Plans to expand cancer services across Bangladesh are welcome, especially for patients who currently travel long distances to reach specialist treatment. But an announcement about new institutes or radiotherapy machines should be understood as the beginning of a public-service commitment, not proof that care has become accessible.
A linear accelerator cannot treat a patient safely without trained radiation oncologists, medical physicists, radiotherapy technologists, nurses, maintenance engineers and dependable quality-assurance systems. A machine that arrives without a functioning clinical team, commissioning procedures or spare-parts arrangements can become an expensive symbol rather than a working service. Workforce development must therefore advance alongside procurement.
Access is also shaped by the costs that patients bear beyond hospital fees. Travel, accommodation, repeated visits, time away from work and the need for a family caregiver can make treatment unaffordable even when a machine is technically available. Decentralisation should be designed around actual patient journeys: diagnostic referral, appointment scheduling, treatment continuity, follow-up and palliative support.
Public reporting would make the programme more credible. Each proposed facility should have a published timeline for construction, equipment delivery, staff recruitment, commissioning and first patient treatment. Once operational, facilities should disclose useful service indicators such as functioning days, treatment waiting times and equipment downtime, while protecting patient privacy. Transparent data would help administrators identify bottlenecks and patients make informed choices.
Medical physics education is an important part of this agenda. Partnerships between universities, hospitals and professional bodies can strengthen training, clinical placements and continuing competence. Such partnerships should be built around recognised safety standards rather than quick numerical targets for graduates.
The central test of expansion will not be how many devices were purchased, but whether a patient outside Dhaka can receive safe, timely and continuous care without facing ruinous costs. Bangladesh should connect investment decisions to staffing, maintenance, clinical governance and equitable access from the outset. A credible cancer-care strategy is a service system, not merely a catalogue of buildings and machines.
Illustrative photo: Accuray/Unsplash.