Antonio never imagined that that backache which began in the summer of 2018 would be the first symptom of something much more serious. “They thought it was a muscle contracture,” he recalls, but after several tests, including a PET scan, he received a devastating diagnosis: a non-small cell lung carcinomawith metastases in the D4 and D5 vertebrae. The news was confirmed after a biopsy performed by a neurosurgeon, who cleaned up everything he could.
They explained to me that this type of carcinoma was “atypical” and consequently the prognosis of evolution would depend on the success of the treatment. The cursed word, “cancer”, is impressive but I thought it was not the time to worry about it but to “take care” of it. Consequently, it was time for a second opinion that was as “prestigious” as possible. They informed me that this was in Spain the one of the Dr. Luis Paz-Ares, co-director of the CRIS Immuno-Oncology Unit of October 12. Dr. Paz-Ares confirmed the diagnosis and explained to me that the evolution of the disease would depend on the treatments and the new drugs being investigated. I understood it and concluded that I was facing a chronic but controllable disease based on the response to those treatments, and I was in the best hands.
The only viable option to treat the metastasis was proton therapy, an advanced technique that at the time was only offered in clinics in Bologna and Switzerland.
From there, their fight began with chemotherapy treatments: long eight-hour sessions every three weeks. Although the process was hard, he endured it with fortitude. However, in the second session it was confirmed that chemotherapy was not working and he switched to immunotherapy treatmentwhich would continue until November 2020. During this time, the treatment eliminated the main tumor in the lung, but failed to eradicate the metastasis in the spine.
© Getty Images“I received so much radiation load on my spine that a new session could leave me in a wheelchair,” the doctors explained. The The only viable option to treat metastasis was proton therapyan advanced technique that at the time was only offered in clinics in Bologna and Switzerland. However, he was lucky enough to access this treatment at the Clínica Universidad de Navarra in Madrid, where he completed it in May 2021. “By August, the report said it was ‘clean’“, says Antonio, although in the January check-up the “damn metastasis” had reappeared.
Since I have no side effects of any kind, I try to lead an absolutely normal life with the dependence of having to go to Madrid every two weeks to receive the treatment.
The battle continued. With the support of Dr. Paz-Ares and CRIS against cancerr, Antonio was included in a immunotherapy clinical trialin which he has so far received 49 two-hour sessions every two weeks. Since then, has managed to eliminate metastases which spread to other organs such as the liver, peritoneum, duodenum and pancreas, the latter with the support of radiotherapy.
Today, thanks to the advances in research and access to cutting-edge treatmentsAntonio lives a practically normal life. “To date, the last two CT scans have not revealed any injuries,” he points out. Since I have no side effects of any kind, I try to lead an absolutely normal life without having to go to Madrid every two weeks to receive the treatment. But take the opportunity to enjoy the leisure and shows of the capital.
Lung cancer, a disease that is no longer a death sentence
Antonio’s testimony is one of the many cases of lung cancer that occur in our country (more than 32,000 a year, according to the Spanish Society of Medical Oncology). One of the reasons for the mortality of this disease is difficulty in achieving early diagnosis, since the disease is usually asymptomatic in the early stages and is detected when it has already reached an advanced state. However, the efforts of the scientific and medical community to change this reality are giving results. Research and advances in the diagnosis, treatment and prevention of this disease open a door of hope for patients and their families.
To celebrate the World Lung Cancer Daywhich will be held on November 17, we spoke with the Álvaro Ucero, researcher at the CRIS Foundation against cancer. This expert is a molecular biologist in the CRIS Immuno-Oncology Unit of the 12 de Octubre Hospital and he will explain the types of lung cancer as well as how advances in treatment are managing to convert this oncological disease into a chronic pathology without a death sentence. .
Small cell lung cancer is the most aggressive, accounting for 15% of cases and is almost exclusively associated with smoking.
Types of lung cancer and their characteristics
It is important to understand that Lung cancer is not a single diseasebut encompasses several types. The first fundamental classification divides this disease into two large categories:
Non-small cell lung cancer (NSCLC): represents about 85% of cases and can develop in smokers and non-smokers. This type groups different subtypes such as adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. Although all of them affect lung cells, the particularities of each of these subtypes influence treatment strategies.
© Getty ImagesSmall cell lung cancer (SMC): this type of cancer, less common but more aggressive, accounts for 15% of cases and is almost exclusively associated with smoking. MPC cells tend to divide more quickly, which leads to early spread to other organs and makes treatment more complicated.
