Taking Guatemala From Cobalt to IMRT: A Tale of US Agency Collaboration With Academic Institutions and Industry.

The not-for-profit organization La LIGA Nacional Contra el Cáncer, with its hospital Instituto de Cancerología (INCAN), is responsible for cancer treatment of much of the indigent population in Guatemala, a country with a population of 16 million. Annually, approximately 70% of patients at INCAN are seen in late stages of cancer, which places a great strain on the hospital's limited resources. Private clinics account for 75% of radiation therapy centers in Guatemala and have considerable resources. However, private facilities are fee-based, which creates a barrier for low-income patients; this is an especially significant problem in Guatemala, which has the highest income inequalities and poverty rates in Latin America. This article describes a project on the transition from cobalt to a Halcyon radiation therapy system at INCAN through a partnership with the US Agency for International Development's Office of American Schools and Hospitals Abroad (USAID/ASHA), Washington University in St. Louis (WUSTL), industry partner Varian Medical Systems, and the US National Nuclear Security Administration to provide access to state-of-the-art radiation therapy technology while increasing the overall treatment capacity for the underserved population of Guatemala.