October 2013

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Highlights:

St Mary's Hospital, Lacor

by Ian MagrathIan Magrath 16 Sep 2018 12:15

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Improving the quality of cancer care in African children

by Ian MagrathIan Magrath 13 Sep 2018 14:44

Summary INCTR is working to create a regional collaborative cancer network to improve early diagnosis and treatment in children with cancer.
This project provides access to comprehensive cancer care to children in northern Uganda who are treated by St Mary's Hospital Lacor in Gulu. The project will pay for for costs of diagnosis and treatment and cover families' expenses including transportation, pathology, treatment, food, accommodation, psychosocial support, education for children undergoing treatment, and costs of diagnosis and treatment. It also provides training for health care personnel caring for children with cancer, and public awareness to increase the speed of diagnosis.

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INCTR Partners with ecancer

by Ian MagrathIan Magrath 02 Jul 2018 14:53

ecancer is a UK based charity which provides free educational resources to the global oncology community. The course, “A dignified death: An essential e-learning course on palliative care for health care professionals in India" is now available at no cost. The course consists of 20 one-hour long modules that provide insight on best practice in palliative care from communication and counselling skills, ethics, opioid use to paediatric care. The course is highly interactive and features video lectures from leading palliative care experts in India who share their experiences to support both the health care provider and patient when treatment is focused primarily on comfort measures. Each module includes assessments and completion certificates. A text version of the course is available to support participants with lower internet speeds. A Hindi version is also available. The course has been developed in collaboration with Karanushraya Hospice (Bengaluru, India), Cardiff Palliative Care Education team (Cardiff, Wales) and ecancer.

To take the course, you must register with ecancer.org. Registration is free. To create your account, go to https://ecancer.org and select "register." The course is hosted on ecancer’s website, ecancer.org, alongside many thousands of hours of other free educational materials.

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The Lara Nara Project

by Ian MagrathIan Magrath 28 Jun 2018 20:18

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The Lara Nara project is an e-learning program through the MNJ Radiation Oncology Residency Program. This is the product of a collaboration between local medical experts led by Dr. Sanjeeva Kumari, professor of Radiation Oncology at MNJ Institute of Oncology, Hyderabad, and Dr. Francois Bachand (Radiation Oncologist, BC Cancer, University of British Columbia and Two Worlds Cancer), Dr. Eva Brun and Dr. Maria Grebe-Medhin (Radiation Oncologists, University of Lund, Sweden) and Dr. Nadia Octave (Medical Physicist, Universite Laval, Canada) has been in place now for three years. The e-learning modules cover a wide range of fundamental concepts in Medical Physics, Radiobiology and clinical basics of Radiation Oncology, informing decision making and determining treatment planning. The program has grown since its start, with the addition of modules that are specific to the needs of the program in Hyderabad, sensitive to the local academic environment and clinical demands. Our team continues to adapt to novel communication methods, using new platform like Whatsapp and Facebook groups, in order to bring the experts and students closer although the distance and time change remains a challenge. The local champions are progressively incorporating their views and knowledge in the modules.

Progress in Improving Access to Palliative care

by Ian MagrathIan Magrath 25 Jun 2018 16:18

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Two Worlds Cancer Collaboration Foundation (2W), also known as INCTR Canada branch, is a not-for-profit, non-governmental charity with a mission to improve cancer control through provision of the necessary infrastructure and to build capacity for high quality palliative care and aspects of cancer control in developing countries.

Weekly Meetings with Pediatric Staff of Lacor Hospital

by Ian MagrathIan Magrath 01 May 2018 17:43

INCTR is planning to develop a continuing education program with Lacor Hospital via weekly on-line meetings. This is particularly urgent since the Head of the Department will be absent for personal leave for three months. In addition to these meetings, which will discuss management issues concerning all pediatric in-patients, INCTR Brazil's leadership (Dr. Sidnei Epelman) will explore the possibility of sending trained pediatric oncologists to Lacor so that they are fully aware of the resource level at Lacor - particularly medical and ancillary staff - for longer periods (the duration of the visits has yet to be determined) to provide on-site training in pediatric cancer care and to upgrade the facilities for this purpose to the extent possible. Of particular importance will be the reinstatement of detailed data collection. It will be necessary to educate the Lacor staff as to the importance of high quality data to assess the efficacy of the present treatment protocol and the the numbers of patients being cared for at Lacor. Although INCTR has held similar programs in the past, the shortage of well trained pediatric oncologists (there are presently none) means that the quality of care can be improved. At present it is known that many patients do not reach Lahor because of the long distance that most patients must travel from their villages to St Mary's hospital. Most cannot afford the cost, or attempt the journey only after the disease has become extensive, when treatment response is likely to be poor,

