Despite Peru’s sometimes-sluggish development when it comes to healthcare, the progression of cancer prevention and control in recent decades is tremendous. This is particularly important as the number of cancer cases increases by 50,000 annually in Peru. Communicable diseases like infectious diseases, which used to be a predominant cause of death in the country, have steadily been eradicated; today, cancer is the second highest cause of mortality in Peru after cardiovascular diseases.
Modern cancer treatment in Peru dates back to 1939, when the foundation of the Instituto Nacional de Enfermedades Neoplásicas (INEN) ushered in a new era of comprehensive treatment of the disease. Over the years, this Lima-based public institution has evolved many times over and today is considered one of the leading public hospitals in South America for cancer treatment. “Our institution is the national gold standard for prevention and oncology healthcare practices,” states Tatiana Vidaurre, chief of INEN. “The high level of excellence and competence in cancer research and oncology education, technical and regulatory control actions in oncology delivery services for health promotion, prevention, early detection, comprehensive oncology healthcare (multidisciplinary oncology treatment and palliative care) and complementary support is working as a platform support for the Peruvian regions. INEN can be match with the best oncology institutions worldwide.”
Of course, ensuring funding for cancer prevention and treatment for millions of Peruvians who are otherwise unable to afford it is no easy task. Yet through decades of hard work and careful planning, the creation of Plan Esperanza (“Hope Plan” in English), a national oncology coverage plan, has sought to provide access to cancer care for the majority of the Peruvian population.
More than half of Peruvian citizens are affiliated with Seguro Integral de Salud (SIS), the public health insurance scheme run by Peru’s Ministry of Health. “Since 2012 SIS has almost tripled its budget, which has allowed us to expand coverage to a larger population directly but beyond that permits us to include new pathologies in benefit plans,” says Pedro Grillo, Chief of SIS. “This includes Plan Esperanza, which allocates PEN 120 million (USD 40 million) for the treatment of lymphoma, leukemia, breast, cervical, colon, gastric and prostate cancer. This only targets treatment, but we are also working on strategies for prevention. Since 2012 more than 100,000 Peruvians have gained access to treatment with chemotherapy, radiation, surgery and in some cases advanced treatments with monoclonal antibodies where necessary for the treatment of cancer.”
In the private sector, comprehensive cancer control has also been a large focus for the country’s top clinics. Most notably, the foundation of OncoSalud in 1989 by Luis Pinillos and Carlos Vallejos, two of the leading health experts in Peru and former Ministers of Health jumpstarted this process. “When we started OncoSalud, the objective for affiliates to pay a nominal fee and receive full coverage in case they obtained cancer, as well as control information for checkups,” explains Pinillos. “We started with a small group of people to see if our model would be financially successful. It was, so we started selling the program, first in groups and then individually. Today we have almost 750,000 affiliates, with 20,000 people undergoing treatment at any given time, and these people are survivors. With a 67.1 percent survival rate after five years and 66.8 percent after ten years, these figures are even better than those of the United States or Europe.”
The race is now on for prevention and early-stage diagnosis of cancer. In addition to the creation of new hospitals across Peru, oncology units are being built at many of the existing hospitals throughout the country. Additionally, the decentralization of cancer care is a big issue for health authorities, and cancer units have been established in the provincial capitals of Arequipa and Trujillo. “Prevention has been one of the best resources in countries like Peru to fight most health problems,” says Vallejos, who notes that Peru’s recent economic growth in the last decade has allowed for improvements in the infrastructure of 3,000 hospitals in Peru. Today, 30 percent of all cancer cases in Peru are diagnosed in early stages, a vast improvement in diagnosis compared to a few short decades ago.
Eduardo Payet, executive director epidemiology and cancer at INEN and vice president of the Peruvian Cancer Foundation, envisions his country as being free of advanced cancer altogether. “If we continue the system we currently run, advanced tumors will continue to be prevalent in Peru. We must improve our recognition of the disease in early stages. It is not the work of this hospital, but rather its influence in universities, medical schools and health institutions.
“We need to talk about cancer,” concludes Payet. “We always need to think in terms of cancer.”
Article by Cameron Rochette