Pediatric Oncology in Peru

The Instituto de Enfermedades Neoplásicas (INEN) in Lima, Peru—the only cancer hospital in the country—began its reorganization 50 years ago with the development of specialties in the different fields of oncology. The medical oncologists treated pediatric patients until 1980 when two new pediatric oncologists joined the medical staff, upon completing training in the U.S. The pediatric ward started with a five-bed unit in 1960 and progressively increased its capacity to 41 beds by 2001.

As everywhere in the world, acute leukemia is the most frequent neoplasm affecting children, followed by lymphomas (Hodgkin's disease and non-Hodgkin's lymphoma) and retinoblastoma, which is the most common solid tumor seen at our Institution. Unfortunately, the majority of cases come to our hospital with advanced disease due to delayed or wrong diagnosis, or inadequate medical care. There are very few cases of neuroblastoma and Ewing's sarcoma compared to the incidence in other countries.

We are currently seeing around 400 new cancer patients per year from all over the country, which has a population of approximately 25 million inhabitants, of whom half are under 15 years of age. Only three pediatric oncologists manage this patient load and not many young physicians are interested in pursuing pediatric oncology as a specialty. This is the major reason for not having a bone marrow or stem cell transplant unit.

With the treatments used, we have an overall disease-free survival of 70% at five years, but more intensive treatments are being implemented to improve upon this.

Antonio Wachtel M.D.
Head, Pediatric Oncology
Instituto de Enfermedades Neoplásicas