By May Abdel-Wahab, MD, PhD, FASTRO
The increasing cancer burden places great pressure on health care systems and leaders worldwide to provide effective solutions, even when the resources to diagnose and treat these conditions may be scarce. Even in high-income countries, the increasing number of cancer cases is presenting significant challenges for countries, their leaders and health care providers. To assist in these efforts, the International Atomic Energy Agency’s (IAEA) Programme in Human Health aims to provide a comprehensive approach to the prevention, diagnosis and treatment of cancer in four main areas of support: nutrition; radiology and nuclear medicine for diagnosis; radiation oncology for treatment; medical physics, dosimetry and quality assurance.
Recent years have witnessed rapid advances in radiotherapy techniques, including intensity-modulated radiation therapy, image-guided radiation therapy, stereotactic radiotherapy, tomotherapy, new brachytherapy and unsealed-source techniques and proton and heavy ion therapy, all of which have one goal in common: treating patients more efficiently, effectively and safely. The IAEA supports these and other treatment techniques in several ways:
Training and education
Supporting the initial education and training of radiotherapy professionals, such as medical physicists, radiation therapy technologists and radiation oncologists, as well as supporting the continuing education and training of previously trained professionals to update or expand their knowledge and skills is a priority. The lack of qualified professionals is one of the main obstacles preventing the needed modernization and expansion of radiotherapy services in the developing world. Adequate human resource planning is essential and must accompany government investment in equipment.
The IAEA supports long-term and short-term fellowships, education and training workshops, such as contouring workshops
, as well as virtual education platforms such as the Human Health Campus
, an educational and resources website for health professionals, and AfroNET
, a virtual tumor board for professionals in the African region. In addition, the IAEA supports the implementation of new master’s programs, such as the medical physics program at the University of Trieste and the radiation oncology program in Chile.
The IAEA fosters the exchange of scientific and technical information. Coordinated research projects allow researchers across the globe to access a platform of quality clinical research, where a full range of projects (from pre-clinical to phase III trials, health economics trials, patterns of care studies and cost-analysis research) can be discussed and actions planned. Funding research to improve health globally allows answers to research questions of relevance that would be difficult to address otherwise. A broad range of research has been supported, including randomized trials in bone metastases
, liver radiosurgery, head and neck and other
Coordinated research projects are instrumental to build capacity in research in IAEA member states while also providing opportunities for scientists and institutions to conduct more strategic research.
Support of new radiotherapy and nuclear medicine centers in countries
and supporting the significant global radiotherapy needs and transferring nuclear technology to developing countries is one of the core IAEA activities. The IAEA has contributed to filling the gaps in access to technologies and education in the fields of nuclear medicine, diagnostic imaging and radiotherapy, contributing in this way to saving lives and improving quality of life across the socioeconomic spectrum.
The IAEA also maintains the Directory of Radiotherapy Centres (DIRAC)
, an online registry of radiotherapy centers worldwide and the world’s only database on radiotherapy resources containing radionuclide and high-energy radiotherapy machines.
Quality assurance and safety
The IAEA contributes to quality assurance and patient safety in radiotherapy
and publishes reports and guidelines on quality assurance programs and quality control procedures to support high quality, safe and effective radiotherapy
. These documents provide general guidance for the implementation of quality management systems, and several national radiation safety regulations and laws are based or include elements of this documentation.
The IAEA develops internationally harmonized codes of practice
and guidelines for dosimetry and quality assurance, as well as recommendations for best practices, and provides guidance to member states for their implementation. Access to teletherapy, brachytherapy and diagnostic imaging at the IAEA Seibersdorf complex in Austria plays an important role in ensuring quality radiotherapy worldwide through access to training, audits and calibration. These activities play a key role in establishing and disseminating best practices for the safe, secure and effective use of radiation in the diagnosis and treatment of cancer.
The dosimetry laboratory provides services to countries to assure that treatment devices can be safely operated in clinical use. Since 1969, the IAEA/World Health Organization (WHO) TLD postal dose quality audit service
has been operating to validate the calibration of radiation beams in developing countries. In addition, in 1976, the IAEA, together with the WHO, established a Network of Secondary Standards Dosimetry Laboratories
, with the aim of improving the accuracy in radiation dosimetry and assure a traceable route for national dosimetry standards.
How the IAEA supports these and other global cancer initiatives will be the topic of this year’s keynote speech at ASTRO’s 60th Annual Meeting by Yukiya Amano, Director General of the International Atomic Energy Agency.
For more information, please visit www.IAEA.org
and the Human Health Campus website.
Dr. Abdel-Wahab is director of the Division of Human Health in the Department of Nuclear Sciences and Applications with the International Atomic Energy Agency in Vienna, Austria.