Cancer X-ray in Vigo

Every day of the year, an average of ten cases of cancer are detected in the Vigo health region: six in men and four in women. It’s the disease that kills the most, although there’s something tricky about talking about cancer in the singular. In fact, cancer is cancer. What they all have in common is that a group of cells—“selfish, immortal and traveling,” according to the famous definition of Professor Carlos López Otín of the University of Oviedo—grows uncontrollably. But every cancer is different, the risk varies for each person, and treatment is becoming increasingly personalized.

“The perspective of what we offer patients has changed radically,” says Joaquín Casal, head of oncology services at the University Hospital Complex Vigo on World Disease Day. “There are now many molecules that target specific changes in each type of cancer,” he elaborates. For some tumors, a target is identified and a drug is released that acts directly against that target. “For example, in the lungs, in 25 or 30% of cases it is possible to identify targets and give drugs for them, so that if ten years ago a patient lived twelve or fourteen months, now he can spend even five years on treatment. if it is palliative,” says the service director. Treatment is usually done with tablets. Their toxicity is low and patients tolerate them well. Nothing like chemotherapy.

This revolution is called precision oncology, and Joaquin Casal says it is already being used in more and more types of cancer. The lungs have been the focus of research due to their high mortality rate, but they have reached other organs such as breast, colon, melanoma and ovaries. Of course, it does not affect all cancers in each organ, but only part of it. Thus, the patient is in the hands of chance.

Another change in pharmacological therapy is immunotherapy. As always, this depends on the type of tumor. “This ensures that 20 to 25 percent of patients will survive five years in a situation with disseminated disease, which was not possible before,” Casal says.

According to the Galician Tumor Registry, in 2022 the most diagnosed cancers in the Vigo health zone were prostate (517 cases), colon, rectum and anus (500, grouped), lung (444), breast (399 cases) ). ) and bladder (333). These tumors account for more than 300 cases and account for 60% of new diagnoses. A total of 3,694 people were diagnosed (2,087 men and 1,607 women).

Many cases are related to habits. “We are paying for the type of American society, for a sedentary lifestyle, poor nutrition, smoking …,” says the head of the oncology department, Cunqueiro. Diagnoses in young people, especially tumors of the digestive system, are cause for concern.

The highest mortality rate is in the lungs: 318 deaths per year, according to the latest data (2021). Next come colorectal (213), pancreas (115), liver (94), prostate (86), mammary gland (81) and stomach (79). A total of 1,552 people (two thirds men) died of cancer in the Vigo health region.

LUNG

“Feminization is a concern.” Lung cancer kills the most. The feminization of this disease is of great concern to doctors. “In the United States, it is already the number one cancer in terms of mortality among women,” warns Alberto Fernandez Villar, head of Chuvy’s pulmonology service, “and it is becoming equal in the frequency of diagnosis.” Today’s figures reflect social changes that occurred three or four decades ago, namely the emergence of smoking among women. In Spain, and in particular in Galicia, this happened later. But in 2021, Vigo has already had almost as many female deaths from lung cancer (74) as from breast cancer (81).

More than ten years ago, the Pulmonology Service warned about this phenomenon in a scientific article. It said that in 1994, only 9% of lung tumors diagnosed in Chuvi were detected in women, and in 2009 the figure was 25%. Well, as of 2022, women already account for 34% of new lung cancer cases. Over three decades, this share has quadrupled. “This is very alarming because women develop cancer five to seven years earlier than men. Tobacco toxicity appears earlier. Thus, the patient is usually a young man who works, has teenage children…” explains Fernández Villar, “and usually arrives in a worse clinical situation.”

Urology

“There are prostate cancers that are detected ten years before they show up.” Urology is the medical specialty in which the most tumors are registered. Prostate, bladder and kidneys account for 26% of all new cancer cases in the Vigo area. The main one is the prostate, an organ in which not everything is bad. “At very early stages, tumors are detected through a blood test that detects prostate-specific antigen, PSA,” says Luis Fariña, head of the urology department at Powys Hospital. In fact, not all tumors are treatable: “For some, we do an active surveillance plan, which is to not treat and watch how the tests change over the years or if there are dramatic changes. In many cases, it is diagnosed ten or fifteen years after it appears.

The tumor that worries urologists most is the bladder tumor. “We know it’s closely linked to tobacco and other environmental toxins.” It’s very masculine: 269 men were diagnosed, compared to 64 women. That’s four times more. However, doctors note that the incidence among women is growing, including those associated with smoking.

Digestive system

“Colon and pancreatic cancer is on the rise.” The breadth of the digestive system means that this specialty of medicine covers a quarter of all diagnosed tumors: colon, rectum, liver, pancreas, stomach, esophagus. “Some of them enlarge, such as the pancreas or the colon,” says Cunqueiro’s head of digestive services, Ignacio Rodríguez Prada.

To detect tumors of the colon, rectum and anus, there is a screening program (fecal occult blood test) of healthy people aged 50 to 69 years every two years. “In our region, participation is low (less than 40% at first visit), and this makes early diagnosis difficult,” he explains. “Of those identified in this way, 70% recover; On the other hand, if they come because of symptoms, then the opposite is true. In 2021, 213 people died from colorectal tumors. Prada considers it appropriate to extend the age of access to screening.

The pancreas is one of the organs with the highest mortality rate. It is the ninth most common (115 cases), but kills a lot. “The treatment is surgical, but more than half of them do not undergo surgery, and life expectancy is from six months to one and a half years. But of those who undergo surgery, 60% return,” explains the head of the service. Overall mortality exceeds 90%. “It’s a very hidden organ and it takes time for symptoms to appear,” he says.

Mother

“Cases are rising due to increased testing.” With breast cancer, something similar happens with what happens with prostate cancer: although it is diagnosed only in one sex – in men it is considered a rare tumor, with one or two cases per year – there are so many cases that it is among the most most common. In 2022, 399 new diagnoses were recorded. “We are noticing that it is increasing,” says Meixoeiro Breast Pathology Coordinator Rosa Maglio, “and partly this is due to the fact that the age of the screening program has been increased.” Mammograms offered each year to healthy women were available until age 69, but starting in 2023 they will be available until age 74. This made it possible to reach a larger population with the great advantage of detecting tumors in women who were asymptomatic. and therefore they are usually in the early stages, so the survival rate is increased. There’s a downside to reaching more women, though: “We’ll need more technical resources, more mammograms and more human resources,” Mallo says.

Another thing is to extend the shielding from below. The junta has even announced that the starting age for testing will be lowered to 45 years (currently 50), but the radiologist says there are technical discussions because mammography may not be as accurate in diagnosis given the “density of the glandular tissue.” ” “.

“There are patients who used to live one year, but now live more than five with non-curative treatment”

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