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What is immunotherapy and which patients benefit from it?
What is immunotherapy and which patients benefit from it?
In the search for the best cancer treatment options, immunotherapy is gaining ground as a proven effective tool for addressing a disease with multiple challenges depending on the organ affected, the stage of the tumor, and its origin.
Unlike chemotherapy, which seeks to directly destroy tumor cells, immunotherapy —administered intravenously—“unleashes the patient's immune system to defend itself against the tumor,” says Iván Maldonado, an oncologist at Hospital Metropolitano.
The specialist explains that the immune system constantly monitors and attacks viruses, bacteria, and cells that begin to deteriorate and become cancerous. But when tumor cells intelligently release molecules—called PD-L1 and PD-1—they trick the immune system and prevent it from attacking.
So, "immunotherapy uses an antibody directed against these molecules to remove the brakes placed on T lymphocytes, which are defense cells or 'natural killers ,' and allow them to act, to attack and destroy tumor cells."
INTERTITLE: Is immunotherapy effective for any type of cancer?
A very important message, says Dr. Maldonado, is that "immunotherapy is not for everyone, and that the patient must be appropriately selected" to achieve the expected results in cancer treatment and avoid unnecessary expenses.
There are three parameters that should be analyzed before opting for immunotherapy:
- Biomarkers. Specialists must measure whether the tumor expresses molecules that trick the immune system—PD-L1 or PD-1—; if these receptors appear in the study, immunotherapy will work.
- Clinical stage. “Immunotherapy has been tested and is approved for almost all tumors, especially advanced ones.” And there are reasons for this, the oncologist adds: drugs are first tested in advanced disease, when they can act on a tumor. “If the tumor has already been removed, it is less effective.”
- Contraindications. Patients with autoimmune diseases must be closely monitored because they may experience complications. Immunotherapy is associated with adverse effects such as hypothyroidism, colitis, and autoimmune hepatitis, because "the system works against the tumor, but it can also work against an organ."
Immunotherapy has demonstrated significant benefits in the treatment of melanoma, kidney cancer, bladder cancer, lung cancer, triple-negative breast cancer, cholangiocarcinoma (a type of bile duct cancer), and squamous cell tumors of the head and neck.
To treat a good portion of cancer cases, the oncologist maintains, chemotherapy and immunotherapy are currently combined. Sometimes, radiation therapy is added, which attacks the tumor locally from outside the body.
Dr. Iván Maldonado
ONCOLOGIST
METROPOLITAN HOSPITAL
Prostate cancer: the first step to early detection is to overcome the taboo
Although prostate cancer is increasingly being diagnosed at an early stage thanks to campaigns and medical efforts, many men continue to postpone visits to a specialist, wasting valuable time when the disease may be curable, says Francisco Cornejo, a urologist at Metropolitan Hospital.
Fear, shame, and sexism are behind the resistance to prostate screening, which is recommended annually for all men starting at age 50, and starting at age 45 for those with immediate family members—fathers, brothers, or uncles—who have suffered from this condition.
For Dr. Cornejo, understanding the progress medical science has made in detecting and treating prostate cancer is the best antidote to the taboo that still persists. Here's what we need to know:
- Current medical guidelines determine that the digital rectal exam, which many men fear, is not always essential. If the prostate-specific antigen blood test yields normal levels, and on a case-by-case basis, this test may be dispensed with.
- A digital rectal exam is always performed on patients with symptoms and is recommended for patients with a family history. For the latter, a genetic evaluation may even be requested to detect the likelihood of chromosomal abnormalities associated with prostate cancer.
- In the process of diagnosing this type of cancer, "we now have minimally invasive methods," notes Dr. Cornejo. MRI and PET (advanced tomography), both used at the Metropolitan Hospital, are key radiological studies for confirming or rejecting the medical suspicion and proceeding with a biopsy.
- “Radical surgery for early-stage prostate cancer has improved with robotic techniques,” the urologist says: better results are obtained in controlling the disease and conditions such as incontinence and sexual dysfunction are avoided.
