Life expectancy increases in developed societies, and with it the consequent presence of multiple diseases that many citizens are forced to deal with as they age. Cancer is, of course, the most common of all of them, which has caused it to be currently considered the biggest social and health problem in the world. In Europe it is already the second most frequent cause of death (the first is still cardiovascular accidents) and, in the case of those under 65 years of age, it rises to the first position.
Expelling cancer from our daily conversation seems, today, impossible. As reported by the Spanish Association Against Cancer (AECC), it is expected that one in two men and one in three women will suffer from it throughout their lives. In our country, by 2030, it is expected that a new diagnosis will occur every 1.8 minutes and a death every 3.8 minutes, according to the Spanish Cancer Research Association (ASEICA).
Fortunately, the percentage of people who manage to leave it behind also increases, thanks to new drugs and the constant development of research projects. In September 2023, the economist Frank R. Lichtenberg, in the medical journal Value in Health Journal, published a study carried out between 1999 and 2016 that demonstrated that the life expectancy of cancer patients in Spain had increased by 2.77 years. during said period (by 96%, thanks to the new treatments).
In a recent interview with the TV3 program Col•lapse, tenor Josep Carreras recalled that “35 years ago, having leukemia was practically a death sentence.” Today, fortunately, overcoming his illness would no longer be as isolated a case as it was at the time he suffered from it. However, overall five-year survival rates must continue to improve to try to reach 70%, according to experts. The key to boosting the numbers of recovered people is, of course, progress in scientific knowledge. World Cancer Day, which was celebrated yesterday, February 4, was a magnificent opportunity for citizens to unite in a large community to urge political leaders to develop the necessary strategies to continue advancing in the improvement of treatments and the prevention of the disease.
As confirmed by the second report prepared in 2022 by the association Committed to Cancer Research – promoted by the ‘la Caixa’ Foundation and the AECC Scientific Foundation, with the scientific advice of ASEICA and the support of various entities and administrations – , during the period studied (2016-2020), there have been multiple notable advances in research, although there is still a large room for improvement.
Although the budget for research and innovation has increased over the last two years, Spain continues to occupy the last position in investment in cancer R&D of all the countries analyzed (the rest are the Netherlands, Italy, Germany, France and Portugal), with only 1.41% of GDP dedicated to this issue. However, there is an undoubted potential for growth, since our scientists continue in the top 10 of the countries that publish the most on the subject, also maintaining the impact of their contributions. Likewise, the country consolidates its capacity to attract European funds and has great leadership capacity. As detailed in the Executive Summary of the aforementioned report, “Spanish researchers have been coordinators in more than 70% of their participations, being the highest ratio in the group of countries analyzed. However, Spain still exhibits an aging profile, with more projects funded to researchers in the advanced stage compared to starting.
The conclusion of the study is unequivocal: “The results continue to point to a difficulty in research talent, endangering the sustainability of the system” in the long term. The importance of having the involvement of the entire health sector – with the support of administrations, private companies and society as a whole – is, therefore, essential to continue developing new treatments, year after year, that optimize results in the fight against the disease.
In Spain, discoveries continue to be made, in many cases supported by the AECC, which allow us to face the future with greater optimism. One of the most notable from 2023 is the one developed by Dr. Carolina Ortiz, together with several researchers from the Vall d’Hebron Institute of Oncology, which has confirmed that it is possible to detect breast cancer – currently the most common tumor in women around the world – at an early age by analyzing breast milk, since it contains DNA from the tumor. This is great news, which promises the possibility of developing a new, low-invasive and early diagnostic tool for the postpartum period, before resorting to mammograms.
Dr. Jenniffer Linares, from the Hospital del Mar Research Institute, for her part, carries out a research project in search of more effective treatments for colon cancer, the most common in our country and the second in terms of mortality. Her team has managed to find a way to avoid resistance to chemotherapy in patients with colorectal cancer. Specifically, these researchers have discovered that platinum used in chemotherapy accumulates, over long periods, in healthy cells surrounding the tumor, activating some genes that help surviving cancer cells to progress again. Next, they have developed a new therapeutic strategy that allows platinum to target only cancer cells, preventing its accumulation in surrounding healthy cells.
We must also highlight the progress in the fight against lung cancer, which is another tumor in the group of the most frequent and with a low survival rate. Research promoted by Dr. Silve Vicent, from the Cancer Center of the Clínica Universidad de Navarra (CIMA-CCUN), has concluded that, in animal models, the effectiveness of treatments can be improved by combining usual therapy with mutations in the gene KRAS with a second drug that is already in use to combat other types of cancer. The next step is to verify its effectiveness in clinical trials.
Likewise, the team of Dr. Manuel Valiente, from the National Cancer Research Center, has managed to demonstrate that brain metastasis can modify neuronal activity and produce cognitive damage that leaves an identifiable trace. This discovery represents a real change in the vision that was had in this field, and will serve to design new strategies for prevention, early diagnosis and treatment.
This is not everything. AECC includes several other notable contributions, such as the development of a “calculator” by Drs. Bruno Paiva and Jesús San Miguel from the aforementioned CIMACCUN, to select the most appropriate treatment in patients with hematological cancers; or the study carried out by the group of Dr. Roger Gomis, from the Institute for Research in Biomedicine (IRB) Barcelona, which allows us to understand the mechanisms that trigger metastasis in breast cancer.
To all this we must add two new advances in the treatment of hepatoblastoma, the most common childhood liver cancer, obtained by Dr. Matías Ávila, also from CIMA-CCUN, Dr. Josep M. Llovet and Dr. Carolina Armengol , from the Germans Trias i Pujol Research Institute (IGTP), with other research groups.
In addition, the team of Dr. Luis Álvarez-Vallina, from the 12 de Octubre Hospital in Madrid, has developed a new immunotherapy for a leukemia that still has few treatment options.
And Dr. Iñaki Comino, from the Malaga Biomedical Research Institute (IBIMA), has found a new non-invasive methodology for the early detection of breast cancer using a blood test.
All these projects that we have mentioned confirm that Spain has top-level researchers and also a good scientific ecosystem and technological platforms. The progression in the volume of research published today continues at a higher growth rate than in other places with more consolidated systems such as the Netherlands or France, increasingly reaching high-impact journals. There is also greater development of clinical studies (in the last five years, above the rest of the countries studied), although Spain is still behind the Netherlands or France. Most of them gather their participation around Madrid and Catalonia (these territories are followed by Andalusia and the Valencian Community). Around 75% of them are privately sponsored, although the role of European and national research networks also stands out.
Furthermore, it is necessary to continue improving the parity of researchers and to be able to incorporate younger profiles. Today, the percentage of women dedicated to research is close to 40%. The average age of these professionals as a whole is around 50 years.
In line with global trends, multidisciplinary research is growing in areas related to chemistry and computer science, and artificial intelligence techniques are being incorporated. They are indicators that, in conclusion, encourage us to continue down this path, investing more and more efforts so that our country can finally match in investments and results the potential of the human talent it has, dedicated to the knowledge of new forms of eradication. of cancer.