The COVID-19 pandemic has overwhelmed health systems around the globe even in countries with strong economies. This is of particular concern for nations with weaker health systems. This article reports the response of a comprehensive cancer centre in a lower-middle income country to prevent COVID-19 transmission and how the implementation of pragmatic strategies have served as a springboard to improve cancer services beyond the COVID-19 pandemic. The strategies included establishment of a local taskforce, increased education and facilitation of good hygiene practices, staff training, patient triaging, improved patient scheduling, remote review of patients and establishing a virtual platform for meetings.

Background: The current standard of radical treatment for patients with cancer of the cervix is combination therapy in the form of radiotherapy with chemotherapy. Generally the same treatment protocol is applied to HIV-positive and HIV-negative patients. However, HIV-positive patients with invasive cervical cancer have not been evaluated in detail regarding treatment response, its toxicities and compliance. Methods: This prospective, quantitative comparative study was conducted to evaluate acute toxicity in radical combination therapy, in HIV-positive (on HAART) and HIV-negative patients for cervical cancer at the Cancer Diseases Hospital, Lusaka, Zambia. In total, 120 stage IB 2-IIIB cervical cancer patients were serially recruited to have an equal number of participants in each arm. Participants received cisplatin-based radical chemo-radiation for five to six weeks and were assessed for acute reactions in four systems: genitourinary, haematopoietic, skin, and gastrointestinal. Toxicity was scored using the NCI CTC v2.0. Results: The results revealed that there was no significant difference with regard to major acute reactions between the two groups. Radical chemo-radiation is therefore well tolerated by HIV-positive patients. Conclusion: Radical chemo-radiation in conventional doses was safely tolerated by a well-selected cervical cancer HIV-positive group on HAART and could be considered suitable for similar patients.

PURPOSE Formal education in the radiation sciences is critical for the safe and effective delivery of radiotherapy. Practices and patterns of radiation sciences education and trainee performance in the radiation sciences are poorly described. This study assesses the current state of radiation sciences education in Africa and evaluates a high-yield, on-site educational program in radiation biology and radiation physics for oncology and radiation therapy trainees in Africa. METHODS An anonymous survey was distributed to members of the African Organization for Research and Treatment in Cancer Training Interest Group to assess current attitudes and practices toward radiation sciences education. A 2-week, on-site educational course in radiation biology and radiation physics was conducted at the Cancer Diseases Hospital in Lusaka, Zambia. Pre- and postcourse assessments in both disciplines were administered to gauge the effectiveness of an intensive high-yield course in the radiation sciences. RESULTS Significant deficiencies were identified in radiation sciences education, especially in radiation biology. Lack of expert instructors in radiation biology was reported by half of all respondents and was the major contributing factor to deficient education in the radiation sciences. The educational course resulted in marked improvements in radiation biology assessment scores (median pre- and posttest scores, 27% and 55%, respectively; P < .0001) and radiation physics assessment scores (median pre- and posttest scores, 30% and 57.5%, respectively; P < .0001). CONCLUSION Radiation sciences education in African oncology training programs is inadequate. International collaboration between expert radiation biology and radiation physics instructors can address this educational deficiency and improve trainee competence in the foundational radiation sciences that is critical for the safe and effective delivery of radiotherapy.