As Luis Sánchez set off for medical training, he made a promise to return to his birthplace in Piura, Peru, to help transform cancer care in one of the country’s poorest regions. Today, the oncologist leads Encaminadas, a project that integrates awareness, screening, and access to treatment, bringing care where it is needed most.
In oncology, when a patient finishes treatment, they ring a bell to mark the milestone and help close a difficult chapter of their lives. Every time Luis hears that bell, he feels the same excitement he did with his very first patient. Today, thanks to the project he leads in Piura, more patients have the chance to ring that bell.
When Luis left Piura to train as a doctor, only two oncologists served this area encompassing millions of people. Luis is now the third.
During his training at Lima’s Instituto Nacional de Enfermedades Neoplásicas, or the National Institute of Neoplastic Diseases, Luis not only gained scientific knowledge but also learned the importance of human interaction and patient-centred care. He cites Tatiana Vidaurre, the hospital director and creator of Club de la Mama, an organisation that supports patients in the fight against breast cancer, as his great inspiration. “She never took ‘no’ for an answer. That’s what we must strive to do. If we set a goal, we achieve it,” he says.
Luis’s goal was to improve healthcare access for women in Piura, an area lacking in infrastructure whose residents sometimes hold deeply rooted myths and cultural misperceptions that can hinder prevention and care.
Each year, 100 new cases of breast cancer are detected in Luis’s hometown. Today, new therapies can change the prognosis for these patients, but only 20% are diagnosed early, when they are easiest to treat. Half are diagnosed at stage 4, after the cancer has spread. “If we detect cancer early, we can cure it,” the oncologist said.
Encaminadas maps out the entire health journey for breast cancer patients. Supported by Roche, the strategy begins with awareness through a strong media campaign, most commonly spreading the word through radio messages. It continues with medical consultations at the primary care level, mammograms, and referrals to the oncology service at Santa Rosa Hospital. All care is provided in Piura, preventing unnecessary travel to Lima or other faraway cities for treatment.
Each patient has a different story. It motivates me to know that we can provide care that they previously did not have access to. It's a great opportunity, as they can achieve the same results as patients with resources.
In just two years, Encaminadas has greatly increased the use of a new mammography machine, doubled the number of consultations, streamlined care, and facilitated access to innovative medications. It has also improved patient follow-up and provides palliative care when needed.
At the heart of the program are community agents who raise awareness and engage members of the community in screening opportunities. In some areas, female staff are chosen to attend to women because the local culture will not allow male doctors to examine women. “This is also about putting yourself in the patient's shoes to benefit them,” Luis explains.
The community plays a key role in Encaminadas. Luis illustrates this with the story of a well-known and beloved patient from Morropón who had communication difficulties, and attended all appointments with her elderly mother. Her neighbours rallied to support her throughout her treatment, holding raffles or selling goods to help with expenses. They were there every step of the way, providing affection and solidarity. That patient, the doctor recalls emotionally, rang the bell joyfully on her last day of treatment.
“The patients create bonds of friendship and support each other. They are practically a family,” he says. When one woman sees another who is proclaimed to be cancer-free, it motivates her as well. “The message is that there are no limitations to accessing treatment, regardless of their condition,” Luis says.
The impactful results of Encaminadas drive Luis to do more for patients. While they are gaining on their goal of managing all cases of breast and cervical cancer as well as intestinal cancers and lymphomas, the program aims to expand coverage to other forms of this disease. Among them is lung cancer, which they cannot yet treat due to the complexity of the disease.
“We are growing as an oncology community. We have more resources, more professionals, we have access to radiotherapy and palliative care,” Luis says. But what motivates him to push forward is everything that is still missing. The treatment space, he admits, has become insufficient due to increased demand, and concerns remain around providing the quality care that patients deserve.
That’s why Luis is finishing a master's degree in health services management to strengthen his knowledge and expand access. He has set a medium-term goal: to establish a dedicated oncology medical centre.
“You have to strive. Be clear about the goal and keep it fixed. And think that we all have a mission, and ours is to give the patient our best effort. If we can cure them, that is success. And if we cannot, let them know we gave our best.”