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24 July 2024
Re-elected head of the entity, Reyes enthusiastically faces a second term and reviews the pending challenges: low-survival cancer, screening, access to drugs or the anti-smoking plan
Cancer is already the leading cause of death in Spain. In 2023, it caused 26,6% of total deaths and, for the first time, exceeded deaths from diseases of the circulatory system. In conversation with El Periódico de España, Ramón Reyes emphasizes this on several occasions. He has just been re-elected president of the Spanish Association Against Cancer (AECC), a second mandate that he faces with enthusiasm and responsibility. "I feel privileged," says the man who captains a great team that goes where the system often does not and that, ahead, has countless challenges. He is concerned, for example, about low survival cancers and know what is happening so that a greater number of tumors are appearing than ever at younger ages than average.
The design of a "dynamic and flexible" portfolio of services to respond to the specific needs of each territory; political influence to defend the right to oncological forgetfulness, to protect smoke-free spaces or to improve the efficiency of screening programs, have been some of the work axes of the previous mandate of Reyes, also at the head of the AECC Scientific Foundation.
The new challenges
Now, ahead, you have 10 key commitments in a new government program focused on three axes: developing a model for humanization in comprehensive patient care; improve both healthy habits, early diagnosis and early care; and increase annual research funding to 40 million euros to achieve differentiated programs.
With a social perspective and the frankness that always characterizes him –Reyes is one of those who speaks loud and clear– the president of the AECC responds to what worries him as the head of an entity that addresses the countless needs of patients in a country where, in 2024, there will be 286.664 cancer diagnoses, 2,6% more than in the year before, according to the latest report prepared by the Spanish Society of Medical Oncology (SEOM).
National tumor registry
At this very moment, he says, he is worried that the funds in research of low-survival cancers or "that we are also able to ensure that patients throughout the country have the same possibilities of accessing the same treatments and that we work as a network with reference centers that are cancer specialists." Also that there is a national tumor registry.
Q. Cancer is already the leading cause of death in Spain. What is happening?
«Our population is aging, so it is normal for the incidence to increase as age increases. But more cancers than ever are appearing below the average age."
Ramon Reyes. President of the AECC.
A. There are two components, one known and another that we have to study. The first is that our population is aging, so it is normal for the incidence to increase as age increases. But, on the other hand, we have a very important challenge and that is that more cancers than ever are appearing below the average age that has always existed: breast below 40 years or colon below 40 or 50. We have to do this investigate it. Is it the environmental conditions, is it stress?, diet?... There are a lot of elements that we all know impact the earliest onset, which is why research is key and so is data processing. We have to know what is happening.
Q. The AECC is committed to lowering the age of screening.
A. Colon cancer has been increasing in appearance in the last ten years, by 4%, in people under 50, and that forces us to lower the age of screening. Now he is between 50 and 69 years old and we have to lower it to 45. In mom, the same. We have to raise the level.
Shopping center
Q. Another worrying problem. The delay in access to medicines already authorized in Europe.
A. I am also president of the European Cancer Leagues. We are there because 60% of the laws developed in Spain have their origin in European guidelines. We advocate that countries' approval deadlines be harmonized. We have to harmonize, but be under the European umbrella. We support a purchasing center for all of Europe. That advantageous volume prices be achieved for each country in centralized purchasing. As happened with the coronavirus. We also ask that there be transparency in the data of the pharmaceutical industry because, within Spain, there are also inequalities.
P. Inequalities that affect patients and not only in access to drugs.
«It is not the same to have cancer in a province with nearby centers of excellence as in another, or it is not the same to suffer from it as a self-employed person»
Ramon Reyes. President of the AECC.
A. Yes, the incidence in one place is not the same as in another. It is not the same to have cancer in a province with nearby centers of excellence as in another, or it is not the same to suffer from it independently, who is left with 450 euros of pension and needs to be given aid like the ones we give. 40% of families face expenses of more than 10.000 euros during illness.
Q. What is your assessment of the year that has passed since the approval of the right to be forgotten oncology?
A. It was something absolutely necessary. It's just terrible. A child has leukemia and all his life he carries the fact that he has had cancer and has the problems he has with access to mortgages, insurance... It was raised and it is true that the Government reacted very quickly. We are delighted, but now we have to land it. Articulate it. The assessment is very positive because, although there are more cases of cancer, fortunately there are also more and more survivors. We have to think about these different needs, therapeutic, psychological, work... Take care of this growing population. Fifty years ago, three out of four patients died. Right now, some cancers have an 80 or 90% survival rate.
Q. But there are others with low survival.
A. In 2023 we open the 'AECC 70% Survival Challenge' call to positively impact research into cancers with survival rates below 30% or stagnant. We cannot address it without research. We have just launched a call without parallel in Europe for ten million euros to investigate Small Cell Lung Cancer, with low survival.
Q. About lung cancer. Doctors also promote screenings at a national level. What do you think?
«Lung cancer is the one that kills the most, more than all the other most prevalent cancers: breast, prostate and colon.
Ramon Reyes. President of the AECC.
A. As AECC we always value positively any type of intervention when there are sufficient indicators to be able to detect a tumor early. In many it is not possible. But in lung cancer, it can be diagnosed. We are in favor and supporting the Cassandra project. It is the one that kills the most, more than all the other most prevalent ones: breast, prostate and colon. Anything that can be done to cancer in a survival rate below 20% should be tried.
Q. But does it still seem that there are certain reluctances in the implementation?
A.- There is even some from some pulmonologists because they talk about the number of false positives that occur, that the test is invasive... Then, I imagine, there will be some consideration from the point of view of cost of the means that would be required. to dedicate many hospitals. This is what has happened in the colon. There are autonomies that have been delayed in launching screening due to lack of resources and financial means.
P. Health has put out to public consultation the project to toughen the tobacco law with new smoke-free spaces. It's enough?
A. It is super timely. Today we see it as normal that there is no smoking in a restaurant, we will have to see it as normal that there is no smoking in stadiums. I have been to the concert Metallica two days ago with people smoking next to me. And vaping. That has to change. Smoking and vaping cannot be prohibited, but it can be prohibited in public places and where children and young people are. We have to avoid the factors that cause lung cancer and that is tobacco. With people who are smoking now it is very difficult, because it is a disease. But we must prevent young people from smoking. Save these generations. And get zero exposure to digital smoke. The industry thing with reducing the harm of smoking with electronic cigarettes, vaping, not combustion... seems like the last straw to me. These new forms of consumption are being trivialized.
Q. How do you value the work of the department headed by Mónica García in the fight against smoking?
A. He has made an enormous effort. He has put in place this comprehensive anti-tobacco plan. But it must be deployed, which has not been done. The most important part is the modification of taxation. We are the tobacconist of Europe, people take their tobacco in spades from Spain because, with Croatia, it is where it is cheaper.
Source: The Newspaper of Spain
