Source: International Atomic Energy Agency – IAEA
Staff at Angau Memorial Hospital in Lae, Papua New Guinea, celebrate the installation of the new brachytherapy machine used to treat gynaecological and other cancers. (Photo: Angau Memorial Hospital)
After nearly a decade of inactivity, Papua New Guinea’s only radiotherapy machine re-started operations six months ago with support from the IAEA, giving renewed hope to thousands of cancer patients in the country.
This month, radiation medicine services at Angau Memorial Hospital received a boost with the start of brachytherapy, a critical procedure in the treatment of cervical cancer.
“This milestone represents a significant advancement in our cervical cancer treatment capabilities, offering more precise and localized therapy options to improve patient outcomes,” said Athula Kumara, medical physics expert at Angau Memorial Hospital, the facility that received the IAEA support.
Located in the city of Lae, Papua New Guinea’s shipping hub in the north, Angau is the country’s second largest hospital, catering for 675 000 people in the Morobe Province and serving as a regional referral hospital for 1.9 million residents.
The improved service is important as cancer remains a major public health issue in the country, with a burden of over 12 000 new cases and more than 7000 deaths every year, according to 2022 IARC figures. Breast, cervix uteri, as well as lip and oral cancers are the most frequent among women.
Brachytherapy is a form of internal radiotherapy in which sealed radioactive sources are placed inside or near a tumour, delivering high doses of radiation directly to the cancer while sparing surrounding healthy tissues. The procedure is a key component of radiation treatment for gynaecological cancers, but it can also be used to treat prostate, breast, soft tissue sarcomas, some head and neck tumours, and skin cancers.
The brachytherapy equipment was installed in late 2024 at Angau and started services this month. The first patient, a woman with cervical cancer, underwent external beam radiotherapy last year and is now receiving brachytherapy treatment as a boost.
The installation of the brachytherapy machine follows previous IAEA assistance in re-establishing radiotherapy at Angau. Services were discontinued in 2016, severely limiting options for cancer patients in the country. Many were referred abroad, but few could afford it. “Some travelled to Manila for treatment, but these cases were rare due to the high cost of travel and treatment,” Kumara said.
In 2023, an imPACT review carried out by the IAEA in collaboration with the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC) recommended to urgently reestablish radiotherapy services in the country.
Through its technical cooperation and human health programmes, the IAEA supported the hospital in replacing the radiotherapy machine’s radioactive source and provided advice on the acquisition of the new brachytherapy unit. Radiotherapy started again in mid-August 2024, and Angau has since been treating around 50 patients per month on average, with hundreds more registered for treatment. “Treatment has been very successful, and we have seen many patients recover significantly after undergoing therapy,” Kumara added.
A key pre-requisite for the upgrade in radiation medicine has been training medical physicists. “These highly specialized health professionals ensure optimal equipment performance and maintain high-quality, safe treatment procedures,” said Daniel Berger, medical physicist in the IAEA’s Division of Human Health who led recent technical missions to build local capacity in the country. “Their expertise enables precise dosimetry, planning and dose delivery while ensuring equipment and clinical processes meet international standards for effective patient care,” he explained.
Medical physicists also provide technical guidance for infrastructure improvements, collaborating closely with regulatory authorities to licence and deploy nuclear and radiation medicine equipment. “Their work ensures that radiotherapy services can meet the growing demand for cancer care, ultimately helping to improve patient outcomes and advance healthcare standards,” Berger added.
Radiotherapy is one of the main pillars of cancer treatment, along with surgery and chemotherapy. In 2022, the IAEA launched the Rays of Hope initiative to support countries in increasing access to this life-saving treatment. Since becoming a Member State in 2012, Papua New Guinea has received IAEA support to strengthen radiation safety, including for the management of radiation sources for medical use, and to build the required capacity to expand cancer diagnosis and treatment.
While progress has been made in advancing cancer care, Kumara highlights that early diagnosis and treatment provision remain a challenge. “Patients arrive at very late stages of their cancer, often with extensive masses. By the time they seek treatment, the cancer has already spread, making it more difficult to achieve optimal outcomes,” he said. “One of our key goals moving forward is to increase awareness, particularly in remote areas where access to healthcare is limited.”
Cervical cancer is the fourth most common cancer in women globally, with around 660 000 new cases in 2022. About 94 per cent of the 350 000 deaths caused by cervical cancer in the same year occurred in low- and middle-income countries, driven by inequalities in access to vaccination against the human papillomavirus (HPV), responsible for 95 per cent of all cervical cancers, as well as screening and treatment services.
In many countries, January is Cervical Cancer Awareness Month, supporting efforts to promote HPV vaccination for prevention and early diagnosis and treatment of precancers, which greatly improve prospects for cure.