My grandmother used to say “Venezuela has it all,” and she was right. We had a stable economy, good medical schools, and hard-working physicians. Things started to change in the early 2000s with a new constitution and the introduction of socialism.[1,2] An agreement with the Cuban government in the mid-2000s brought Cuban physicians to Venezuela to help improve care in rural areas,[3] but overall, cancer care remained unchanged. By the year 2010, cancer treatments were mostly limited to private hospitals, but sadly, this was still typical for a country in Latin America.We left Venezuela in 2004, and over the years, we witnessed its deterioration. Data regarding the status of cancer care in Venezuela are difficult to find. For the past several years, the Ministry of People’s Power for Health has published bulletins sporadically, if at all, and cancer is scarcely mentioned.[4] Therefore, we interviewed Venezuelan surgical and medical oncologists to understand the current status of cancer care in Venezuela.When did the problems start? They all agreed things started going downhill in the year 2010 when the medication shortage worsened[5]; the first shortage was with tyrosine kinase inhibitors, and now (in 2019) there are shortages of drugs such as cisplatin and bevacizumab. Estimates suggest that Venezuela has only 10% of the drugs necessary for cancer care.[5] Despite these sobering numbers, the Venezuelan government continues to refuse to admit that it has a health care crisis.[4,5] The availability of cancer drugs directly correlates with the political situation in Venezuela. Close to the elections, the government signs agreements with other countries to increase the importing of medications. Most of these agreements are not sustainable in the long-term, and the shortage of particular cancer medications remerges. Today, drugs such as aromatase inhibitors and tamoxifen are subject to this fluctuation, and it is not uncommon for patients in Venezuela who have breast cancer to start treatment by taking anastrozole and be switched to two other hormonal agents before they complete their first year of adjuvant therapy.Many public hospitals are lacking essential resources such as electricity and water. In 2018, a survey conducted by the Central University of Venezuela reported that 79% of Venezuelan hospitals had interruptions in water service.[6] Patients with cancer have migrated to private hospitals in search of medications. Nonetheless, with 87% of Venezuelans living at or below the poverty line,[7] only a small number of patients are able to afford care in the private sector. Roberto Gonzalez, MD, a senior medical oncologist, shared that patients of low socioeconomic status who have cancer are frequently sent home on hospice care without any medical interventions.Hundreds of surgical and medical oncologists have migrated out of Venezuela.[4] During interviews with physicians still residing in Venezuela, a sense of perseverance and fatigue permeated the conversations. The physicians who remain have to work twice as hard to fill the service gap; many of them have to hustle to find cancer drugs in the black market or send their patients to receive treatment in neighboring countries.Regarding the cancer physicians residing outside of Venezuela, all used the phrase “I will go back if things slightly improve.” Many Venezuelan surgical and medical oncologists are currently living in Chile, Colombia, and the United States. Throughout our conversations, we heard disappointment and resignation in their voices. They all saw the quality of cancer care in Venezuela decline before their eyes.The future of cancer care in Venezuela is also in danger; thousands of medical students are emigrating every year.[8] For the first time since its foundation, Hospital Dr. José María Vargas de Caracas has empty fellowship slots for surgical and medical oncology. The next generation of Venezuelan cancer physicians is not being trained, and the problem may worsen over the years. In Venezuela, medical oncologists, as we know them, are at risk of becoming extinct.An additional challenge faced by patients in Venezuela who have cancer is access to analgesics. Today, intravenous nonsteroidal anti-inflammatory drugs are the primary source of pain control for patients with metastatic cancer. Fentanyl can be found at very high prices (a 5-day supply costs an average of six times the minimum monthly salary). Gassan Yordi, MD, a medical oncologist, shared with us the so-called “recycle system” for opioids. Opioids are donated by family members of deceased patients who had cancer and are then given to other terminal patients who have cancer. At times, this is the only way hospice patients can get access to opioid painkillers.Every day, more cancer regimens are approved, but in Venezuela, many patients with cancer do not have access to regimens from the 1980s, especially those that include radiation therapy. Ricardo Ravelo, MD, and Liseth Duque Duran, MD, both surgical oncologists, shared that countless patients with breast cancer are getting total mastectomies with extensive lymph node dissections because they will not have access to adjuvant breast radiation. Radiation machines are often broken and abandoned in public and private hospitals, because of the lack of supplies, technicians to repair them, and physicians to operate them.[9] Many oncology physicians are practicing as though radiation therapy does not exist in Venezuela.[9]We asked how we could help. Physicians want their voices to be heard, and they thanked us for allowing them to share their experiences. As Venezuelans, the hardest thing about this crisis is knowing that we once had it all, that our country once was an excellent place for oncology training across Latin America, and our patients with cancer formerly received state-of-the-art oncology care.