Weaver Shell | Valencia (EFE).- The “message today” to a patient recently diagnosed with advanced cancer “must be full of hope” and associated with a “very different reality” from the one that these cancer patients were forced to face a few years ago. years, when this ailment was associated with death.
This is how the head of the Medical Oncology Service of the Valencian Institute of Oncology (IVO), Ignacio Gil-Bazo, defends it in an interview with EFE, who assures that “the survival of patients with advanced cancer has increased exponentially” .
In his opinion, in Spain it would be necessary to develop a “national plan against cancer” and that there be international cooperation for equitable access to all therapies.
Reversing metastatic cancer
He ensures that cancer is no longer equal to death as it was decades ago, and patients with metastatic lung cancer who twenty years ago had an average survival of just seven months, can now reach rates of more than five years from diagnosis. “It is patients that we are beginning to consider as cured, to the extent that the disease has disappeared or has stabilized”, she emphasizes.
He also states that in some cases of patients who obtain great clinical benefit from treatment with immunotherapy, metastatic cancer can be reversed: “Although a few years ago, when asked by the patient or his family about the prognosis, we could not be very flattering, nowadays we often warn the patient that even cure is possible in his case”.
In addition, there are various oncological pathologies in which the chronification of the disease “is possible” or even in which the patient ends up dying of other causes unrelated to his tumor, even though he has not been cured of cancer. This means that in some tumors, such as breast or prostate cancer, the prevalence of the disease has increased significantly.
Progress in treatments, although similar needs
Although the advances in therapies and treatments against cancer in recent decades have been exponential, the “needs of patients continue to be very similar,” he indicates to add: what “we can help and relieve the patient remains the same and the clinical deterioration and the psychological impact of this disease and its diagnosis continue to mark the patient’s life forever”.
The fields in which most progress has been made in this specialty are the new radiotherapy techniques, which are increasingly more precise and less toxic, minimally invasive surgery, and systemic treatments directed against specific targets and with the capacity to activate the immune system. .
Need for resources for cancer research
Gil-Bazo stresses that, as Nobel Prize winner Severo Ochoa said, a country without research “is a country without development” and believes that the only way to innovate in science, and therefore in medicine and oncology, is hand in hand with basic, translational and clinical research.
However, he adds, internationally competitive and quality academic research “requires resources that public administrations generally do not allocate” and, therefore, he stresses that the importance of pharmaceutical companies, where they come from, is “crucial”. most of new drugs that end up demonstrating their effectiveness.
In his opinion, in cancer research there are still many questions for which there are no answers, such as those related to the mechanisms of resistance to some drugs such as immunotherapy or targeted therapies, and he explains that further progress must also be made in the discovery of new therapeutic targets whose targeted treatment changes the course of the disease in patients.
He highlights the importance of being able to develop adoptive cell therapies also for patients with solid tumors, in an attempt to verify if the “enormous benefit” observed in patients with blood cancers is also confirmed in other tumors such as lung, colorectal, breast or prostate
Cancer patients after the pandemic
Although it indicates that an increase in cases of advanced-stage cancer was observed during the second half of 2020 and reached its peak during a large part of 2021, in 2022 it decreased and, at this time, the health situation derived from the pandemic does not have an impact high in diagnostic or therapeutic delays.
Despite this, he adds, “we know that the enormous stress to which public and private health has been subjected over the last three years has generated an increase in waiting lists that, for the moment, do not seem to be reducing”, and insists on the need to consult a specialist in case of suspicious signs or symptoms.
Equitable access to new cancer therapies
He considers international cooperation to be a “pending issue” so that there is equitable access to new therapies, and in this sense he believes that it is necessary to strengthen not only public-private alliances but also raise awareness of the difficulties for the approval of some drugs and access to them on equal terms, within the framework of the European Union.
In this sense, the IVO expert points out that even within Spain “there are situations of inequality between different territories that are very difficult for patients, their families and the doctors” who try to help them to understand.
In Spain, a country with enormous resources and great medical and research training, it would be necessary to develop a “national plan against cancer”, because “it is not efficient for each autonomy to make its decisions”, and prioritize those resources according to a previous analysis of the needs and complexity of research and care in the country.
Lack of recognition of science
He acknowledges that the “brain drain” is a “very real problem” and points out that, although a large part of the national talent should be encouraged to seek new horizons to complete their training, the problem is that these researchers see it as possible to continue their career in other countries that believe in their work and recognize their efforts, and not return.
“There are still few opportunities to obtain return scholarships financed by public funds that make it possible to attract those exceptional researchers abroad back to Spain,” underlines Gil-Bazo, who also points out that while the culture of patronage is widespread in the Anglo-Saxon world, in Spain “it has been promoted on a very small scale”.
In his opinion, “to a large extent it has to do with the lack of recognition that science and researchers have in our country. Everyone naturally assumes that the budget of a football club is several hundred million euros, but no one is aware of the lack of budget suffered by thousands of quality research projects that could transform our quality of life and our Life expectancy”.
“Putting this into value is the responsibility of the public administration and private entities (universities, pharmaceutical laboratories, research centers…), and encouraging it, by reducing withholdings in personal income tax or wealth tax, for example – he says-, also in the hands of the central and regional governments”.
Better results in super specialized centers
Although he indicates that in the fight against cancer all available resources are necessary, he stresses that Cancer Centers, due to their greater super-specialization and the greater allocation of human and material resources concentrated on the diagnosis and treatment of cancer, “obtain better results in survival parameters, shorter attention times and start of treatment or quality of life”.
This aspect, he points out, has meant that the EU, within the European Plan to Fight Cancer, has set for 2025 the development of a network of comprehensive cancer centers in all countries, so that by 2030 the majority of patients can access to one of them and thus achieve the most appropriate approach in the fight against oncological pathologies.
Gil-Bazo, who came to the IVO last year from the Clínica Universidad de Navarra, where he co-directed the Department of Medical Oncology, to replace the recently retired Vicente Guillem, assures that he was attracted to the Valencian center by the fact that it is a “very solid”, a monographic cancer center with a “long history and leadership at the national level” and at the “vanguard of cancer treatment”.
