“Lung cancer is currently the leading cause of cancer death in the world, mainly due to the lack of early diagnosis,” explains Dr. Susana Simões, a pneumologist at the Champalimaud Clinical Centre. But today, this deadly disease can be managed.
“ Lung cancer; It is the deadliest cancer in the world and the second most important after breast cancer in women and prostate cancer in men. ,” explains Dr. Susana Simões, a pneumologist at the lung unit of the Champalimaud Foundation in Lisbon, adding that “ 70% of diagnoses are made in stage 4 ,” which means that cancer has spread to other organs or parts of the body. This is “mainly due to the lack of early diagnosis and the fact that the symptoms that lead patients to consult a doctor appear late in the course of the disease ,” deplores the specialist.
Apart from people at risk over 50 years of age who smoke the equivalent of a pack of cigarettes daily for 20 years, or who have quit smoking for less than 15 years, for whom screening is highly recommended, unfortunately there are no lung cancer screening programs.
At the Champalimaud Clinical Center (CCC), the state-of-the-art medical, scientific and technological establishment of the Foundation, patients with undiagnosed lung cancer generally go through a smoking cessation appointment. “Every person who comes to the consultation enters a screening program ,” since people who smoke are high-risk cases. “This is what is called opportunistic screening,” she says.
However, even though 80% of lung cancer patients are smokers, in some regions of the world, such as Asia, lung cancer in non-smokers has been associated with air pollution. “At the Champalimaud Foundation, we are looking for and trying to understand if there could be another, more biologically recognized cause,” explains Dr. Simões, whose team is also currently working on the development of a simpler and more accessible screening technique that will not involve the risk of radiation, “thanks to a respiratory biopsy that allows the evaluation of the chemical constituents of exhaled air,” she explains.
For the pneumologist, the most urgent message is that lung cancer is the leading cause of cancer mortality, but it is now screenable. “Being screenable involves early detection, because symptoms only appear at an advanced stage, and that is when we do not pass on radical therapies to cure the disease, but therapies to control it.”
These therapies include chemotherapy, which destroys malignant cells; Targeted Molecular Therapy, in the form of pills, which gives patients more freedom and comfort; and immunotherapy, which stimulates the immune system to recognize and destroy malignant cells, the latter acting as a complementary mechanism to chemotherapy, in some cases.
“Before starting any treatment, a genetic test of the tumor tissue must be performed to search for genetic mutations. If there is a genetic alteration, the treatment will target that particular mutation. If there is no mutation, it is a choice between immunotherapy or chemotherapy. “
To illustrate the process, Dr. Susana gives the example of Pedro Afonso, one of her “Champions of your cancer,” as she calls them, patients who have defied all odds and entered complete remission. “ In April 2016, this 47-year-old man from the Algarve received a stage 4 lung cancer diagnosis . and two months later, following the doctor’s recommendations, he participated in a clinical trial during which he underwent chemotherapy sessions. “ Less than a year later, he was in complete remission . “
The disease reappeared two years later, and that’s when Pedro Afonso underwent a thorough genetic study, which revealed a mutation for which a new drug was being developed, “ We started with the new drug, and since Pedro started targeted therapy in 2019, he has had a complete response, with no signs of disease. “ exclaims the doctor, adding that Pedro’s unique way of seeing life also helped, “In a way, he accepted the disease and did not let it stop him from living.” Pedro himself admits, “For the past seven years, I completely ignore the fact that I am sick or have a problem.”
For Dr. Susana, when treating a patient with advanced stage cancer, the goal is above all to maintain the quality of life with the best therapy, while maintaining daily activities as much as possible. “ Living with the disease and not for the disease ,” she insists.
The Champalimaud Center for the Unknown.
An impressive and futuristic building on the riverbank in Lisbon, the Center Champalimaud for the Unknown contributes to placing Portugal at the forefront of global science . It is a beacon of new clinical discoveries “in the sense that our mission is to discover the unknown and that it also pays homage to the navigators who left here 500 years ago, to also discover the unknown,” explains Dr. João Silveira Botelho, vice-president of the Fundação Champalimaud.
This is where the CCC works hand in hand with Champalimaud Research to provide translational and interdisciplinary clinical care, resulting in personalized patient-centered medicine, allowing for higher levels of efficacy in disease control, leading to longer survival and better quality of life.
Thanks to generous donations, it now also houses the Botton-Champalimaud Pancreatic Cancer Center dedicated not only to deepening knowledge of the biology and evolution of pancreatic cancer, but especially to developing more innovative forms of treatment and clinical trials capable of offering patients a better response in disease control.
Inaugurated in 2021, it was funded by a €50 million donation from the Spanish couple Mauricio and Charlotte Botton Carasso, former owners of Danone, and an additional €50 million donation made in November last year by the German group Würth and the Würth Foundation. “ This represents the international recognition and credibility that the Foundation has to attract this type of donations ,” says Dr. Silveira Botelho.
The Center for the Unknown is also the fourth institution in the world to publish in the field of neuroscience and is currently developing a large Clinical Digital Therapeutics department. This new field of brain diseases, namely Parkinson’s disease, Alzheimer’s disease, dementia, and stroke, developed in the United States at Johns Hopkins Medicine, involves monitoring brain circuits through digital therapies, “and not toxic therapies, such as pills or medications, but only digital therapies, to rebuild specific areas of the brain affected by a disease, or provide space for other circuits in the brain that can in some way be trained to perform functions that other altered areas are no longer capable of doing ,” concludes the vice-president of the Foundation. Another step towards the unknown.
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2024-02-14 00:36:09
