Prevention, progress in research, and the work of a multidisciplinary committee that evaluates each case in particular are the current keys to reducing mortality from cancers and improving the quality of life of patients with more effective and less toxic treatments.
Cancer is a disease that has been mentioned since ancient times. Hippocrates used the term carcinos when comparing tumors with crabs, due to the appearance of certain tumors with their extensions and that reminded him of the crustacean.
For a long time, cancer was an incurable disease, but thanks to the advances in medicine, today many cancers are cured, although the word still has a negative symbolic charge in society.
Cancers are caused by a malfunction of certain cells in the body, which begin to multiply, proliferating, first locally, then to neighboring tissues, and then remotely, forming metastases. Cancer can appear almost anywhere in the body.
According to the WHO (World Health Organization) 8.8 million deaths per year are attributed to cancer. And those that cause the highest annual number of deaths are those of the lung, liver, stomach, colon and breast.
RISK FACTORS AND IMMUNE SYSTEM
Cancer is not the result of a single cause, it is generally the product of different external and internal factors and genetic predisposition.
The external factors are those linked to the environment (radiation, viruses, bacteria and industrial products) or to lifestyle (tobacco, alcohol and an incorrect diet).
Internal factors are those associated with age (higher risk after age 60) and heredity (mutations inherited from relatives present in all cells). Lastly, genetic predisposition is responsible for 5-10% of all cancers.
Meanwhile, the immune system is the body's natural defense barrier. It has specialized weapons that are capable of detecting abnormal cells and eliminating them. Only if the immune defenses are overwhelmed can cancer develop.
According to the WHO, at least a third of all cancers can be prevented. Prevention is the best long-term cost-effective strategy to control cancer.
That is, between 30% and 50% of cancers can be prevented by adopting healthy habits.
Tobacco is the preventable risk factor that alone causes the most deaths from cancer worldwide, causing approximately 22% of deaths annually.
The cancers associated with smoking are of: lung, esophagus, larynx, mouth, throat, kidney, bladder, pancreas, stomach and cervix.
Regular physical activity and maintaining a healthy body weight, along with a healthy diet, would reduce the risk of cancer.
Alcohol consumption is also a risk factor. Likewise, viral infections such as hepatitis B and C are associated with liver cancer, the human papilloma virus with cervical cancer, and Helicobacter pylori can increase the risk of stomach cancer.
Environmental contamination of the air, water and soil, by different chemical agents increases the risk of cancer and ionizing radiation can cause leukemia and various solid tumors.
Avoiding the most well-known risk factors is a fundamental mode of action to prevent certain cancers. The Argentine Association of Surgery recommends not smoking, having a diverse and balanced diet, avoiding being overweight, playing sports regularly and avoiding exposure to ultraviolet rays.
Early cancer diagnosis saves lives and reduces treatment costs.
THE IMPORTANCE OF INVESTIGATION AND THE MULTIDISCIPLINARY COMMITTEE
Oncology research aims to improve knowledge about cancer, to reduce mortality, and improve the quality of life of patients, with more effective and less toxic treatments, favoring prevention, early diagnosis and new treatments.
Currently one of the keys to cancer treatment is the discussion of each case in a multidisciplinary committee, with professionals from different specialties, achieving with the competence of different opinions, approaching the best treatment for the patient with more probability. The members of the committee have a more global vision of the pathology, optimizing the evaluation of each patient, achieving a higher percentage of cure. An erroneous evaluation, at the beginning of the disease, by individual decisions, can be very difficult to reverse.
Also called personalized medicine, molecular medicine, stratified medicine or 4P medicine (predictive, preventive, personalized and participatory) offers the patient a treatment adapted to the characteristics of their tumor. It does not replace current treatments but rather serves to complement what exists today.
For its application, it is necessary to know the retratomolecular portal of each tumor, which is obtained from DNA analysis with advanced diagnostic methods (molecular diagnosis). With this analysis of the genomatumoral, the drugs are directed on a specific target, according to the genetic profile of the tumor of each patient. Its two pillars are targeted therapy and immunotherapy.
SOME REFLECTIONS TO TAKE INTO ACCOUNT
· Talk with the patient and their environment to face the test with the greatest serenity possible. It is important to generate actions for patients and their relatives and support them morally and psychologically. Therefore, it is a fundamental challenge for the medical environment to intervene in active communication to modify the social image of cancer.
· The Internet has almost infinite information for the patient and the doctor. Misunderstood can trigger fear, rejection and mistakes. It is essential that medical professionals approach clear, reliable and quality concepts. This dialogue with the patient is the foundation of a trusting relationship for cancer treatment.
· All those involved in the treatment of cancer are very important: doctors, nurses, assistants, paramedics, nutritionists, psychologists, psychiatrists, technicians, clerks, and so on. The objective is to generate actions that improve the quality of life and the care of cancer patients.
WHERE ARE WE GOING
Today many cancers can become a chronic disease thanks to new treatments and their effectiveness. However, improvements in cancer knowledge will come from: modern oncology, prevention, screening, imaging and biotechnology, multidisciplines, improvements in organizational quality, artificial intelligence (big data) and a new culture in the global assessment of the illness.
We are living a human, technological, medical and organizational revolution, providing hope to patients. Against cancer we all have a role to play, and it is the duty of all medical professionals to build progress in cancer treatment with patients.
Advised: Dr. Roberto M. Badra. (ME 8951) (MP24510). Member of the Oncology Commission of the Argentine Association of Surgery (MAAC). Staff Surgeon of the Sanatorio Allende and Hospital Nacional de Clínicas de Córdoba. Professor of the Chair of Surgery 1 (UHC N II) of the National University of Córdoba.