation oncology department, requesting anonymity, explained, "The four were declared obsolete in phases due to exceeding their lifespan. We were managing with the remaining two, but now both are out of order."

Dr Md Jahangir Kabir, acting director of the institute, said that for repairing the machines, the company from which they were purchased has been contacted and the machines will be fixed soon. However, the company has not provided a definitive timeline and  efforts to repair the machines locally have also failed.

Consequently, patients are facing significant hardship due to the suspension of radiotherapy services, with many being forced to return home without receiving treatment, he told TBS on Tuesday.

According to the institute sources, there has been no good news as of yesterday.

Patients' sufferings intensify

Patients, many of whom travel long distances and wait months for treatment, are now in a state of uncertainty. 

Rozina Akhter, a breast cancer patient from Patuakhali, said after undergoing five radiotherapies at the Cancer Institute, she arrived for her sixth therapy only to find that the machines had gone out of service.

"I can't afford private hospital costs, which are 10 times higher than those at Cancer Institute. I've been relying on help from kind-hearted people for treatment. Now, I don't know when I'll get the remaining 10 therapies," said Rozina.

Radiotherapy at the Cancer Institute costs Tk12,000–15,000 for a complete course, compared to Tk100,000–150,000 in private facilities. Typically, patients with cervical, breast or brain cancer require 15–25 sessions.

National shortfall in cancer equipment

The collapse of radiotherapy services at the institute highlights a broader issue: Bangladesh's severe shortage of radiotherapy equipment. 

According to the World Health Organization (WHO), the country needs 300 radiotherapy machines to meet patient demand. However, only 37 machines are available across public and private hospitals, many of which are non-functional.

Data from the Global Cancer Observatory (2020) reveal that 1.56 lakh new cancer cases are diagnosed annually in Bangladesh, with 1.08 lakh fatalities. 

According to the Bangladesh Cancer Society, there are approximately 13 to 15 lakh cancer patients in the country, underscoring the urgency of expanding radiotherapy capacity.

Fasttrack policy needed to buy equipment

Experts have stressed the need for policy changes to address the crisis. Dr Md Habibullah Talukder Raskin, project coordinator at Gonoshasthaya Samaj Vittik Cancer Hospital, criticised the government's traditional procurement process.

"Fasttrack policies are essential to purchase 15–20 radiotherapy machines at once for hospitals treating cancer. Machines nearing the end of their lifespan must be replaced proactively, not after they go out of order. The current machines at Cancer Institute were bought in 2005-2006 with a lifespan ending in 2015," said Dr Raskin.

Dr Raskin also highlighted the importance of urgent servicing contracts for government-owned equipment. While private facilities typically repair machines within days, government repairs can take months, leaving patients without critical care.

Future crisis

Without immediate intervention, the crisis will worsen cancer care inequities in Bangladesh. Cancer is already a leading reason for patients seeking treatment abroad due to insufficient domestic resources. 

Dr Raskin emphasised the need for prevention and early detection to ease the burden on the healthcare system.

"The government lacks the capacity to provide radiotherapy to patients in the late stages of cancer. Prevention and early diagnosis must become priorities," he said.

Meanwhile, the collapse of radiotherapy services at the Cancer Institute serves as a stark reminder of the systemic challenges in Bangladesh's healthcare system, leaving thousands of patients in limbo.