Instituto Nacional de Enfermedades Neoplásicas (INEN)

Historically, health care in Peru has not received the attention and funding required to adequately meet the needs of the population.

This situation has not improved in recent years. With its citizens experiencing a high infant mortality rate, a life expectancy of around 50 years and a progressively deteriorating economy, Peru has not considered cancer to be a high priority within its health care arena. This sad scenario is exacerbated by uncontrolled growth of the population and unrealistic and out-moded health care policies. As a result, cancer in this developing nation has reached epidemic proportions.

Cancer is a serious public health problem that is the second-leading cause of death, responsible for 17% of the mortality in adults. If risk factors are not identified and appropriate interventions initiated, the problem will increase in magnitude. This is the reality that has to be tackled by the present administration of INEN, which was established in 1939 as the only institution in Peru exclusively dedicated to cancer. More than sixty years later, it remains the nation’s only cancer institution.

The Eduardo Cáceres Instituto Nacional de Enfermedades Neoplásicas.

The Institute was reorganized in 1952 under the leadership of a new Director, Eduardo Cáceres Graziani, M.D, after whom it is now named (see physician profile). He organized the medical services as specialized departments focused on organ or system-specific cancers (gynecologic, hematologic, etc.), and established the first residency program in cancer. The INEN has been affiliated with the Universidad Peruana “Cayetano Heredia” since 1966. The Organization of American States (OAS) has recognized our institution as having an appropriate educational program for the training of professionals in the care of cancer patients. During the 1970s INEN received government assistance, through a special tax on tobacco, to build a new hospital.

This new hospital, built on a 12-acre lot in Lima, began its operations in 1987 under the guidance of Dr. Luis Pinillos-Ashton, the first Director General.

Dr. Carlos Vallejos-Sologuren

Presently Dr. Carlos Vallejos-Sologuren occupies this position. Under his leadership, several important initiatives are being implemented to make the organization more efficient and cost-effective. The most pressing issues confronting the administration at this time are: sharing the responsibility for the care of the cancer patients with other medical centers in the city of Lima and other areas of the country, further developing education and prevention programs by emphasizing the detection of risk factors, and promoting research through the Institute’s Division of Research and Education. INEN has signed agreements with several hospitals in Lima for the creation of Oncological Units, some of which have already begun to function.

The World Health Organization (WHO), through the International Agency for Research in Cancer (IARC), provided technical and financial assistance for the establishment of an Epidemiology and Cancer Registry Service. A nationwide program for the Control of Cervical Cancer of the Uterus has been in operation since 1972 through a Cytodiagnostic Center and the “Center for Research and Education Maes-Heller.” Our patients also benefit from research protocols in cooperation with hospitals and universities from other countries, as well as research groups such as the Eastern Cooperative Oncology Group (ECOG), the Breast International Group (BIG), the European Organization for Research and Treatment of Cancer (EORTC), the European Society of Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO). These important cooperative efforts allow our patients to benefit from state-of-the-art prevention, diagnosis and treatment programs.

INEN Organization

The General Director supervises the Executive Directors of Medicine, Surgery, Research, Education, and Specialized Care. The latter includes the Departments of Radiation Therapy, Radiodiagnosis and Laboratory, with support services for diagnosis and treatment. There are 112 staff physicians in 27 specialties.

Programs For Cancer Care Management of Pediatric Cancer

INEN maintains a staff of internation-ally recognized physicians specialized in pediatric oncology. Within the hos.pital, an entire floor of the building
is dedicated exclusively to pediatric cases. To get this far has taken a great deal of effort, and has included the raising of funds from the community through a special program called “Give with your Heart”. The pediatric services include chemotherapy areas, infant care, invasive procedures and a small school, made necessary because of the long periods of hospitalization that are sometimes required.

Health Promotion and Cancer Control

At INEN we are constantly concerned about cancer prevention as well as cancer treatment. The Ministry of Health has supported the creation of a national prevention initiative, named “Program of Prevention and Control of Cancer in the Community.” The purpose of this program is to educate the population in lifestyle behaviors that reduce the risk of cancer, with special emphasis on improved nutrition, genetic counseling, and control of infections that may lead to malignancies, such as the human papilloma virus, known to be associated with cancer of the cervix. We have also participated in national campaigns to promote the early detection of cancer.

We have agreements with two important hospitals in the metropolitan Lima area — Santa Rosa and Carrión. These hospitals have oncological units for detection, diagnosis and treatment of cancer. Furthermore they participate in the prevention programs devised by INEN. We have supported, with great enthusiasm, the creation of cancer institutes in two other regions of Peru. This will permit persons who live far away from Lima to receive the benefits of cancer treatment and prevention, and will relieve the pressure on our institution so that more time can be dedicated to research.

As part of our education and outreach efforts, we have updated our web page with a section designed for patients and others seeking information about cancer. We are also creating videos in VHS and DVD formats to be used by groups in the community that show interest in developing awareness about cancer.

We hope that all our efforts will be successful and will result in improved early detection and a better outcome of treatment, and most of all, that the population will participate in nationwide programs of prevention.