- In the treatment of advanced tumors, "hormone therapy has made significant progress"; the development of new formulas, he explains, "allows us to offer patients a longer life expectancy and better quality of life."
Prostate cancer, Dr. Cornejo emphasizes, has three unique characteristics: it often causes no symptoms; if diagnosed early and with appropriate treatment, it can even be cured; and there are cases of microscopic, highly localized tumors that only require monitoring.
Dr. Francisco Cornejo
UROLOGIST
METROPOLITAN HOSPITAL
Cáncer de cuello uterino: el más prevenible, pero en Ecuador, todavía es mortal.
26 de marzo Día Mundial de la Prevención del Cáncer del Cuello Uterino
El cáncer de cuello uterino es el segundo cáncer más frecuente entre las mujeres de América Latina, siendo la causa de muerte de 35.000 mujeres cada año y con un estimado de 83.000 mujeres diagnosticadas anualmente.
Las tasas de mortalidad por cáncer de cuello uterino son tres veces más altas en América Latina, y si las tendencias actuales continúan, se prevé que el número de muertes en las Américas aumente un 45% para 2030.
Ecuador no es la excepción, de acuerdo con los últimos datos de la Agencia Internacional de Cáncer y GLOBOCAN, en 2022 se diagnosticaron 1792 mujeres con cáncer de cérvix y fallecieron 939 mujeres ecuatorianas por esta causa, representando más del 52% de mortalidad por esta enfermedad.
El cáncer de cuello uterino es prevenible, a través de la vacunación del virus del papiloma humano (VPH) durante la adolescencia temprana, ya que el principal factor de riesgo para desarrollar esta enfermedad es la infección por este virus, que además sea de alto riesgo, cause una lesión precursora, persista y no se trate adecuadamente.
Otros factores de riesgo son el inicio temprano de la vida sexual, múltiples parejas sexuales, tener un historial de enfermedades de transmisión sexual, antecedentes de inmunosupresión (defensas bajas) o el tabaquismo y afecta más a los países en vías de desarrollo por la falta de información y acceso a las vacunas.
El cáncer cervicouterino no presenta síntomas en sus etapas iniciales hasta que se desarrolla la enfermedad. El sangrado transvaginal posterior a las relaciones sexuales es el síntoma más común. Cuando el cáncer es más avanzado, las pacientes empiezan a tener síntomas intestinales y urinarios, inclusive con la aparición de fístulas hacia la vagina.
A pesar de los nuevos tratamientos de pacientes con cáncer de cuello uterino, en nuestro país, desde el 2020 hasta el 2022 hubo un incremento de 258 nuevos casos y 129 muertes en mujeres ecuatorianas, por lo que es necesario seguir trabajando en la mejora y difusión de las estrategias de prevención a través de:
- Prevención primaria: educación sobre factores de riesgo y vacunación a niños y niñas de 9 a 14 años.
- Prevención secundaria: Mujeres mayores 30 años, con detección con pruebas de alta precisión y tratamiento de lesiones precancerosas como el Papanicolau y pruebas de genotipificación.
- Prevención terciaria: Tratamiento oportuno y adecuado para pacientes con diagnóstico de cáncer invasor: Cirugía, radioterapia, quimioterapia o inmunoterapia.
"Una persona con una cardiopatía puede tener una vida normal, pero los padres y las familias deben tomar conciencia de que necesitan un control pediátrico y cardiológico periódico, cuidado diario e higiene para evitar infecciones que se puedan alojar en el corazón, como las de tipo dental
"
https://gco.iarc.who.int/media/globocan/factsheets/populations/218-ecuador-fact-sheet.pdf
Dra. María Elena Lara
Ginecóloga Oncóloga
HOSPITAL METROPOLITANO
HOSPITAL METROPOLITANO
Ovarian cancer: three ways to prevent and detect the disease early
Preventing and detecting ovarian cancer early are the only effective tools for combating this silent disease, with symptoms that—when they occur—can be confused with other pathologies and are therefore almost always diagnosed in late stages.
