Earlier studies in this region by the International Atomic Energy Agency (IAEA) indicated that the region ranked second-highest in the world (only behind sub-Saharan Africa) in the proportion of cancer treatment machines that relied on cobalt-60. While these cobalt-60 external beam radiotherapy machines do provide access to an essential component of cancer care, medical linear accelerators (LINACS) are more secure and generally accepted to more effective than cobalt-60 units for cancer radiation treatment, delivering more advanced treatment options resulting in better treatment outcomes. Cobalt-60 machines also present environmental risks related to aged-source disposal and security risks associated with the cobalt-60 source being used in the manufacture of improvised explosive devices knows as “dirty bombs”. Therefore, ORS seeks an updated deep understanding of access to cancer radiotherapy technology in Eastern Europe, Central Asia, and the Caucasus, with an emphasis on the use of cobalt-60 treatment machines and linear accelerators. This main objective of the survey will be to determine barriers to and plans for adoption of linear accelerators for cancer treatment.