The National Cancer Institute Cairo University www'nci'edu'eg Kasr ElAini Street, Kornish ElNil, Fom

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CANCER CARE IN EGYPT PAST, PRESENT
FUTURE
By Prof. Sherif Omar MD, FACS
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HISTORY
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HISTORY

• Cairo first radiotherapy treatment machine (DXR)
  in 1928
• Alexandria first radiotherapy treatment machine
  (DXR) in 1954

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HISTORY

• Prof. M. Mahfouz first to introduce Cobalt
  teletherapy in Egypt.

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HISTORY OF NATIONAL CANCER INSTITUTE, CAIRO
UNIVERSITY

• The idea of establishing a National Cancer
  Institute arose in the 1950s and it was
  eventually implemented through the determined
  efforts of professor Ahmed Lotfy Abou El Nasr.

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HISTORY OF NATIONAL CANCER INSTITUTE, CAIRO
UNIVERSITY

• With the same enthusiasm, Prof. Ismail EL-Sebai
  introduced radical surgery for cancer and trained
  a large group of Egyptian surgeons.

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HISTORY OF NATIONAL CANCER INSTITUTE, CAIRO
UNIVERSITY

• Thanks to their efforts, Cairo University
  recognized oncology as a separate specialty in
  1959.

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HISTORY OF NATIONAL CANCER INSTITUTE, CAIRO
UNIVERSITY (cont.)

• The National Cancer Institute, including its
  first hospital of 270 beds, was opened in 1969.
• The 2nd building was opened in 1989.

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HISTORY OF NATIONAL CANCER INSTITUTE, CAIRO
UNIVERSITY (cont.)

• Now, NCI is the largest comprehensive cancer
  center in Egypt, the Middle East and Africa.
• Both buildings, among other facilities, includes
  558 beds
• 362 beds for free section
• 196 insurance and private section

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Prof. P. Denoix
Prof. P. Denoix
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Training Abroad

• France
• USA
• Japan
• United Kingdom
• Netherlands

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CANCER PROBLEMIN EGYPT
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CANCER PROBLEMIN EGYPT

• In Egypt today, the number of new cancer patients
  per year is estimated to be 100,000.
• Accumulated patients represent about three times
  the number of new cases.
• This patient load will expand in the future as
• The population continues to grow and age
  increases.
• Advances in early detection and medical
  facilities.
• The prevalence of known etiological factors
  increase.

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PATIENT POPULATION Of NCI

• About 38 of patients came from the Cairo
  metropolitan area, 40from Lower Egypt, and 22
  from Upper Egypt.
• About 65 of patients are treated free of charge
  and private patients generally have health
  insurance which covers their cost.
• No. of new cases 18,000/year follow up from
  previous years

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Most Common Sites in Males
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Most Common Sites in Females
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Clinical Breast Exam for IBC
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Bilharzial Bladder Cancer
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FACILITIES

• The hospital includes a broad array of medical
  services
• Ten operating theatres, an intensive care and
  recovery unit (36 beds).
• Adult and pediatric medical oncology units.
• Radiotherapy facilities include 4 linear
  accelerators, 2 cobalt machines, 2 simulators,
  and interstitial therapy after-loading
  capabilities.

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FACILITIES (cont.)

• The hospital includes a broad array of medical
  services
• Bone marrow transplantation unit .
• Pain control clinic.
• Nuclear medicine unit.
• Radiodiagnosis department equipped with standard
  x-ray facilities, mammography, computerized
  tomographic scanning, ultrasonography, and
  magnetic resonance imaging.

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FACILITIES (cont.)

• The hospital includes a broad array of medical
  services
• There is a diagnostic endoscopies unit.
• Several clinical pharmacy units.
• Clinical pathology laboratories, a blood bank.
• Laboratory of surgical pathology and a laboratory
  of cytopathology.
• Cancer registration and epidemiology department.
• Cancer biology department, an electron microscopy
  unit, and an experimental surgery unit associated
  with an animal house.