And to prevent and diagnose this cancer early, says oncologist Jenny Calvache, from the Metropolitan Hospital, there are three key actions women should take:
- Have regular gynecological checkups.
Once a year, women should see a specialist for a gynecological checkup. The gynecologist evaluates each patient, takes their medical history, determines whether or not there are any risk factors, and may order tests or studies.
There is no specific test to detect ovarian cancer, like mammography is for breast cancer. Therefore, she emphasizes, "regular checkups and medical history" are essential. - Know what the risk factors are.
The main risk factor is genetic, says Dr. Calvache. "If we already have a grandmother, mother, or aunt with breast or ovarian cancer, we should look for mutations in the BRCA1 and BRCA2 genes, which increase the risk of developing this disease by 44% and 17%, respectively." Genetic testing is recommended when there is a family history of diagnosed aggressive cancers—for example, ovarian, breast, colon, or endometrial cancer.In addition to genetics, other factors such as endometriosis—when endometrial tissue grows outside the uterus—obesity, a sedentary lifestyle with high fat intake, and smoking can also influence the development of ovarian cancer, the oncologist indicates. - Be alert to nonspecific symptoms.Ovarian cancer can, in some cases, present symptoms associated with other ailments or diseases, the specialist says. Warning signs may include:
- Menstrual cramps.
- Abdominal distension or swelling.
- Pelvic pain or abnormal vaginal bleeding.
- Changes in bowel habits or feeling of satiety.
"It's important that these symptoms, which can be confused with other health problems, don't go unnoticed; don't wait, see a doctor, and don't self-medicate," warns the oncologist.
When diagnosed early, surgery is effective, and additional treatment may be necessary depending on the case. In advanced stages, therapy is individualized: advances such as targeted therapy and immunotherapy increase survival and improve patient quality of life.
Dr. Jenny Calvache
CLINICAL ONCOLOGIST
METROPOLITAN HOSPITAL
Cáncer: seis datos clave para seguir tomando conciencia
Una mayor expectativa de vida, el envejecimiento de la población y un estilo de vida poco saludable explican la creciente incidencia del cáncer en el mundo. En el año 2022, según la plataforma Globocan, hubo 20 millones de diagnósticos; para el 2050, habrá 30 millones.
Una realidad más que suficiente, sostiene Iván Maldonado, oncólogo del Hospital Metropolitano, para seguir luchando por concientizar a la población sobre lo que se considera actualmente un ‘grupo de enfermedades’ pues cada cáncer es distinto.
Y para avanzar en este propósito, hay seis datos sobre esta patología que es importante revisar a propósito del Día Mundial contra el Cáncer; el especialista los comparte:
1. Si bien el cáncer mata a millones de personas al año, la prevención salva vidas.
Existen, según el oncólogo, dos tipos de prevención. La primaria que consiste en conocer los factores de riesgo de los tipos de cáncer más comunes para evitarlos; y la secundaria que es la detección oportuna a través de exámenes como la mamografía a partir de los 40 años, la colonoscopía a partir de los 50 y el papanicolaou o prueba de VPH a partir de los 18 años.
2. En el estilo de vida, está identificado lo que aumenta el riesgo de un cáncer
“Factores reconocidos que influencian en la mayoría de tumores son el alcohol, el tabaco, la obesidad y el sedentarismo”, afirma el doctor Maldonado. En el 2024, se publicó el ‘Código Latinoamericano y Caribeño contra el Cáncer’ que hace 17 recomendaciones; el ejercicio físico y la dieta saludable son claves.
3. Dos vacunas evitan las condiciones que generan dos tipos de cáncer
Con la vacuna para el virus del papiloma humano (VPH) se evita la infección que provoca el cáncer de cérvix o cuello uterino; y con la vacuna para la hepatitis B y C se evita que esta enfermedad derive en cirrosis y, luego, en un hepatocarcinoma o cáncer al hígado.
