Cancer in My Community is a Cancer.Net Blog series that shows the global impact of cancer and how people work to care for those with cancer in their region. Alvaro Menendez, MD, is a staff member of hematology/oncology at Hospital de Diagnostico in El Salvador. Dr. Menendez is also a professor of hematology/oncology at Universidad Dr. Jose Matias Delgado and 2 public hospitals in San Salvador, El Salvador. His research is focused on the prevention of chemotherapy-induced nausea and vomiting. View Dr. Menendez’s disclosures.
Why I care for people with cancer
Many doctors in El Salvador think that referring a patient to an oncologist means “goodbye,” and many patients think that way, too. So, my first goal when I see a patient is to inform them and their family about the real status of the disease and what the treatment options and prognosis are. I have found that even in the most advanced cases, patients and their relatives are satisfied and grateful when they get the full picture of their disease and that, in most cases, something can be done. I really enjoy the kind of relationship that develops between me and my patients during the treatment months and after. The relationship between oncologists and their patients is one that you rarely see in other medical areas. If I were born again, I would still choose to be an oncologist.
What cancer is like in El Salvador
It’s very difficult to talk about what cancer is like in my country without mentioning the economy. Cancer care for people in El Salvador is basically divided into 3 systems:
The public health setting, where approximately 70% of people go for general and/or cancer care
The Instituto Salvadoreño del Seguro Social (Salvadoran Social Security Institute), which takes care of those with a formal job and their families and covers about 20% of the population
Private practice, which covers about 10% of patients who have some kind of private insurance or the financial resources to afford private care
Especially in the first 2 sectors, resources are limited. Nevertheless, oncologists find ways to treat their patients as best they can. High drug prices, particularly for targeted therapy and immunotherapy drugs, and expensive technology, such as radiation therapy machines and expensive diagnostic tools, put an enormous burden on our public health institutions. Still, most patients get successful treatments that give them good quality of life and the hope to survive. And even though we lack certain diagnostic and therapeutic tools, we oncologists find satisfaction and even joy every time we get thankful smiles from our patients and their loved ones.
Like many countries with limited resources, a significant illiteracy rate, and difficulties for the population to access medical care, it is no wonder that one of the most common cancers in El Salvador is cervical cancer. Cultural barriers, especially among older female patients, make screening for cervical cancer very hard to perform.
One interesting trend we’ve seen for the past 2 decades in El Salvador is low-income families getting access to private medicine. This happens not only in El Salvador, but also in many other Latin American countries. The money for private care comes from the millions of Hispanic workers living in the United States who regularly send money to their relatives in Latin America as economic support, including for medical expenses.
Where patients can find local resources and support
Everyone living in El Salvador can get medical care in the public clinics and hospitals for free. However, the road to accessing cancer care can be long and winding, as getting an appointment is not always immediate.
As far as I know, no oncology facility has its own website where patients can get information or an appointment. However, below you can find the contact phone numbers of several centers in El Salvador the offer cancer care. The country code for El Salvador is (503).
Hospital Oncologico del Instituto Salvadoreño Seguro Social: 2591-5000
Hospital Nacional de la Mujer (gynecologic oncology): 2206-6200
Hospital Nacional Rosales (general oncology): 2231-9200
Hospital Benjamin Bloom (pediatric oncology): 2225-4114
Fundacion Ayudame a Vivir (pediatric oncology): 2263-0575 or available via email at firstname.lastname@example.org. This is a foundation that provides the Hospital Benjamin Bloom with cancer drugs and other resources for children.