2024-01-22 12:00:00
Every 20 minutes, one person dies lung cancer in Spain. A situation that worries clinicians and patients and that could change as soon as possible. use of Personalized Medicinetranslated into an impulse of the molecular biology committees, but also in the interdisciplinary teams that are in hospitals and that every day have health professionals more specialized in each type of cancer. All of this was discussed at the ‘Personalized medicine and lung cancer’ conference, organized by Medical Writing with the Johnson & Johnson collaboration.
For his part, Luis Paz-Ares, head of the Medical Oncology Service at Hospital 12 de Octubre, explained the main problems associated with this disease: high incidence and late diagnosis. “It is the deadliest tumor in the Western world, almost two million people die from this cause, mainly associated with tobacco. It is important to start detecting it earlier, since if we diagnosed all lung tumors with less than one centimeter, the 90 percent of cases would be cured“, he indicated.
Luis Paz-Ares, head of the Medical Oncology Service at Hospital 12 de Octubre (Madrid) and president of the Oncosur Foundation.
In this sense, the expert has pointed out that the pilot lung cancer screening programs are giving good results, since they are able to reduce high-risk patients among 20 and 60 percent. Spain can look to its European neighbors who are already developing similar strategies, while here the Cassandra research project.
“The scientific evidence has no doubts, the benefits of these screenings are clear because reduce mortality and improve life expectancy. But yes, it is necessary to clearly define who it is done to, generally, those who are most at risk of having serious lung cancer are those who smoke or have stopped smoking but they did it for years,” said Pilar Garrido, head of the Medical Oncology Service at the Ramón y Cajal Hospital.
Pilar Garrido, head of the Medical Oncology Service at the Ramón y Cajal Hospital (Madrid).
The first ones who want to be diagnosed, without a doubt, are the patients, who ask that all the techniques and techniques be made available to them. tools for the detection of this tumor. “We need screening now,” claimed Bernard Gaspar Martínez, president of the Spanish Association of Lung Cancer Patients (Aeacap). He himself has been the first to put on the table the need for greater prevention, for which it is essential to have awareness and information campaigns about the damage caused by tobacco and its close relationship with the lung cancer.
Bernard Gaspar, president of the Spanish Association of Lung Cancer Patients (Aeacap).
Distinguish the subtypes of lung cancer
Advances in lung cancer have undergone a great revolution lately because every day the subtypes are better known of the same, which improves both the prognosis and the treatment. “Although at first glance they may seem similar, the mechanisms of production, growth, invasion and metastatic capacity are different. If we are able to know the genes that induce the tumorthere are more possibilities of success,” Paz-Ares stressed.
Therefore, understanding the genetic alterations will allow targeted treatment for lung cancer with best results therapeutic and fewer side effects. Having pathologists is essential when classifying these tumors. Clara Salas, head of the Pathological Anatomy Service at the Puerta del Hierro Hospital in Majadahonda, explained that they are clinically familiar with the case and can know these differences also after applying the treatments. “Us we see the impact with neoadjuvantthe lungs treated with immunotherapy are different, they do not weigh,” Salas quoted.
Clara Salas, head of the Pathology Anatomy Service at the Puerta de Hierro Hospital in Majadahonda (Madrid).
Likewise, the clinical trials have suffered variations, as commented by the professional of October 12, with Personalized Medicine the disease has been defined and it has been removed most of the heterogeneity. “Now we differentiate patients and this helps us on many levels to guide treatment. Also, if we have the initial proof of concept that the strategy works because we inhibit a certain gene“There is no need for randomized clinical trials,” said Paz-Ares. In fact, many of these studies include patients from the beginning and, as Gaspar has stated, they themselves are preparing to become more integrated, through specific training.
Interdisciplinary teams in lung cancer
Another topic that has focused the conversation has been the changes that have occurred in the Oncology teams, which work in interdisciplinary groups along with professionals from other specialties. In Garrido’s words, doing your work together provides security given the complexity of the disease: “You only reach a successful conclusion in company and we do not want leave out any relevant options for the patient.”
Nuclear medicineSurgery, Radiology or Pathological Anatomy, among others, are part of this ‘dream team’ to fight lung cancer. “The adaptation of Oncology equipment has to do with the advance in knowledge of the illness. We have multidisciplinary teams because no professional is capable of monopolizing all the knowledge so that the patient benefits,” Paz-Ares clarified, who added that having time to dedicate to the committees, especially the molecular one, has direct advantages for the patient. Along these lines, Salas has focused on the fact that pathologists have had to subspecialize in some tumors to be able to offer quality information and their work has “multiplied by two in the last ten years.”
However, although there have been great improvements, sometimes not all patients can opt for the latest therapeutic innovations. Equity in lung cancer is one of the pending issues, which not only covers drugs, but also psycho-oncology, a socio-health support or reintegration In the laboral world.
“To treat a patient you have to diagnose them and many do not have access to molecular diagnosis. We have worked hard to bring access to the healthcare world and we have forgotten to do this with the high complexity centers“Lamented Paz-Ares.
Clara Hernández, head of the Medical Writing Companies section.
“We have done a study on several autonomous communities and molecular diagnosiswe have seen that patients know that they have been diagnosed with it but they have no information about him“said the president of the Aeacap.
Finally, the speakers at this table have reflected on the pending challenges in lung cancer. For Gaspar, the disease must be destigmatized, since “any person who has two lungs can have it” and put stop smoking. Garrido has also mentioned this last purpose, since smoking is “being normalized again”, including vaping, and has added more financing for health. While Paz-Ares advocates reducing the incidence of cases with the elimination of tobacco.
“If we remove tobacco, we remove nearly 90 percent of lung cancer suffering and also from others. We must help prevent people from starting to smoke and help them quit,” said the head of the Medical Oncology Service at Hospital 12 de Octubre.
For his part, Salas has considered that it is necessary shake hands with digitalization and artificial intelligence to put an end to “Services that function as they did 50 years ago and modernize.” “It would be interesting to create a map of molecular biology centers“said the pathologist.
A moment from the debate held on the Medical Writing set.
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