Today in Paris, Josep Tabernero (Barcelona, ??1964) will receive the accreditation that the Organization of European Cancer Institutes (OECI) has granted to Vall d’Hebron as a comprehensive oncology care center. It is the first hospital in Spain to have this seal. “It’s a very important fact and it’s a way to increase the quality of everything we do”, says the head of the center’s medical oncology service and director of the Vall d’Hebron Institute of Oncology (VHIO), which has 35 years of oncological practice.
What does it mean to have obtained OECI accreditation?
It is a recognition of the procedures we use and the quality of the treatment and care we have with patients. It reinforces Vall d’Hebron’s commitment to place cancer as a priority disease. It compares us to monographic centers such as the Karolinska University Hospital in Stockholm (Sweden), the Istituto Nazionale dei Tumori in Milan (Italy) or the Netherlands Cancer Institute in Amsterdam (Holland).
Does it affect patients?
The continuous coordination of the entire cancer area between the major institutions means that patients are better treated. It has been studied that in centers where there is a multidisciplinary approach and they do a lot of research, the treatments are much better. In the Vall d’Hebron, the OECI accreditation process has lasted a year and a half, and it has helped all the professionals to be better integrated, to control much better all the procedures, the response time or the quality of care . The management of the center has poured into it.
How many people research at VHIO?
The accreditation is for the whole hospital. The VHIO is the research center of the Vall d’Hebron campus and currently hosts 600 researchers. We do a lot of clinical research activity there, we are the center in Europe with the most open clinical studies, 950. More than 2,800 patients are included in our studies every year.
They are running out of space.
Labs are getting small. We have bought a piece of land next to the Cellex building and the next step is to build a new building there. We are awaiting municipal permits. The aim is to have more spaces to incorporate new lines of research and more researchers. We are a center for translational research, which is highly nourished by our patients, and our activity has a very rapid application.
Prevention, diagnosis or treatment, what should be prioritized?
Prevention is being promoted more and more. The European plan to fight cancer aims to reduce the number of cases by 35% by 2035 through prevention. It also proposes that the survival of cancer patients will increase by up to 75% that year. This means that much more prevention needs to be done, but also prevention research. A prevention that is based on properly applying the measures of the European Code against Cancer: avoiding tobacco, alcohol, eating a fat-free diet… The fight against obesity is very important. It is necessary to avoid excess ultraviolet radiation and ionizing radiation, and external pollutants, both atmospheric and chemical products present in food, which have a lot to do with digestive tumors. In addition, there are vaccines, such as the one against the human papilloma virus, which are decisive against some tumors.
Are we compliant?
Everyone knows the Decalogue, but it is not applied well. It should be integrated in primary schools, in outpatient clinics, in the work of family nurses. It would help us prevent many cases. 35% of cancers are easily preventable and 45% would be preventable. The impact of prevention on breast or prostate tumors would probably be quite limited, but with regard to the colon, lung, head and neck or esophagus we would gain a lot.
What do we need to understand about cancer?
The adaptability mechanisms of the disease to survive. We know a lot about the genomics, the vulnerabilities of malignant cells, but they end up finding a way to adapt and survive the aggressions we inflict on them with treatments. We need to understand much more the dynamics of the disease, its heterogeneous composition. We are studying a lot with techniques like liquid biopsy.
What does liquid biopsy provide?
With a simple procedure we can gradually see how the composition of the disease changes by analyzing the DNA, RNA or other molecules that the tumor cells release into the body fluids. We can know how the disease evolves and what its composition is. It is a technique that still needs to be developed, but it has a long way to go.
Are you relying on a miracle therapy or will we rather see multiple advances in parallel?
We are following the line of many parallel developments, the product of numerous investigations. In recent years immunotherapy has been a revolution, but it is not a unique treatment. There are multiple treatments because the immune system must be activated through different pathways.
The landscape has changed quite a bit since it started.
It’s completely different. We are very fortunate that in 30 years cancer has experienced a unique transformation compared to other diseases. When I started there was a 40% survival rate; now we have an average of 62% in women and 58% in men. Knowledge of the human genome has given us an opportunity to diagnose and treat, and what will come is the personalization of medicine. There will be a radical change with the incorporation of big data technology and artificial intelligence. Being able to compare databases with millions of patients will give us strength to personalize therapies more and more.