4. La terapia molecular y la inmunoterapia son grandes avances en el tratamiento
Además de la quimioterapia, que sigue siendo válida -sostiene el especialista-, están la terapia molecular dirigida y la inmunoterapia. La primera utiliza medicamentos que atacan a mutaciones puntuales de cada tumor y cada paciente; la segunda potencia el sistema inmune para que se defienda del cáncer. Otro avance es la radiocirugía que acaba con tumores en lugares inoperables como el cerebro.
5. Cualquier decisión para enfrentar el cáncer debe tener respaldo científico
Al enfrentar un cáncer, el paciente y su familia deben diferenciar lo anecdótico de lo científico. “Cualquier decisión en oncología debe tener un respaldo sólido en evidencia médica”, afirma el doctor Maldonado. Su consejo: escuchar solo al médico especialista.
6. La detección oportuna, la biología del tumor y el tratamiento marcan la diferencia
Para mejorar el pronóstico y el desenlace de un cáncer, es clave la etapa clínica del tumor; “un paciente que está en etapa 1 va a vivir seguramente casi igual que una persona sin cáncer, en etapa 4 es incurable”, dice el oncólogo. También importan la biología del tumor -si es agresivo o no- y el acceso oportuno a un tratamiento multidisciplinario.
Dr. Iván Maldonado
ONCÓLOGO
HOSPITAL METROPOLITANO
Cáncer: seis datos clave para seguir tomando conciencia
Una mayor expectativa de vida, el envejecimiento de la población y un estilo de vida poco saludable explican la creciente incidencia del cáncer en el mundo. En el año 2022, según la plataforma Globocan, hubo 20 millones de diagnósticos; para el 2050, habrá 30 millones.
Una realidad más que suficiente, sostiene Iván Maldonado, oncólogo del Hospital Metropolitano, para seguir luchando por concientizar a la población sobre lo que se considera actualmente un ‘grupo de enfermedades’ pues cada cáncer es distinto.
Y para avanzar en este propósito, hay seis datos sobre esta patología que es importante revisar a propósito del Día Mundial contra el Cáncer; el especialista los comparte:
En ambos casos, indica el doctor Jiménez, el paciente debe someterse a un estudio urológico para determinar la causa de la inflamación y a un cultivo de orina para identificar la bacteria a la que hay que atacar. La enfermedad se trata con antibióticos.
1. Si bien el cáncer mata a millones de personas al año, la prevención salva vidas.
Existen, según el oncólogo, dos tipos de prevención. La primaria que consiste en conocer los factores de riesgo de los tipos de cáncer más comunes para evitarlos; y la secundaria que es la detección oportuna a través de exámenes como la mamografía a partir de los 40 años, la colonoscopía a partir de los 50 y el papanicolaou o prueba de VPH a partir de los 18 años.
2. En el estilo de vida, está identificado lo que aumenta el riesgo de un cáncer
“Factores reconocidos que influencian en la mayoría de tumores son el alcohol, el tabaco, la obesidad y el sedentarismo”, afirma el doctor Maldonado. En el 2024, se publicó el ‘Código Latinoamericano y Caribeño contra el Cáncer’ que hace 17 recomendaciones; el ejercicio físico y la dieta saludable son claves.
3. Dos vacunas evitan las condiciones que generan dos tipos de cáncer
Con la vacuna para el virus del papiloma humano (VPH) se evita la infección que provoca el cáncer de cérvix o cuello uterino; y con la vacuna para la hepatitis B y C se evita que esta enfermedad derive en cirrosis y, luego, en un hepatocarcinoma o cáncer al hígado.
4. La terapia molecular y la inmunoterapia son grandes avances en el tratamiento
Además de la quimioterapia, que sigue siendo válida -sostiene el especialista-, están la terapia molecular dirigida y la inmunoterapia. La primera utiliza medicamentos que atacan a mutaciones puntuales de cada tumor y cada paciente; la segunda potencia el sistema inmune para que se defienda del cáncer. Otro avance es la radiocirugía que acaba con tumores en lugares inoperables como el cerebro.