INCTR India Initiates Health Visits

by Ian MagrathIan Magrath 25 Apr 2018 16:28

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The International Network for Cancer Treatment and Research, India (INCTR India) in collaboration with Biyani Girls Nursing College, Rajasthan; has initiated a pilot project for Cancer Awareness with emphasis on the early detection of oral, breast and cervical cancer in selected villages in the district of Jaipur, Rajasthan. The Primary Health Centers (PHCs) work for the Ministry of Health & Family Welfare Govt. of Rajasthan and  also co-operated with INCTR during project implementation.  Pilot projects were initiated in March 2018 after final year female students had received training at the SMS Govt. Hospital for Early Detection of the three cancers. After completing their training, the students, in teams of 2, visited houses in the project area and examined women/girls for the presence of symptoms that could be due to one of the three cancers.  They were also asked about other symptoms relating to their general health.  In one day 2 students were able to visit about 10 houses and examine 40 to 50 women. Those with symptoms were directed to a PHC for further examination and treatment. The students provided information on cancer awareness during their household visits and also took part in  meetings, mass rallies and "camps" to ensure that the public is aware that tobacco can cause oral and other cancers.  Several Women’s Self Help Groups who had indicated a keen interest in the project also participated.  Similar projects are being initiated with other Nursing Colleges located in the rural regions of Rajasthan where the majority of people are extremely poor.  The overall goal of the project is to encourage more nurses to take an active role in the early detection of these cancers and to implement cervical cancer screening as soon as they have been trained to perform testing suitable for Rajasthan.  Data from these early pilot projects will be used to explore approaches to constantly increasing the number of young women who have received training in the symptoms experienced by these cancers and where to go to be examined if symptoms consistent with them should arise. 

Newsflash Archive

by Stuart PageStuart Page 31 Mar 2018 13:17

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Second Quarter 2014

by Ian MagrathIan Magrath 23 Mar 2018 15:42

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First Quarter 2014

by Ian MagrathIan Magrath 22 Mar 2018 17:07

First Quarter 2014

by Ian MagrathIan Magrath 22 Mar 2018 15:12

Nick and Emma return home

First Quarter 2018

by Ian MagrathIan Magrath 09 Feb 2018 17:48

Not yet Published

Publication of Fifth Edition of Cancer Control

by Ian MagrathIan Magrath 01 Feb 2018 16:28

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The fifth edition of INCTR's annual Journal, Cancer Control has been published.

Further Discussions Regarding Causes of Mortality In BL Patients

by Ian MagrathIan Magrath 09 Jan 2018 15:19

There is very little information about the incidence and mortality rates in BL in African countries. Our own experience has suggested that not only do patients frequently fail to reach a center capable of effective care of patients with this disease (and are not registered), but a significant fraction of patients die prior to the initiation of therapy. The lack of registration systems, suggests that many patients have found the hospital, but failed to find an individual who can tell them where to go. Remarkably, in one case, the patient had been sleeping in the hospital for some weeks before his presence became known. He was finally found by a visitor to the hospital and admitted for treatment. Not surprisingly, he died from the complications that result from extensive BL.

Improving On-Line Connectivity

by Ian MagrathIan Magrath 09 Jan 2018 14:57

In the 21st century we are witnessing a rapid growth of all things related to information technology - and soon we'll be establishing our identity biologically. Thumbprints and retinal scanning, even facial expressions, will be enough for us to cross borders between countries or to be unequivocally oneself - the possibilities of artificial intelligence are, well, mind-blowing. Vehicles (except perhaps for rockets) will run on natural gas or electricity and at last, we'll see a downturn in our use of fossilized fuel. Instead of oil rigs, we'll see vast fields of wind-driven turbines and thereafter, a whole new culture anxious to squeeze the last ounce of energy from anything that moves or gives off radiation, Many such devices already exist although we may not be aware of their permeation of our lives. Already, already children are adapted to computers whilst the elderly, whose lives have only recently abutted against the new kind of digital technology which they find unintuitive (unlike children) and difficult, if not impossible, to use efficiently. The change for some will be much more painful than for others, but many will find their old lifestyles gone forever.

Diagnosis and Treatment of Burkitt Lymphoma

by Ian MagrathIan Magrath 09 Jan 2018 14:56

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. Burkitt lymphoma was recognised as a clinical syndrome by Denis Burkitt - an Irish surgeon who worked in British East Africa for the British Colonial Medical Service after the Second World War. Remarkably, it was not until 1957 - 10 years after his arrival in British East Africa (Uganda), that he saw a case.  The hospital Pediatrician (Hugh Trowel) asked Burkitt to see a 5 year old boy with tumours that had developed in all 4 jaw quadrants.  Burkitt could only confirm that the child had an inoperable cancer. Remarkably, just a week later, while visiting the District Hospital at Jinja (the location of the source of the Nile, he saw a second child with tumours present in all 4 jaw quadrants. This child also had palpable abdominal masses.  Since Burkitt had never seen such a tumour, he studied pediatric case records to determine whether tumours of this type had been seen previously.  As he soon discovered., a significant number of such cases has been seen.  Fortunately, a cancer registry had been established some 7 years before, and after painstakingly examining the records Burkitt was able to identify a total of 37 children who had died with jaw tumours - often multiple and often associated with tumour at various other anatomical sites, particularly the abdomen. The tumour also quite frequently involved serous membranes, the orbits, endocrine glands, ovary, breasts and central nervous system.  He also found a number of references to the tumour in the published literature.   The professor of pathology, Jack Davies, could not make a diagnosis other than "small round cell sarcoma" and it was not until 1959 that Gregory O'Conor, a young pathologist recently arrived from the USA, reviewed, with Davies, all the childhood cancers in the Kampala registry.  O'Conor concluded that the tumour was a type of lymphoma.  Remarkably, it accounted for 50% of all childhood cancers in the Kampala cancer registry.     

