Nurse-led chemotherapy day units with a doctor on a screen
Trained nurses following strict written protocols can safely run chemotherapy clinics for common cancers, with an oncologist available by video for decisions and problems.
Task-shifting delivered HIV treatment to millions when there were no doctors to do it. Chemotherapy for common, protocol-driven indications (early breast cancer, Hodgkin lymphoma, paediatric ALL, cervical chemoradiation) can be delivered by specialist nurses and clinical officers under protocols, with tele-oncology supervision. Partners In Health's Butaro Cancer Centre in Rwanda has run a version of this for more than a decade. The proposal is to define the national protocol set, credential the roles, and measure outcomes at scale.
- Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.
- Not enough oncologists, nurses, pathologists, physicists · The number of people with cancer is rising faster than the workforce trained to treat them.
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- InstitutionButaro Cancer Center of Excellence
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