Cancer is one of the illnesses that worry our society the most. On the occasion of the presentation of issue 77 of Mètode, devoted to cancer, the journal organized, together with Claustre Obert, the debate «Cancer: Social and Scientific Challenge». The event took place in the Main Hall in La Nau Centre, and included the participation of different specialists on the illness who contributed to the monograph devoted to cancer.
The Rector of the University of Valencia, Esteban Morcillo, highlighted the importance of medical communication in his introduction to the debate. Martí Domínguez, Professor of Journalism at the University of Valencia and Director of Mètode, introduced the issue and foregrounded the journal’s bet on medical information during its run. Ana García, Clinical Chief of Ginecology in the IVO Foundation and coordinator of the issue, outlined some of the main ideas of different articles in the monograph about cancer.
María José Juan Fita, Associate Doctor in the department of Medical Oncology of the IVO Foundation, delivered an introduction to the illness and talked about the importance of environmental factors in cancer. According to data shown by the doctor, the most common cancer in men is lung cancer, followed by colon and rectum, bladder and prostate. In regard to women, the most common are breast, colon and rectum, uterine and stomach cancer. Of the total number, only 20 to 25% is related to endogenous causes, while 75 to 80% is also related to exogenous or environmental causes.
Among environmental causes, we can distinguish chemical (produced by unhealthy habits such as a fat-rich diet, tobacco and alcohol), biological (viruses and bacteria) and physical carcinogens (UV and ionized radiation). María José Juan concluded her presentation reminding that a lot can be done to improve some habits, like stop smoking. In this respect, she pointed out that a person who stops smoking decreases the risk of lung cancer to the point that, in fifteen-years time, their risk is equivalent to that of a non-smoker.
«Only 20 to 25% is related to endogenous causes, while 75 to 80% is also related to exogenous or environmental causes»
«A person who stops smoking decreases the risk of lung cancer to the point that, in fifteen-years time, their risk is equivalent to that of a non-smoker»
Can risk be modified?
On the other hand, Marina Pollán, Chief of the Cancer Epidemiology Unit in the National Epidemiology Centre (Instituto de Salud Carlos III), focused her presentation on breast cancer, primary health concern for women. Each year, she said, 1.4 million new cases are diagnosed, 450,000 of them in Europe and 26,000 in Spain.
With breast cancer, she stated, there are some hereditary cases, but she insisted that not every answer lies in genetics. To prove it she quoted a study made in the 90s with Asian women in the United States. It showed that women who were born in their home country had less risk of breast cancer than those born in America. And those who had spent more than eight years in the country had more risks than those who had come to the country later. «Therefore, not every answer lies in genes and the environment has something to say, too», confirmed Marina Pollán.
However, another issue tackled in the debate was the genes that predispose a woman to suffer from breast cancer, and she mentioned Angelina Jolie as an example. She had a bilateral prophylactic mastectomy when she discovered that she carried genes that notably increase the risk to develop the illness.
Marina Pollán emphasized the importance of the influence of hormones on breast cancer. Thus, she cited other factors that contribute to increase the risk and which are related to hormone changes, like the fact of having the first child after 35. In this regard, Spanish women are the latest European women to get to motherhood.
«Marina Pollán cited other factors that contribute to increase the risk and which are related to hormone changes, like the fact of having the first child after 35»
«Esteban Morcillo defended the role of research that allowed us to make progress in the treatment of the illness during the last years»
Hormone Replacement Therapy is also related to a higher risk of breast cancer, as well as hormone antidepressants. Obesity and alcohol consumption help augment the oestrogen levels, a fact that also raises the risk. Tobacco consumption and exposure to ionizing radiation, especially in people under 20, are other aspects we must avoid. In any case, specified Pollán, they are not determinant components, but «risk modulating factors».
In the same way as factors that increase risk, some factors that work as protective elements against cancer were highlighted, such as, for instance, Mediterranean diet. At the end of the presentations, the audience took the floor and voiced doubts and comments that contributed to the richness of the debate.
Rector Esteban Morcillo did not close the debate before stressing the high level of oncology in Valencia, as well as their international protocols and clinical trials in which medical communication and doctor/patient feedback are capital elements. Finally, he defended the role of research that allowed us to make progress in the treatment of the illness during the last years. He also addressed the need for every research to be carried out under strict ethical surveillance to avoid conflicts of interest.
Different documents, as well as some of the presentations, can be found in the NAU XXI programme, the debate and reflection platform by the Culture and Equality Office of the University of Valencia.
Lucía Sapiña. The Two Cultures Observatory, Mètode, University of Valencia.