Josep Tabernero (Barcelona, 1964) will collect today in Paris the accreditation that the Organization of European Cancer Institutes (OECI) has granted Vall d'Hebron as a comprehensive cancer care center. It is the first hospital in Spain to have this seal. "It is a very important fact and it is a way of increasing the quality of everything we do," says the head of the center's medical oncology service and director of the Vall d'Hebron Institute of Oncology (VHIO), which has accumulated 35 years of oncology practice.
What does it mean to have obtained the OECI accreditation?
It is an acknowledgment of the procedures we use and of the quality of treatment and care we have for the sick. It reinforces the commitment of Vall d'Hebron to place cancer as a priority disease. It compares us to monographic centers such as the Karolinska University Hospital in Stockholm (Sweden), the Istituto Nazionale dei Tumori in Milan (Italy) or the Netherlands Cancer Institute in Amsterdam (Holland).
Does it affect patients?
The continuous coordination of the entire cancer area that exists between the large institutions means that the patients are better treated. It has been studied that in centers where there is a multidisciplinary approach and they do a lot of research, the treatments are much better. At Vall d'Hebron, the OECI accreditation process has lasted a year and a half, and has helped all professionals to be better integrated, to control all procedures, response time and quality of care much better. The management of the center has turned to it.
How many people do research at VHIO?
The recognition is for the entire hospital. The VHIO is the research center of the Vall d'Hebron campus and currently hosts 600 researchers. We carry out a lot of clinical research activity, we are the center in Europe with the most open clinical studies, 950. More than 2,800 patients are included in our studies each year.
They run out of space.
Laboratories are getting too small for us. We have bought a piece of land next to the Cellex building and the next step is to build a new building. We are pending municipal permits. The objective is to have more spaces to incorporate new lines of research and more researchers. We are a translational research center, which draws a lot from our patients, and our activity has a very rapid application.
Prevention, diagnosis or treatment, what do you prioritize?
Prevention is being promoted more and more. The European plan to fight cancer proposes to reduce the number of cases by 35% in 2035 through prevention. It also proposes in that year that the survival of cancer patients increases up to 75%. It means that much more prevention needs to be done, but also prevention research. A prevention that is based on properly applying the measures of the European Code against Cancer: avoiding tobacco, alcohol, eating a non-fat diet... Excess ultraviolet or ionizing radiation, external pollutants, both atmospheric and the chemical products present in food, which have a lot to do with digestive tumors. Besides, there are vaccines, such as the human papilloma virus, determinants in some tumors.
Are we compliant?
Everyone knows the decalogue but it is not applied well. It should be integrated in primary schools, in outpatient clinics, in the work of family nurses. It would help us prevent many cases. 35% of cancers are easily preventable and 45% would be preventable. The impact of prevention in breast or prostate tumors would probably be quite limited, but in colon, lung, head and neck or esophagus we would gain a lot.
What is missing to understand about cancer?
The mechanisms of adaptability of the disease to survive. We know a lot about genomics, the vulnerabilities of malignant cells, but they end up finding a way to adapt and survive the attacks that we do to them with the treatments. We have to understand much more the dynamics of the disease, its heterogeneous composition. We are studying a lot with techniques such as liquid biopsy.
What does the liquid biopsy provide?
With a simple procedure we can see how the composition of the disease changes by analyzing the DNA, RNA or other molecules that the tumor cells release into body fluids. We can know how the disease evolves and what composition it has. It is a technique that is still a long way to develop but has a very long journey.
Do you trust a miracle therapy or multiple advances in parallel?
We are following the line of many parallel advances as a result of numerous investigations. In recent years, immunotherapy has been a revolution, but it is not a single treatment. There are multiple treatments because the immune system has to be activated in different ways.
The landscape has changed since it began.
When I started there was a 40% survival; now we are at an average of 62% in women and 58% in men. Knowledge of the human genome has given us an opportunity to diagnose and treat, and what will come is the personalization of medicine. There will be a radical change with the incorporation of big-data technology and artificial intelligence. Comparing databases with millions of patients will give us the strength to increasingly personalize therapies.
