In the province of Ontario, Canada, surgical oncology is organized at the provincial level by the government agency Cancer Care Ontario (CCO). CCO is a data driven organization which monitors health outcomes, surgical volumes, population study and demography as well as providing guidelines for patient management through the Program for Evidence Based Care (PEBC). Resource allocations are made at this level, but local decisions across the 14 regions in the province are also made. Nationally, similar programs exist in most provinces with national guidelines guiding management, but few national standards are strictly enforced. Further, there is no comprehensive national process for drug access, although the drug approval process is nationalized. Discussion will revolve around lessons learned and outcomes in the Canadian model, and how these can be translated to the development of surgical oncology throughout Africa.

Surgical oncology is surgery of oncologist. It enters a mandatory context of multidisciplinarity. It is a diagnostic, therapeutic, reconstructive and preventive surgery for cancers. In Africa, several models of surgical management of cancers exist. In Senegal, cancer surgery depends on the place of practice, the speciality and the availability of surgical oncologists who work in multidisciplinary teams. At Cheikh Anta Diop University in Dakar, there is a training in surgical oncology whose vocation is to give learners skills in the screening, diagnosis, surgical treatment, reconstruction and monitoring of mainly digestive, gynecological, breast, soft tissues and skin cancers. This model makes it possible to group anatomically or functionally related conditions by optimizing their resections and their follow-ups in a multidisciplinary environment. This model also makes it possible to offer a frame of reference for the peripherical medical centers for the management of patients coming from specialties for which a training in surgical oncology has not been carried out or an uninstituted multidisciplinary framework.