Advances in early diagnosis
As we anticipated, the Early diagnosis is a key factor in the fight against lung canceras it significantly increases the chances of survival. Screening programs, designed to identify the disease in its early stages, are demonstrating their effectiveness in at-risk populations, such as current and former smokers. Thus, through the use of low-dose CT scans, the disease can be detected before it progresses too far and surgical treatments can be applied that allow the tumor to be removed and thereby improving survival rates.
In some cases, patients receive neoadjuvant treatment before surgery, allowing shrink the tumor and weaken itincreasing the chances of success in the intervention. This treatment, which may include immunotherapieshas established itself as an effective tool in the treatment of lung cancers that would otherwise be inoperable.
Targeted therapies act on specific mutations in tumor cells, they are a clear example of personalized medicine: they allow cancer cells to be precisely attacked without affecting healthy cells as much.
Targeted therapies: a revolution in treatment
One of the most notable advances in oncology is the development of targeted therapiesa treatment modality that has especially revolutionized the management of non-small cell lung cancer. These therapies, which act on specific mutations in tumor cells, are a clear example of personalized medicine: they allow cancer cells to be precisely attacked without affecting healthy cells as much, which reduces side effects and improves patients’ quality of life.
Likewise, targeted treatments have been shown to be particularly effective in advanced casesalthough, unfortunately, it is common for cancer cells to develop resistance over time. Despite this limitation, they represent a fundamental treatment option for those patients who can benefit from them.
© Getty ImagesThe role of immunotherapy in lung cancer
Another of the greats advances in the treatment of lung cancer is immunotherapywhat are you looking for activate the immune system of the patient to attack the tumor cells. This therapy is especially important for those cases in which there are no mutations treatable with targeted therapies. Likewise, immunotherapy is a first-line option in patients diagnosed with advanced lung cancer.
This treatment can be administered alone or in combination with chemotherapy and has been shown to prolong survival in certain cases. Almost all lung cancer patients will receive immunotherapy during the course of the disease. It is not equally effective in all patients, but it can work for long periods of time.
Minimally invasive surgery and advances in radiotherapy
On the other hand, there have also been technological advances which, fortunately, have benefited from surgical and radiotherapy interventions in lung cancer. Thanks to new techniques minimally invasive surgeryit is possible to perform operations with smaller incisions and precision that reduces damage to surrounding tissues. This translates into a faster recovery and in better conservation of respiratory function after surgery, which represents an important advance in the quality of life of patients.
The radiotherapyfor its part, has also evolved significantly. With new imaging and application technologies, it is possible to precisely direct the radiation beam toward the tumor, minimizing the impact on surrounding healthy tissues. This approach allows higher doses of radiation to be used and reduce the number of sessions required, increasing the effectiveness of the treatment and reducing its side effects. This is the case, for example, of the proton therapy, a revolution in the treatment of some types of cancer, such as lung cancer.
Thanks to advances in the genomic and molecular study of specific mutations, personalized treatments with a greater probability of success and fewer adverse effects
The importance of precision medicine
Targeted therapies are an example of precision medicineand we must not forget that this allows the treatment to be personalized according to the individual characteristics of the patient and their tumor. Thanks to the advances in genomic and molecular studytoday it is possible to identify the specific mutations that drive cancer growth in some patients, allowing us to design personalized treatments with a higher probability of success and fewer adverse effects. The integration of this precision medicine in the treatment of lung cancer has expanded the therapeutic options available and has brought renewed hope to many patients.
© Getty ImagesPrevention and risk factors
Despite all the advances in the treatment of lung cancer, Prevention remains one of the most effective tools in the fight against this disease. He smoking is the main risk factor, and although tobacco control policies and awareness campaigns have contributed to reducing their consumption, the risk persists in those who have smoked for many years. Additionally, other factors, such as exposure to environmental pollution and radon gas, can also increase the risk of developing this disease.
Regarding vaccination, although there are no preventive vaccines for lung cancer, they are being ddeveloping pioneering studies to create vaccines that can personalize the treatment and reduce the chance of relapses in some types of cancer. An innovative example is the andnclinical trial led by the CRIS Foundation against cancer in collaboration with the Oxford Universitywhich seeks to prevent relapses in patients with lung cancer through a personalized vaccine.