5. Cualquier decisión para enfrentar el cáncer debe tener respaldo científico
Al enfrentar un cáncer, el paciente y su familia deben diferenciar lo anecdótico de lo científico. “Cualquier decisión en oncología debe tener un respaldo sólido en evidencia médica”, afirma el doctor Maldonado. Su consejo: escuchar solo al médico especialista.
6. La detección oportuna, la biología del tumor y el tratamiento marcan la diferencia
Para mejorar el pronóstico y el desenlace de un cáncer, es clave la etapa clínica del tumor; “un paciente que está en etapa 1 va a vivir seguramente casi igual que una persona sin cáncer, en etapa 4 es incurable”, dice el oncólogo. También importan la biología del tumor -si es agresivo o no- y el acceso oportuno a un tratamiento multidisciplinario.
Dr. Iván Maldonado
ONCÓLOGO
HOSPITAL METROPOLITANO
The hereditary factor, determining factor in ovarian cancer
Two factors make the early diagnosis of ovarian cancer complex, whose mortality rate is 70%, says Iván Maldonado, oncologist at the Metropolitan Hospital. The first, unlike the breasts and uterus, the ovaries do not have a validated 'screening' method.
“There is no test that we can recommend annually” to detect it in patients without symptoms, says the specialist. Neither the tumor marker CA125 (cancer antigen) nor transvaginal echo have demonstrated an impact on reducing mortality from this pathology.
The second factor that delays its diagnosis, points out the oncologist, is the type of symptoms it presents, since they are not exclusive to ovarian cancer and are very frequently associated with gastric problems, irritable bowel syndrome or urinary tract infection.
How to prevent ovarian cancer?
There are two ways to prevent this type of gynecological cancer or to detect it in time to improve the prognosis and reduce mortality. Dr. Maldonado explains them:
- Set a high level of suspicion. The following symptoms, if they persist over time and do not disappear with treatment for other diseases, should raise the alarm:
- Feeling of abdominal distention
- Persistent and widespread abdominal pain
- Sensation of early fullness
- Symptoms similar to those of irritable bowel such as diarrhea and/or constipation
- Urinary discomfort
- Weight loss
- Fatigue or shortness of breath
- Consider the hereditary component. A patient with close relatives, such as a mother, sister, aunt or grandmother who have had ovarian, breast or colon cancer (they share genetic mutations) falls into a high-risk profile.
" A person with heart disease can have a normal life, but parents and families must be aware that they need periodic pediatric and cardiological monitoring, daily care and hygiene to avoid infections that can lodge in the heart, such as "dental "
A study of your genetics must be considered, explains Dr. Maldonado, to go (if the mutation exists) to surgery to remove the fallopian tubes and ovaries or to a strict surveillance scheme.
If the patient has already been treated for ovarian cancer, the protocol determines that a genetic study must be performed. If the mutation is confirmed, the family will be able to act in an informed manner and the patient will receive medications that reduce the possibility of a relapse.
Dr. Ivan Maldonado
CLINICAL ONCOLOGIST
METROPOLITAN HOSPITAL
Suspecting and acting quickly are key to confronting childhood cancer
" The vast majority of children diagnosed with cancer are cured for life and that means they will be able to grow up, graduate, start a family and lead a normal life "
The parents of a child with this disease, the doctor emphasizes, must abandon the idea that “cancer is a sign of death” and that, while they are still small, they are not going to win the battle.
The encouraging prognosis is subject to two factors: the type of cancer and how far it has advanced in the child's body before being diagnosed. And if children's health care is in the hands of parents, they are the ones who are called to identify the alerts.
When to suspect childhood cancer?
When to suspect childhood cancer?
Unlike adults, who can undergo specific exams for the early detection of breast, prostate or stomach cancer, children are not subject to check-ups for this objective "because the disease occurs very quickly in them."
However, there are signs or symptoms that can alert you to the presence of possible childhood cancer, says Dr. Sánchez; These are the most important:
- Pain in unusual parts of the body such as back, hips, shoulders, arms.
- Pains that occur from one moment to the next; that are acute and do not disappear, that alter the child's daily life and that even prevent him from sleeping.