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FACILITIES (cont.)
High dose rate Brachytherapy
Electron Microscopy
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Bone Marrow Transplantation

• Number of cases already transplanted 1055 by the
  team of the NCI.
• BMT facilities are present in
• NCI
• Naser Institute
• Mansoura University Hospital
• Maadi Military Hospital
• Kasr Al Aini Hospital
• Alexandria University Hospital
• Private hospitals

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Positron Emission Tomography (PET Scan)
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NATIONAL CANCER INSTITUTE STRATIGIES

• Prevention and Early detection
• Management Diagnosis and Treatment
• Education Training and Certification
• Research Basic and Clinical
• National and International Role

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Prevention and Early Detection

• Active programs in cancer prevention and early
  detection through public education.

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Prevention and Early Detection
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Prevention and Early Detection

• Active programs in cancer prevention and early
  detection through public education.

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Education Training Certification Post
Graduate Studies

• NCI offers academic degrees in various oncology
  specialties, including

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Education Training Certification (cont.)

• Educating doctors throughout Egypt who serve in
  various health care sectors via its visiting
  residency programs.
• Continuing education programs, and staff visits
  to satellite clinics.
• National Cancer Institute Journal,

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Education Training Certification (cont.)

• Guidelines of treatment

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Education Training Certification (cont.)
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Education Training Certification (cont.)
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• National TOBACCO Control Activities

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National Cancer Control Centers

• University Cancer Institutes.
• M.O.H. 8 cancer centres.
• Oncology departments of other universities.
• Non Governmental Organizations.

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Radiation Therapy in Africa

• Total 160
• Egypt 62
• South Africa 40

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Future
Children Cancer Hospital
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Future

• New Extension of the National Cancer Institute
• Restructuring and Expansion of Small cancer
  centers already functioning.

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Future (cont.)

• National population based registry designed to
• Monitor cancer trends over time.
• Determine cancer patterns in various populations.
  
• Guide planning and evaluation of cancer control
  programs (e.g., determine whether prevention,
  screening, and treatment efforts are making a
  difference).
• Help set priorities for allocating health
  resources.
• Advance clinical, epidemiologic, and health
  services research.
• Provide information for a national database of
  cancer incidence.

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Future (cont.)

• Cancer Informatics and Information Flow.
• Activation of Telemedicine programs

• Telemedicine involves the use of electronic
  communication technologies to provide or support
  clinical care at a distance.
• The care includes the medical diagnosis,
  management, or monitoring of diseases or
  illnesses through the use of technology

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Future (cont.)

• Implementation of screening and early detection
  programs.

Early detection Without Screening
Opportunistic Screening
Organized Screening
Methods of early detection
Early detection of breast cancer in countries
with limited resources
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Accuracy of Mammography
In a diagnostic centre in Cairo, Egypt between
July 2002 to December 2003, 7220 mammograms have
been done for 6585 patients
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Future (cont.)

• Professional and public education activities.
• Medical schools curriculum.
• Continuous medical education.
• Training of para-medical staff.

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Future (cont.)

• National Clinical Trials Program
• Studying Emerging Trends in Cancer. 
• Regional oriented research
• AMAAC
• KFSH RC
• Salah Aziz Cancer Center ( Tunisia)

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Future (cont.)

• International
• World Health Organization WHO.
• European Organization for Research and Treatment
  of Cancer EORTC.
• Internal Union Against Cancer UICC.
• International Atomic Energy Agency IAEA.
• International network for cancer treatment
  research INCTR.
• The National Cancer Institute, Holland. .

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Future (cont.)

• Enforcing activities for better control of
  tobacco consumption

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Future (cont.)

• Living related liver transplantation

• In selected cases of hepatobiliary tumours

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www.nci.edu.eg
Thank you
Cairo University
National Cancer Institute