Departure of Dr Calbi From Lacor

by Ian MagrathIan Magrath 08 Jan 2018 15:17

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At the end of 2016 Dr Calbi, an Italian hematologist who had been working at Lacor hospital and played a major role in both the coordination and documentation of data collected in the course of the Burkitt lymphoma study supported by INCTR and OFID (OPEC Fund For INTERNATIONAL Developmentt) returned to Italy after several years in Uganda where sh was chief of the Pediatric Cancer department. She was involved in all aspects of the study, which covered access to care, treatment and follow-up. She also assisted with data collection and management. Her efforts to improve survival bore fruit: in a case series of 118 patients, survival rate was 71%. The data was analysed with the help of an expert statistitican and presented at Lugano in June 2016.

Further Discussions on Monitoring of Burkitt lymphoma

by Ian MagrathIan Magrath 07 Jan 2018 17:02

Further discussions with Dr Martin Ogwang and his staff were held in an attempt to determine the cause of the increased mortality during the months following the departure of Dr Calbi. These will not be discussed specfically in the context of Locor, since the data belongs to Lahor, but the problem of increased mortality in general is a central problem to all who treat cancer. Some of the issues that should be considered by hospitals that accept Burkitt lymphoma patients for treatment include 1. Education of all staff members 2. Periodic review of pathology, annual or semi-annual auditing of data collected and intermittent visits after the completion of treatment. This is essential if a figure for long term survival is to be obtained.

Departure of Dr Calbi from Lacor

by Ian MagrathIan Magrath 07 Jan 2018 15:33

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Dr Valeria Calbi, an Italian haematologist (see picture) spent several years working at the Lacor hospital in the Gulu district in Northern Uganda.  In charge of the children's ward, most of her patients, as would be expected in Equitorial Africa, had Burkitt lymphoma, which is now known to be caused by Plasmodium falciparum malaria and probably Epstein-Barr virus, which are thought to complement each other in the development of the disease.  Dr Calbi worked closely with Melissa Adde, INCTR's Executive Director in documenting the proportions of patients with disease at different sites as well as the response to treatment in terms of survival rate and toxicity encountered.  Financial assistance for the cost of treatment (a standardized protocol was used) and documentation of sites of disease and treatment outcome was providing by INCTR funds collected by Mr Geoffrey Thaxter, a member of the Board of Trustees of INCTR Challenge Fund and OFID (OPEC Fund for International Development).  INCTR's Executive Director, Melissa Adde coordinated the  various components of care, including the purchase of chemotherapy, and worked with an informatics expertert (Jovan Vladic) to create a data-base in which disease extent and treatment outcome could be diocumented.  Dr Calbi also initiated a program of public education to attempt to educate the people, especially those living in distant villages so that they could recognize children with signs that could indicate cancer.  Such patients underwent diagnostic tests and necessary chemotherapy was initiated as soon as possible after a diagnosis had been made.   Although the results of the study, which included 118 consecutive patients were excellent, the extent to which early diagnosis improved tolerance of therapy could not be accurately determined since there was no randomization to Early Detection versus no attempt at early detection.  Similarly, even comparison of patients who present with different stages of disease is not easy, since the examination of patients had not been standardized.  Thus, this study remains to be done.  Dr Calbi did an excellent job and the data relating to the 118 patients - 71% survival at 3 years - is probably the best reported from equitorial Africa so far.

INCTR Signs an MOU with Lacor Hospital

by Ian MagrathIan Magrath 02 Jan 2018 18:39

Following the vist to Lacor hospital, Melissa Adde, Executive Director of INCTR in Brussels discussed INCTR's recommendations with Dr Martin Ogwang. It had been clear that many of the children being treated for Burkitt's lmphoma or other childhood malignancies often had little to do once treatment administration was completed. Ms Adde suggested that a teacher be employed to avoid the children falling behind as a result of long periods of time away from home. INCTR Offered to provide a salary and an MoU was written to document ths addition to the scope of the existing agreement, which covers all costs related to treatment apart from the salary of the head of pediatrics (who is in charge of all children with cancer), which was shared between INCTR and Lacor Hospital.

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