- Bleeding that does not calm down.
- Bruises in places where there was no blow.
- Lumps, masses, or lymph nodes that grow rapidly.
- Unexplained fevers that are not associated with an infectious process.
- Neurological alterations such as loss of vision or already acquired abilities.
How is cancer diagnosed in children?
How is cancer diagnosed in children?
Suspicion is the first fundamental step in the diagnosis of cancer in children. If any of the alerts occur, parents should go to the pediatrician, a family doctor, a medical center or the emergency service. And there, professionals should not rule out anything.
“If something is not improving, the doctor has to investigate further, think about the possibility of cancer and ask for help,” says the pediatric oncologist. Already in the hands of a specialist or a hospital with greater capabilities, there are several tests that allow diagnosis.
Time is decisive to successfully treat childhood cancer, emphasizes Dr. Sánchez. In children, tumors, cancerous cells or tissues grow rapidly and, therefore, diagnosis and treatment go hand in hand.
Parents play a fundamental role. The specialist is very clear: “when in doubt, you should go to the pediatrician; Don't trust what you see on the internet; and diagnosed with cancer, commit to treatment and fight, fight and fight to get your child cured.”
Gynecological cancer: symptoms, risk factors and prevention of five types of pathologies that affect women
To educate about the prevention of malignant pathologies that can affect a woman's reproductive organs located in her pelvic area, the medical community has designated September as the month to raise awareness about gynecological cancer.
Within this umbrella, there are those cancers that are detected in the cervix, ovaries, uterus, vagina and vulva. “All women are at risk of contracting them, although the factors that increase their probability are different, and the risk increases with age.”
The statement is made by Dr. María Elena Lara, gynecologist-oncologist at the Metropolitan Hospital and is accompanied by a call for attention about what current statistics tell us: “we are seeing them in increasingly younger women, under 40 years old.”
What are the symptoms of gynecological cancer?
Each type of gynecological cancer presents different symptoms, although they may share some signs. The fundamental thing, Dr. Lara emphasizes, is to go to the gynecologist when any of them occur and, as a first step of prevention, make an annual visit to the specialist.
Attention to risk factors
A sedentary lifestyle, which leads to overweight and obesity, increases the risk of suffering from any type of gynecological cancer, maintains the gynecological oncologist. Therefore, a balanced diet, physical activity for at least 30 minutes a day and healthy habits are forms of prevention.
Dr. Lara details the risk factors for each type of cancer:
- For cervical cancer, carrying the human papillomavirus (HPV), having multiple sexual partners, starting sexual life at an early age or not using a condom during sexual relations.
- For ovarian cancer, the role of genetic mutations is decisive; also polycystic ovary syndrome and endometriosis.
- For uterine cancer, obesity, hypertension and diabetes; any factor that leads to an increase in hormonal production.
- For vulvar and vaginal cancer, the risk factors are similar to those for cervical cancer; in addition to vulvar dystrophies (alteration of the skin of the vulva).
" Nulliparity, that is, never having been pregnant or having had children, is a risk factor for endometrial (or lining of the uterus) and ovarian cancer; pregnancies reduce the damage that the ovary experiences at the time of ovulation "
The Pap test allows the detection of cervical cancer, even in its earliest stages when treatment is most effective. This test, explains Dr. Lara, identifies changes in cells that could become cancer if they are not treated.
Currently, the sample taken for the Pap smear and placed in a liquid base is used to determine if the woman has the human papillomavirus, the presence of which leads to precancerous states that can become cervical cancer.
Primary prevention is vaccination against human papillomavirus. Boys and girls from the age of 9 until before starting their sexual life and men and women up to the age of 45 can receive the vaccine.
For ovarian cancer, there is no test that prevents it or detects it in time; If there is a family history of this disease, explains the specialist, the patient can go to her doctor to determine if a genetic test to identify the mutation is recommended.
To reduce the risk of gynecological cancer, the specialist makes some final recommendations:
- Pay attention to your body; know what is normal for you.
- Avoid smoking and protect yourself during sexual relations.
