Is it a utopia to think that in a few years cancer can be eradicated? The reflections of oncologist Joan Massagué (Barcelona, 1953), director of the Sloan Kettering Institute in New York and protagonist of a new edition of Foros de Vanguardia, held this Thursday in the MGS auditorium and titled, precisely, revolved around this question. , End cancer. To questions from journalists Josep Corbella, editor of La Vanguardia specializing in science, and Benet Iñigo, head of society at RAC1 – also from the host of the event, journalist Ramon Rovira -, Massagué argued, among other things, that we live in the era in which cancer is no longer synonymous with tragedy. And that, for him, is already a great achievement.
“There will always be cancer, but we are in a historic moment,” he noted. “Our relationship with the disease is evolving. It is a serious pathology, even serious in some of its modalities, but in many cases it is curable, chronicizable. “We are ending cancer as a synonym for something sinister,” he added.
So much so that he launched into affirming that science is “turning cancer into a normal disease.” Of course, he made it clear that it will never disappear. “It's a product of being alive,” he argued. “As a biological process – he continued – it will continue, like infections. What we have to eradicate is tragedy. For just over a decade we have been achieving it, although it will never be possible to eradicate it.”
It has become so much a normal disease that cancer can now be detected through a blood test, known as a liquid biopsy. “It is already done now with some type of cancer, for example to detect prostate markers,” he noted. And he predicted that this detection system will go further, “although it will not be possible to do so with all forms of the disease.” In this sense, he highlighted that the priority is to early detect those types of cancer in which it is very effective, to combat them, to locate them in a very primary phase.
And what about vaccines? In record time, they were developed to combat the feared covid, and millions of people were able to benefit from them. Will there ever be a cure for cancer? It is known that pharmaceutical companies such as Moderna or BioNTech are developing some. In this regard, Massagué explained “that there is very promising work underway”, but somewhat different from what happened with respect to covid.
According to him, these vaccines that are being developed will be aimed more at “trying to make a virus like hepatitis lose the ability to, subsequently, end up causing cancer.” He pointed out that the objective will be to generate RNA vaccines to strengthen the immune system and prevent a tumor that has been removed from reproducing again over time.
Certainly, immunotherapy is a technique that has been shown to be very effective in combating different cancers, but not all. It also does not act the same in all patients, being effective for some and not for others. Why? They asked Massagué. “It is the big question, an objective of current research. Sometimes it has to do with the individual's own immunity,” he argued.
And when will we end the obstacle posed by the high cost of some drugs? In this regard, he pointed out that it is always a problem when an oncology drug has just hit the market. However, thanks to technological advances, “prices are going down,” he said. It is true that he warned that in some cases “it will not be feasible to apply a drug to the entire population that needs it,” although he added that there is no therapy that can survive over time at a cost of 400,000 euros. “At some point it will have to come down in price.”
There is a popular saying that prevention is better than cure. So, what can we do to avoid getting sick from this pathology? "Well, what is done to prevent many others, that is, a balanced diet, exercise, not exposing oneself to sources of mutations, such as tobacco...", he said, remembering that cigarettes are also a source of inflammation, "which is the great friend of cancer, a generator of opportunities for it to appear.”
And genetics, what role does it play? In other words, is one sentenced by genetic inheritance in the event that one's parents have suffered from cancer? Fortunately, according to the Catalan oncologist, “its impact in most cases is mild.” What happens –he pointed out- is that cancer is a very common disease. It does not mean that if you suffer from it, it is due to genetic inheritance, but rather to the fact that it is a recurring pathology. The figures do not lie. Every year in Spain, 280,000 new cases are diagnosed.
Fortunately, and due to scientific advances - as Massagué stressed on several occasions during his interventions - this diagnosis no longer has to be a synonym for tragedy. And all thanks to six pillars that have made this change possible, highlighted the oncologist. Firstly, having promoted scientific discovery. “Science solves our problems, as in the case of covid.” Secondly, innovative clinical strategies based on scientific knowledge. A third point, take advantage of the capabilities of the immune system. Fourth, expand precision oncology, developing specific drugs, for example. As the penultimate point, transform data into cures. "The biopsies are digitized, the tumor genome is sequenced, collections of images are gathered that allow us to see the cancer cells... we have to know how to manage this enormous amount of data to obtain useful information." And sixth and last, train the next generations of scientific leaders.
Present at the event held in the MGS auditorium on Illa Diagonal in Barcelona were Javier Godó, Count of Godó and editor-in-chief of La Vanguardia; Carlos Godó, CEO of the Godó Group; Ana Godó, director of Libros de Vanguardia and Vanguardia Dossier, and the director of La Vanguardia, Jordi Juan, accompanied by personalities from the health and hospital field - such as Dr. Josep Tabernero, director of the Vall d'Hebron Institute of Oncology -, pharmacist, economic and research
