During the last 20 years, cancer has become one of the main causes of mortality worldwide. According to recent WHO studies, in 2020 there were almost 10 million deaths from this disease.
It is expected that, with current growth rates, changes in lifestyles and population aging, by 2040 there will be a 60% increase in the number of cases, reaching 21.7 million new cancer diagnoses and 13.1 million deaths associated with this disease”
In Chile, the advance of cancer has also been sustained during the last decades. Cancer mortality has increased by 109% between 1986 and 2016. The Department of Statistics and Health Information (DEIS) indicated that, in 2016, cancer was the second cause of death in Chile, followed by diseases cardiovascular (CVD). However, in regions such as Arica and Parinacota, Tarapacá, Antofagasta, Maule, Biobío, Los Lagos and Aysén, cancer was the leading cause of death.
According to figures from Global Cancer Observatory (GLOBOCAN), in Chile, during the year 2020, were diagnosed 54,227 new cases and around 28,584 deaths from this disease.
In 2019, the Vital Statistics bulletin, published by the INE, announced a worrying milestone: for the first time since there are records in the country, cancer became the main cause of death among Chileans, surpassing deaths from tumors. . Among the main factors that would induce this growth is the demographic aging of the country, since age is one of the risk factors associated with the development of cancer.
About this theme, Francisco VidangossyDirector of the Cancerlife Foundationindicates that the country faces problems typical of developing countries. “Among other things, Chile has an increase in the elderly population, there are the same health problems as in a developed country, with high work demands, stress, poor nutrition, over-medication, a high level of obesity, a high level of alcohol consumption, and a sedentary lifestyle, all factors that create a pro-cancer profile, a poor prevention and education policy in this regard. That led us to the fact that, today, cancer is the first cause of death in Chile”it states.
The importance of prevention and preventive detection
Recently, the International Union Against Cancer called: “more than a third of cases can be prevented”.
At this point, the doctor and hermatologist Pilar León Maldonado specifies: “In solid tumors, prevention can be given. Depending on the type of screening (search for the disease in a population) you can have a diagnosis at a very early stage and there you can treat and prevent. There are approved screening such as mammography for breast cancer, Pap smear for cervical cancer, or colonoscopy for colon cancer.
However, there are cancers that do not have prevention, and among which are included the so-called “liquid tumors”: in this type, early detection is essential. “In oncohematology, screening would be a routine health checkup once a year with general exams that include a complete blood count (blood test) and early consultation. Then, go to a specialist,” points out Dr. León.
It is in the world of liquid tumors where the different types of leukemia appear, such as acute myeloid leukemia, more common in adults (or lymphoblastic leukemia, more common in children and adolescents), or chronic myeloid leukemia. Because of its “emergency” category, acute myeloid leukemia must be diagnosed as soon as possible and treated immediately, in order to achieve the best possible prognosis. In chronic leukaemias, meanwhile, it is key that the patient complies with the treatment and that the medication supply is not interrupted.
In this regard, Dr. pillar lion -who currently works at the Van Buren Hospital- details about the different treatments currently offered to patients. “Acute leukemia requires intensive chemotherapy treatment, with patient hospitalization. For years, an oral treatment has been used for chronic myeloid, which has had a very good response; there are also new generation treatments that help a lot in case of mutations, they are drugs that we have access to and that are in the GES. But, chronic lymphocytic leukemia still receives more conventional treatments, the coverage we have now is only conventional chemotherapy “reveals the professional.
New target or molecular treatments
During the last decade, oral treatments have been developed -also called target or molecular treatments- with very good results and that improve the quality of life of the patient. They are subdivided into finite and permanent oral treatments, which are used, in theory, until the progression of the disease or intolerance of the patient. The big problem is their high cost and that they still do not have state coverage for the public system, since they are not included in the GES or in the Ricarte Soto Law.
However, according to Dr. León, other ways can be generated to facilitate access. “It is being evaluated that, hopefully in a short time, they will be included among high-cost drugs, which is another form of financing. Today it is difficult to prescribe these drugs, because if one does, the financing, or it is from the petty cash of the hospital, or privately from the patient”.
Regarding the type of model for access to cancer treatment, Francisco Vidangossy is clear: “All types of discrimination in health must be eliminated through the new Constitution with a model of universal access, without distinction, with resources and without profit.”
Regarding the new treatments, the also director of Oncosummit is optimistic, “Cancer and its therapeutic environment have come a long way in the past 10 years, including precision diagnostics and targeted therapies. This, of course, includes innovative health technologies, which have allowed not only a good quality of life and even a cure, but also the hope of thousands of patients”.
For her part, Dr. León complements: “There is a bit of talk about personalized medicine, which extends to cancer. It is no longer a question of doing as a standard treatment for all patients with a type of cancer, but of doing molecular studies for a more targeted treatment, giving each patient the treatment that will best assess them. What we are going for is a more personalized medicine with a deeper study of the disease that the patient has. That is the future.”
