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KABUL (PAN): Hundreds of people die needlessly in Afghanistan because of a lack of cancer specialists and diagnostic centres, doctors say.

Afghanistan did have a cancer diagnostic centre at Ali Abad Hospital in Kabul, but that was destroyed during the civil war 30 years ago and has never reopened.

Doctors say that if the cancer is caught early enough some patients can be operated on and with treatment live another 10 years. But if the cancer is not detected and spreads, the patient has less chance of survival.

Due to a lack of cancer specialists in Afghanistan, those who can afford it travel overseas for treatment, but many more die, having never been properly diagnosed.

Noor Jan, 45, has suffered from stomach cancer for eight years. She was working as a teacher at Zarghona high school in Kabul when she started to get severe stomach pains. She made several trips to doctors at government and private hospitals, but none were able to agree on what the problem was, and at the same time, the pain got worse.

"One doctor diagnosed me with intestinal tuberculosis, while another said I had a stone in my gall bladder and a third said it was a kidney stone," she said.

When the illness started to get very bad, Jan went to India where she was diagnosed with stomach cancer.

Speaking from New Delhi, Jan said she had just been operated on and was feeling much better. She said she had paid about $10,000 for the treatment, half of which was a loan.

For many people in Afghanistan though, paying to seek treatment overseas is not an option.

Amirudin, 29, resident of Saragi district in Kabul, has had blood cancer for the past year. He also said that the lack of specialised treatment centres in Afghanistan meant he had to pay a lot of money to travel abroad.

"I have gone to Pakistan for treatment three times, each time I spent 40,000 to 70,000 Pakistani rupees ($470-$820)."

However, now, Amirudin, the owner of a general store, said he had run out of money and was seeking medical care at Jamhoriat Hospital, in Kabul.

The illness makes him nauseas, unable to sleep and keeps him in constant pain. His pale, weak body was shaking as he complained about the lack of adequate care for cancer patients in Afghanistan.

Like Amirudin, most Afghans cannot afford to seek treatment overseas. And without specialised care, many die, according to doctors.

Rahmatullah, who lives in Kher Kana in Kabul, said his father had a pain in his kidney, and even though he was given different medication, it just got worse.

Finally, a doctor diagnosed his father as having urinary bladder cancer, but at that time, the disease had progressed so far, there were no treatments.

"We found out that our father had cancer when the disease was so bad that the possibilities for treatment were few and we couldn't afford to take him abroad. Ultimately he died."

Najeebullh, a resident of Shah Sahed district in Kabul, said his mother had complained about a pain in her digestive system for about seven months, during which time she was living off beverages. Nothing the doctors gacve her made any difference, he said.

Eventually, doctors said his mother might have a tumour in her intestines, and suggested he take her out the country for treatment.

Speaking with tears in his eyes, Najeebul said he could not afford to take his mother to another country and that after seven months, she died.

He criticised the government for failing to set up even one medical and diagnostic centre for cancer patients, even though the international community had poured a lot of money into health care.

A number of doctors also said the lack of cancer diagnostic and other equipment reflected a big gap in health care services.

Dr. Ahmad Walid, doctor for internal medical inspect and blood, working in Jamhoriat Hospital Kabul, said because of this lack dozens of patients go to Pakistan, India and other countries for treatment.

The only treatment doctors in Afghanistan can give to cancer patients is a blood transfusion, he said.

With a recommendation letter, a patient can get such transfusion from the blood bank, he said. However, the only real treatment for blood cancer is a bone marrow operation, which cannot be carried out in Afghanistan.

In India, the operation costs about 1.6 million Indian rupees ($35,000).

Dr Daud, a surgeon at the Wazeer Akbar Khan Hospital in Kabul, said diagnosing and treating cancer patients is not possible in Afghanistan. Doctors must send their biopsies out the country, he said.

Daud and other doctors have also called for a greater focus on establishing treatment and diagnostic centres and training cancer specialists.

Dr Abdullah Fahim, an adviser to the Ministry of Public Health, said they needed $5 million to build centres with equipment and specialists needed to diagnose and treat cancer.

He said the international nuclear agency had promised to set up such a centre in Jamhoriat Hospital.

Fahim also said that a 200-bed cancer centre was being built with assistance from Pakistan, but that only half of it had been completed so far.

He said the ministry was still trying to open the centres, but they lacked doctors who were experts in cancer treatment. He said the service cannot start until they have 20 doctors trained to treat cancer, which could take another five years.

This year, five doctors were sent to Turkey to specialise in cancer treatment and another 15 will also be sent to Turkey and India to expand their experiences.

Mansoor Ahmad, an assistant at the Pakistani Embassy in Kabul said 2,000 visas are issued daily, among which 500 to 700 are for medical reasons.

He said that most patients going to Pakistan have either heart problems or cancer.

Fahim said he did not know the exact number of Afghans travelling overseas for medical treatment.