- Know your family's health history and share it with your doctor.
Cancer continues to attack us, but it is no longer a death sentence
The World Health Organization, the International Cancer Research Center and the International Union Against Cancer come together, on February 4 of each year, to insist on prevention and access to diagnosis and treatment of the disease.
With the scientific certainty that each type of cancer has its particularities and that each human organism faces it in a different way, the medical community is accepting - with increasing force - a different view of the disease.
“It is no longer a death sentence; It is a diagnosis and, in many cases, it can be easier to manage and treat than a chronic disease like diabetes,” says Johanna Rojas, hematologist-oncologist at the Metropolitan Hospital.
And although among the first doubts of patients are still 'the length of life they have left' or 'possible hair loss due to treatment', scientific advances have allowed all types of cancer to have greater probabilities of an early diagnosis, better survival indicators – the years that can pass between a person's diagnosis and death – and clear advances in the types of treatment.
Conventional chemotherapy continues to lose ground, although there are cancers that still require this more invasive therapy. However, it is immunotherapy that is demonstrating the most effectiveness for most types of malignant cells.
Rojas explains the difference between one and the other with a very visual example: “if you fumigate the entire garden to kill the weeds, good and bad things disappear; With immunotherapy, you can go to the weeds and pull them out, with a little bit of collateral damage, but you don't drop a total bomb.”
The advantages of this therapy, which is already a trend worldwide, and which is also applied in Ecuador, are many, says the specialist. It is a minimally invasive treatment. Subcutaneous procedures are used, and even pills, which replace the long hours of administering intravenous chemotherapy and reduce its painful effects.
“We make the body itself begin to heal,” says Rojas. The antibodies that are introduced into the body are designed to attack a specific target.
In its area of specialty - hematological cancers such as leukemias, myelomas, lymphomas - more than 80% of the types of this disease can be managed with immunotherapy. Currently, the doctor emphasizes, “a lot of importance is given to the quality of life of a person with cancer (…); We try to ensure that the disease becomes chronic and that, once the intensive treatment has passed, the patient can eventually even return to his daily life.”
There are no gender or age restrictions for immunotherapy. The only one is, unfortunately, the economic one. In the future, the expectation is that these treatments will reduce their cost.
For the hematologist-oncologist, two additional advances stand out in the current approach to cancer: the use of genetics to opt for the most effective personalized treatment -according to the type of mutations- and achieve the best possible prognosis; and therapies based on cellular engineering.
“Especially in hematological cancers, the patient's T cells are collected and reengineered or genetically modified to program them so that they know which cell they should attack and kill.” They are called Car T Cells.
Along with the advancement of science, says Johanna Rojas, it is key that the medical community generates a high degree of empathy with cancer patients; “It is a disease that requires more support and closeness” and both have a great contribution to therapy.
Dr. Johanna Rojas
ONCOLOGICAL HEMATOLOGIST
METROPOLITAN HOSPITAL
Probiotics may help reduce colon cancer
Every year there are 240,000 new cases of colon cancer in the world, of which approximately 96,000 patients die with this condition, according to the Pan American Health Organization (PAHO).
But not everything is bad, colon cancer has inspired the medical and scientific community to conduct research on this disease and learn about its causes and, above all, how to prevent it.
cutting-edge research
A study conducted in the United States and published in 'The Journal of the National Cancer Institute' suggests that the use of aspirin before diagnosis could help reduce mortality from rectal cancer in the population by limiting the metastatic spread of tumors. colorectal cells before their detection.
On the other hand, the team of scientists at the Dana Farber Cancer Institute establishes that patients with this type of metastatic cancer who drink more than one cup of coffee daily show better disease progression, live longer and take longer to recover. worsen.
Although this research is still in the study stage, it has already been confirmed that the use of probiotics helps reduce the chances of developing colon cancer.
Dr. Miguel Rueda, oncologist at the Metropolitan Hospital, tells us that a diet rich in fiber, which includes the consumption of yogurt and fruits, are healthy habits that help prevent cancer diseases.
