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The insufficiency of radiotherapy-based treatments in Romania

March 31, 2022 Radiotherapy

If we were to take an x-ray of the health system in Romania, without being specialized doctors we would realize that there are many aspects to improve. Issues such as lack of direction and strategy, insufficient funding, training of medical staff are addressed for a good amount of time in various articles and research. The Romanian government has not yet managed to formulate a well-designed strategy for the health system.

Even though Romania has implemented numerous reforms in the field of public health, and not only, since it is a member of the European Union, the level of medical assistance remains behind the average European standards. In this article we will analyze a narrower but imperatively important part of the health system, namely radiotherapy treatments.

Article Summary

Understanding radiotherapy

Radiotherapy is one of the most effective methods of cancer treatment. [1 ]The aim of radiation therapy is to destroy cancer cells so that they do not affect other healthy tissues. Radiotherapy treatment involves the use of controlled doses of radiation on the tumor area. [2]

Access to radiotherapy in Romania

In Romania, radiotherapy sessions, for the treatment of cancer, are free for patients who benefit from health insurance (settled by the National Health Insurance Agency), regardless of whether they are carried out in a state hospital or in a private radiotherapy center . In addition, in Romania the cost of medicines is compensated through a national program. The problem after that is that genetic testing and imaging examinations for the proper prescription and follow-up of drug treatment are only partially compensated.

Challenges cancer patients face in Romania

Cancer patients also face other administrative and social obstacles. A barrier for patients in radiation oncology treatment is the rarity of supportive care units or home services. Moreover, the health system has the problem of the small number of radiotherapy centers, which deal with all cancer patients who need this type of treatment, as well as the uneven distribution of these centers at the national level. [3]

This situation results in overcrowding of medical facilities in large university towns, and cancer patients can be put on waiting lists for months for treatment. In many discussions and interviews, the doctors claim that it would be recommended to have a radiotherapy center in each county.

Radiotherapy infrastructure and capacity in Romania

According to DIRAC (Directorate of Radiotherapy Centers) data, in 2020, 34 radiotherapy centers are registered in Romania. [4] Out of 83,461 new cases (2018), 14,622 patients receive radiotherapy treatment, i.e. 17.5%. [5] This percentage is a worrying one in the context where, according to scientific articles, at least half of cancer patients need radiotherapy. Moreover, for some patients radiation therapy is the only cancer treatment. [6] In Romania, more than half of the patients who need radiotherapy do not benefit from it because there is no equipment and no enough doctors, according to the Association of Cancer Patients.

In 2018, Romania ranked last in the European Union in the number of radiotherapy machines for treating cancer patients: an average of 0.39 per 100,000 inhabitants, while Belgium was at the opposite pole, with an average of 1.84 machines per 100,000 inhabitants. [7]

There are some non-governmental organizations, such as the Federation of Associations of Cancer Patients (FABC) or the Melanoma Romania Association, which strive to improve the management of cancer patients in Romania. Both the associations, the state institutions and each of us must focus on identifying optimal solutions that will bring Romania’s oncology medicine (from the perspective of the radiotherapy branch) to European standards.

Lack of specialists and the rise of medical tourism

In addition to the insufficiency of equipment, another impediment in the context of radiotherapy treatments is represented by the lack of specialists in public hospitals, a main reason being the low level of salaries.

Because of the barriers mentioned above, cancer patients often do not trust our medical system and prefer to go and pay directly for care in cancer centers in countries such as Turkey, Austria, Germany, France or the United Kingdom.

Solutions to improve cancer treatment in Romania

Some potential solutions to improve cancer treatment in Romania would be:

Implementation of support centers and home services
Investing in the education, training and remuneration of oncology specialists
Building radiotherapy centers in most counties of the country and modernizing the existing ones by equipping them with technology and equipment

Conclusion

Romania’s radiotherapy challenges require urgent action. While insured patients can access free treatment, the shortage of equipment and specialists forces many to wait months or seek care abroad.

Improving cancer treatment in Romania requires a unified strategy involving state authorities, healthcare professionals, and NGOs. Investing in infrastructure, workforce development, and patient-centered care is no longer optional, it is essential.

Author:

Alexandru Zariosu, MD