Advances that hit the bull’s eye in the fight against breast cancer

We live in a world of vertigo in which ceases to be as soon as they are born and where changes take place at enormous speed. And this, however disconcerting, is not always bad: in the case of medical science, it allows for continuous advances and for small steps to be taken. It is what makes every October 19, when we celebrate World Breast Cancer Day, we can review how treatments and approaches have been improving in recent months. «Everything is going very fast, yes», corroborates Dr. Aleix Prat, head of the Hospital Clínic de Barcelona and scientific coordinator of the academic research group of reference breast cancer SOLTI, «in these last two years the research has gone to an unthinkable speed two decades ago On the one hand, we have managed to identify and give surnames to many more cancers, on the other hand, a plethora of new drugs is coming that allow us to hit the target in a much more accurate way «. It is what is known as individualized or precision medicine. A specialty that reminds us Dr. Ana Lluch, head of Oncology at the Hospital Clínico de Valencia, «aims to personalize the treatment for each patient and each type of tumor, but what is important now is not whether it looks large or small, whether it has nodes or no, but the biological type of the cells. » Among the novelties is advancing in the so dreamed field of vaccines. «For some time we have seen that immunotherapy was used in other cancers, now in the European Congress of Oncology (which is held these days in Munich), are going to present results in breast cancer that had not seen for a while» explains Dr. Prat. And what is immunotherapy? «These are drugs that ignore the tumor and try to activate the patient’s immune system, they are antibodies that will help our defenses to eliminate cancer.» Interesting, and even more so that this new therapy is aimed at patients who have breast cancer known as triple negative, difficult to treat and very aggressive. «For these patients, we only had chemotherapy, now we have seen that there is a group among them whose defenses they are trying to fight, but they can not by themselves, and that’s where immunotherapy offers very positive results,» says Dr. Prat. Since November 2017, there are also biological drugs available that are not chemo, which «act against the Her2 + tumor, touching a protein so that the cell can not divide: stop the proliferation or the cell cycle,» continues Dr. Prat. . They are known as cyclin inhibitors and double survival in patients with advanced hormone-sensitive breast cancer. «It’s outrageous, for years we did not see such an advance,» he says. These encouraging developments, which are increasing the survival rate year after year, are seen on a daily basis, in search of tumor surnames that are serving to individualize treatments and that is possible «thanks to molecular technology , genetics and genomics that is allowing us to see alterations quickly, «says Dr. Lluch. An example: at this time it is possible to sequence the tumor in 24 hours and see its genetic signature in record time. Somehow, everything is being made to fit, as the doctor explains: speed – «before an analysis of a gene required weeks of waiting» -, efficiency – «now done with the usual hospital biopsies» -, and effectiveness – «we have treatments, if we only knew the surnames of the tumor but did not have drugs, we would feel powerless» – the 15% who continue in the battle «One word. A woman. A life.’ This is the title of the metastatic breast cancer dictionary (CMm) that has just been presented and reveals the differences between what we commonly know and the advanced stages of the disease, which imply a totally different reality for those affected. This dictionary, developed by the Pfizer laboratories in collaboration with the patient Amelia Nerín, responds to the needs of building a general knowledge about this disease, since it has been detected that patients usually experience moments of incomprehension, difficulty of communication and feelings of isolation and marginalization in their day to day. Let’s not forget that every time we talk about breast cancer having a cure rate of 85%, we implicitly acknowledge that there is a 15% that will have to keep fighting, that will continue to need more cycles of chemo, drugs, trials. They are women warriors, who rarely appear in the media and who, nevertheless, deserve to be heard. For this, the Metastatic Breast Cancer Association (cancermamametastásico.com), the first Spanish-speaking one, is fighting. Its main objective is «to make this disease chronify.

We need more research, «they say, cutting it off until 1986. All breast cancer surgeries in Spain involved breast amputation until 1986. In that year, Dr. Antonio Sierra was the first surgeon to operate on a woman without performing a complete mastectomy, the first quadrantectomy, which was considered a great advance, and it continued to be the preferred treatment of choice (provided, of course, that the tumor of the patient would allow it), but mediatic cases such as that of Angelina Jolie, and More recently, Terelu Campos, have begun to make their way among some women at high risk of cancer, and there are those who wonder if a bilateral mastectomy will be better to get rid of that sword of Damocles. Beata María Ana Hospital in Madrid, also director of breast cancer courses of the Medical Association, and is forceful in this regard: «I am not at all a supporter of this practice, because not all women with a risk factor will end up suffering from a tumor. If you have a genetic load that increases your chances of suffering from breast cancer, I would tell you the percentage of risk you have and that I should review you four times a year. If it finally appears, nothing happens: we detect it very soon, we operate with local anesthesia and sedation, with radioactive isotopes and very sophisticated techniques, and at four hours you go home with your breasts just as they were, but without tumor. «