“A third of cancer deaths are avoidable and are due to risk factors.”

Cancer is the leading cause of death in the Basque Country. This disease is responsible for 26% of deaths in Euskadi. The number of new cases has increased in recent years, but so has the survival rate due to greater knowledge and new treatments being developed through research. Maria Angeles Sala is an oncologist in Basurto and since 2018 she has been coordinating the implementation of the Basque Oncology Plan.

Both the Spanish Society of Medical Oncology and the Spanish Association Against Cancer say tumors have been on the rise in both Spain and the Basque Country in recent years.

– Cancer is a disease whose incidence is increasing here in the Basque Country, as well as at the national, European and global level. In 2020, 18 million cases were diagnosed worldwide, and by 2040 the number is expected to reach 28 million.

What is the reason for this increase?

– Fundamentally to population growth and aging. To this must be added the risk factors for this disease. These are tobacco, alcohol, poor diet, sedentary lifestyle and infections such as human papillomavirus or hepatitis. We can influence risk factors, but not demographics.

Besides older people, are there more cancer cases in younger people?

– It was recently published in a relevant scientific journal. This disease is increasing among young people and we are not 100% sure why. It appears that unhealthy lifestyles in our society may be related to this. We know that up to a third of cancer deaths are preventable because they are caused by the five risk factors I mentioned.

However, despite the increase in incidence, the mortality rate from this disease is decreasing.

– This is encouraging news. This is something real that we see in Euskadi. Currently, according to the latest data from the Spanish Society of Medical Oncology, the overall survival rate is about 61% in women and about 55% in men. These percentages are growing more and more. This reduction in mortality is more significant in men, although it varies by tumor type. For example, with lung cancer, mortality decreases in men but increases in women. In them, over the past 20 years, it has tripled. This is due to the introduction of women to smoking.

What is the reason for such a low mortality rate?

– We are working on prevention. Screening also allows us to detect tumors at much earlier stages, which prolongs survival. To this should be added all the improvements achieved in treatment strategies. All advances in the field of cancer go hand in hand with knowledge gained from research. The more we know about this disease, the better we can fight it.

Is Osakidetza planning to conduct new tests for other types of cancer?

– The focus of the Oncology Plan, especially in the framework of European research projects, is the medium-term inclusion of screening for lung, prostate and gastric cancer.

At the therapeutic level, how has progress been made in treatment?

– Treatment is now much less invasive at all levels, be it surgery, radiation therapy or less toxic therapy. Previously, we only had chemotherapy. Today, thanks to research, we have many weapons. We also have immunotherapy, which awakens and stimulates our immune system to fight cancer, or personalized medicine. With its help, we find a change in tumor cells and attack it. – Osakidetsa is going to install proton therapy equipment donated by Amancio Ortega.

In men it decreases

“Lung cancer deaths in women have tripled in 20 years due to tobacco use.”

What is it and what leap will it bring in cancer treatment?

– This is another way of conducting radiation therapy. Its big advantage is that it can be applied in areas where we were previously limited due to its proximity to areas and organs that are very sensitive to radiation. This will be a great achievement. It will be especially used for pediatric tumors. This will undoubtedly expand to solid cancers in the future, as will CAR-T therapies that are currently focused on hematologic tumors.

Will cancer cease to be the leading cause of death in the Basque Country?

– I think so. The mortality rate from this disease is trending downward. Through prevention, early diagnosis and improved treatment, the incidence is expected to continue to decline, and why will it not decline until it is no longer the leading cause of death in the Basque Country?

Is it curable in all cases?

— Cancer is a complex and confusing enemy. We still have a long way to go. The data really supports us. Over the past 20 years the situation has improved significantly. But I think full healing will take time.

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