Caring for patients with surgically resectable cancers: experience from a specialised centre in rural Rwanda
Objectives: To describe characteristics, management and 6-month outcome of adult patients presenting with potentially surgically resectable cancers.
Design: Retrospective cohort study of patients presenting between 1 July and 31 December 2012.
Results: Of 278 patients, 76.6% were female, 51.4% were aged 50 –74 years and 75% were referred from other district or tertiary hospitals in Rwanda. For the 250 patients with treatment details, 115 (46%) underwent surgery, with or without chemotherapy/radiotherapy. Median time from admission to surgery was 21 days (IQR 2–91). Breast cancer was the most common type of cancer treated at BCCOE, while other forms of cancer (cervical, colorectal and head and neck) were mainly operated on in tertiary facilities. Ninety-nine patients had no treatment; 52% of these were referred out within 6 months, primarily for palliative care. At 6 months, 6.8% had died or were lost to follow-up.
Conclusion: Surgical care was provided for many cancer patients referred to BCCOE. However, challenges such as inadequate surgical infrastructure and skills, and patients presenting late with advanced and unresectable disease can limit the ability to manage all cases. This study highlights opportunities and challenges in cancer care relevant to other hospitals in rural settings.
Keywords: Africa; operational research; rural care; solid cancers; surgery
Document Type: Research Article
Affiliations: 1: Partners in Health/Inshuti Mu Buzima, Butaro, Burera District, Rwanda 2: Partners in Health/Inshuti Mu Buzima, Butaro, Burera District, Rwanda, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA 3: Ministry of Health, Butaro District Hospital, Butaro, Rwanda 4: Partners in Health/Inshuti Mu Buzima, Butaro, Burera District, Rwanda, Brigham and Women's Hospital, Boston, Massachusetts, USA 5: International Union Against Tuberculosis and Lung Disease, Paris, France, London School of Hygiene & Tropical Medicine, London, UK 6: International Union Against Tuberculosis and Lung Disease, Paris, France 7: Partners in Health/Inshuti Mu Buzima, Butaro, Burera District, Rwanda, Dana Farber Cancer Institute, Boston, Massachusetts, USA 8: Brigham and Women's Hospital, Boston, Massachusetts, USA 9: Dana Farber Cancer Institute, Boston, Massachusetts, USA
Publication date: 21 June 2014
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