The good expectations regarding this disease are reflected in the fact that cancer mortality in Spain has experienced a sharp decline in recent decades, with improvements in survival due to preventive activities, early diagnosis campaigns and therapeutic advances .
Cancer is a diagnosis that today contains both pain and hope, as stated by the Dr. Jesús García-Foncillas, director of the Oncohealth Institute of the Jiménez Díaz Foundation University Hospital, who points out: “At present, very relevant advances have been made in the cure rates of tumors such as breast, colon, prostate, and even lately lung cancer. However, the most important factor to achieve important survival rates is given by early diagnosis “.
According to figures provided by the Spanish Association Against Cancer (AECC), cancer can be considered the most important health, social and economic problem in our country, since only at a monetary level this disease costs Spain at least 19,300 million euros. Every year around 275,000 new cases are diagnosed and there are around 1.5 million people affected by this condition. Behind the word cancer there are little-known realities of loneliness, pain and anguish, but also promises, progress and results capable of lighting the light of hope.
For the WHO, cancer is one of the leading causes of death worldwide and although its incidence has grown in recent years, advances in technology and research have significantly increased the chances of cure, the figure of deaths is reduced thanks to technological advances, research and early detection campaigns. In the opinion of Jesus Garcia-Foncillas, the detailed study of each case and the treatment applied is essential to overcome the disease.
We are talking about an old and entrenched disease that medicine is gradually dominating. Let us remember that the oldest description of cancer (although without using that term) comes from Egypt, from 1600 BC, approximately. The Edwin Smith papyrus describes 8 cases of cancer tumors or ulcers that were treated with cauterization, with a tool called “the fire fork.” Things have changed since then, many aspects for the better. According to report data Comparator Report on Cancer in Europe 2020, conducted by the Swedish Institute for Health Economics, reflects that cancer mortality in Europe in real terms has dropped significantly in the last 20 years.
Cancer treatment rests on three fundamental pillars which are surgery, radiotherapy and medical treatment where today we have chemotherapy, hormonal therapy, biological therapy and immunotherapy. They can coexist in the same treatment depending on the particular circumstances of each disease and each patient.
Surgery is the procedure to remove the cancer, it is usually very radical, taking entire organs to avoid hidden neighboring malignant cells. Surgical units in today’s hospitals are made up of professionals with extensive experience in this field, as well as in the subsequent reconstruction that may be necessary in some cases.
According to SEOM, the survival of cancer patients in Spain is similar to that registered in neighboring countries. It is estimated to have doubled in the last 40 years, and is likely to continue to increase in the coming years, albeit slowly.
We speak with Dr. Jesús García-Foncillas, director of the Oncohealth Institute of the Jiménez Díaz Foundation University Hospital
How common is cancer in our society?
The incidence of cancer worldwide in 2018 was 18 million people with cancer. But the point is that the forecast for 2040 is for this figure to rise to 29 million cancer patients in the world. That means an increase of 63%. At the national level, the figures in Spain last year (2020) were approximately 277,000 patients diagnosed with cancer, of which 169,000 were over 65 years and 108,000 under that age.
Who can get cancer?
As for men and women, curiously, below 65 years they are practically level (about 53,000 men compared to around 54,000 women, according to these data), but above that age, there were about 106,000 men and about 62,000 women. In fact, due to this increase in men, of the 277,000 diagnosed patients, some 160,000 were men, compared to around 110,000 women.
What are the causes? What factors have more weight, genetics or lifestyle?
Risk factors are alcohol, diet rich in animal fats, infectious agents such as HPV, excessive sunlight, obesity, tobacco, tar, asbestos, benzene, nickel compounds, radon, trichlorethylene … Inherited genetic mutations are a cause of cancer in 5-10% of cases and have been described as about 50 hereditary cancer syndromes characterized by a significant incidence of cases in family nuclei presenting at an early age .
Can other factors like stress cause cancer?
Little by little we have more evidence that intense, chronic, long-term stress can lead to an increase in the release of pro-inflammatory cytokines that can generate a molecular environment conducive to the development of cancer.
How can we prevent it?
Following guidelines such as: Avoid excessive sun exposure; No Smoking; drastically reduce alcohol consumption; practice physical exercise; follow a Mediterranean diet rich in vegetables, legumes and fruits, with a very significant reduction in fats of animal origin; fight obesity; carry out continuous check-ups in tumors such as breast, colon and prostate and avoid the mentioned carcinogenic substances.
Thanks to diagnostic and therapeutic advances, cure or remission has been achieved in many of them. In which subtypes are better survival rates or progression-free survival achieved?
Very relevant advances have been made in the cure rates of tumors such as breast, colon, prostate, and even recently lung cancer. However, the most important factor in achieving significant survival rates is given by early diagnosis.
What role does personalized medicine play in the current approach to cancer?
Genomic analysis of tumors has allowed the identification of multiple different subtypes within each tumor. These differentiations within each tumor lead to different prognoses and different personalized treatments. Additionally, the genomic and molecular study of cancer is today a fundamental element to define the best treatment and provide a greater probability of survival and cure for the patient.
Is the age of diagnosis being advanced in many tumors?
The data in this regard are not definitive, but there are some studies that have analyzed the age of diagnosis in some tumors and suggest that statistically there could be a decrease in the mean age of presentation of some of them, such as breast cancer.
To what extent has the pandemic affected the approach to cancer in our country?
The maelstrom of the first wave produced delays in diagnoses and treatments. This contingency has forced a reorganization and a rethinking in the generation of circuits that maintain care for cancer patients and allow the risk-benefit of diagnostic and therapeutic interventions in these patients to be evaluated at all times. Likewise, it has forced and allowed the opening of new channels based on telemedicine to evaluate and follow cancer patients.
Eddie is an Australian news reporter with over 9 years in the industry and has published on Forbes and tech crunch.