“Many studies have shown that probiotics are beneficial for metabolism, contribute to better digestion and help avoid inflammatory processes in the colon, which could trigger cancer,” highlighted Dr. Rueda.
It is important to remember that these eating habits must always be accompanied by medical checks. Preventive health examinations are, without a doubt, the best way to avoid major discomfort.
Five foods where you will find probiotics
Eating these foods helps enrich the bacterial flora in your intestine.
- Natural yogurt (unpasteurized)
- Kombucha, a drink made from fermented tea
- Olives and pickles (not preserved)
- Microalgae, such as spirulina, chlorella or kombu algae
- Raw cheese (unpasteurized).
Dr. Miguel Rueda
ONCOLOGICAL SURGEON
METROPOLITAN HOSPITAL
lung cancer
Risk factor's
Dr. Hugo Hernán Lupera Pazmiño, Oncologist-Hematologist at the Metropolitan Hospital, tells us what the most important risk factors are and the frequency with which this disease occurs.
The first risk factor for developing lung cancer is smoking since tobacco contains chemical carcinogens such as nitrosamines or the dense pyrene diol epoxide. The risk of lung cancer increases according to the number of cigarettes smoked per day. It is counted by the number of packs of cigarettes smoked each year, and the number of years of exposure to this danger.
Non-smokers who are close to smokers are also at risk, but it is much lower: 1.24 per 100 thousand inhabitants.
Among the other probable causes of lung cancer that we must take into account is the existence of a history of this type of cancer in the family, and exposure to other carcinogens such as arsenic, nickel, silica and the fumes generated by the diesel.
In Ecuadorian statistics based on the national cancer registry, the incidence in men is around 7.9 per 100 thousand inhabitants. That places men in fifth place in incidence. Women are in ninth place. The incidence is six per 100,000 inhabitants.
As epidemiological data, in countries where there are well-documented mortality statistics, such as in the United States, this is the first cause of death, surpassing other tumor models. However, this mortality decreases over time and this is probably due to the development of new molecules that can block the growth of lung cancer tumor cells.
The gain in lung cancer treatment in recent years is very significant and the statistics are changing rapidly. In addition, the advent of immunotherapy has truly generated a new approach in the management of lung cancer.
Child cancer
In the month of February, the International Day for the Fight against Childhood Cancer is commemorated, Dr. Gissela Sánchez Fernández, specialist in Pediatric Hemato-Oncologist, comments that cancer in children is not a common pathology, it occurs less than in adults and is a curable disease for life in a high percentage of pediatric patients. The objective is not to keep the little one safe for a while, but to offer him a chance for healing, for him to grow up, study, graduate, have a profession, get married and start a family.
In children, cancer generally proliferates rapidly because it mostly affects developing tissues, and since there are no comorbidities typical of adults, it allows doctors to be quite aggressive and fast in treatment.
The most common cancer in children is leukemia. This disease occurs in days or weeks, so blood tests cannot be routinely performed to know if a patient is going to develop leukemia. Thus, as soon as symptoms appear, the family pediatrician must be present to place the child in the unit where there are specialties that adequately care for this type of patient.
Under these circumstances there is not much time to grieve. The parents are given the diagnosis and we immediately begin the fight to cure their little one. The main scares for children are framed in the punctures, the hours in the hospital, the processes to draw blood, the operating rooms and even the fact of not being at home, in their environment. However, our patients who are heroes and their families are almost always there to fight together, for the same goal.
Chemotherapy in children is generally intense, but they are stronger. Children do not smoke, they do not have high cholesterol, they are not diabetic, and that helps a lot to resist more aggressive treatments to offer them a chance of cure.
We must find a center that has all the pediatric specialties because we need to have on hand the intensivist, infectious disease specialist, cardiologist, neurologist, and all the pediatric subspecialties.
Cancer in children is a curable disease and the Metropolitan Hospital is prepared to care for this type of patient with great care.
Dr. Gissela Sánchez
HEMATO – PEDIATRIC ONCOLOGIST
METROPOLITAN HOSPITAL