Cardiovascular disease and cancer are the first and second leading causes of death in Peru, respectively. In an International Page published Nov. 17 in JACC: CardioOncology, Enrique Ruiz-Mori, MD, PhD, et al., offer insight into the growing field of cardio-oncology in the country.

The authors explain that Peru established the National Cancer Institute in 1939 and has continuously worked to improve geographic and economic access to cancer care over the subsequent decades. Although Peru has recently experienced positive economic growth, health resources remain limited. Between 2012 and 2016, cancer health facilities in Peru grew from 21 facilities in nine regions to 43 facilities in 18 regions, reflecting the growing need for diagnostic and treatment programs that address the widening health gap between rural, indigenous and low-income areas with urban, developed and high-income areas.

They note that in 1952, Ricardo Subiría Carrillo, MD, was the first cardiologist to join the National Institute of Neoplastic Diseases (previously the National Cancer Institute); and he evaluated patients with metastatic cancer to the heart. In 1973, Carrillo highlighted the significance of cardiac dysfunction developing secondary to cancer therapy. According to Ruiz-Mori, et al., there is now increasing knowledge regarding the potential cardiovascular effects associated with certain cancer treatments. In 1992, Ruiz-Mori introduced fundamental tools to the Peruvian cardiovascular community to assess cardiac function in patients who underwent chemotherapy, which enabled the first anthracycline-induced cardiotoxicity diagnosis, monitoring and follow-up in Peru.

Since 2016, cardio-oncology has been actively promoted in Peru as an increasingly important medical discipline for the enhanced care of cancer patients. In 2018, the first cardio-oncology manual of the South American Society of Cardiology was published, followed by the first cardio-oncology unit in Peru in 2019, and in 2020 the first cardio-oncology rotation for cardiology residents was initiated, though it was interrupted by the COVID-19 pandemic.

Overall, "cardio-oncology has proven to be a true oncological and medical necessity in Peru, throughout South America, and across the world to improve care for our citizens affected by cancer," conclude Ruiz-Mori et al.

Clinical Topics: Cardio-Oncology, Cardiovascular Care Team

Keywords: ACC International, Cardiotoxicity, Peru, Anthracyclines, Medical Oncology

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