For two and a half years, the young doctor Luis Fuertes trained abroad and in Spain to take charge of the cancer machine that the Ministry of Health of Madrid had nicknamed "the cucumber", an expensive nine million device that it had been donated by billionaire Amancio Ortega.
Fuertes was the best-trained person in the country in this technology when the big day of its presentation arrived, on December 17, 2021, in an act before the media of the Madrid president, Isabel Díaz Ayuso, which generated expectations about the benefits it would bring the device, the MR-Linac Unity, for thousands of people from Madrid with cancer.
Fuertes had been prepared with national and international scholarships that financed his stay in British hospitals where the machine was already being used.
But when the moment of truth arrived,
As a consequence, the machine was stopped for just over six months and just over fifteen patients have been treated to date, in contrast to the hundreds of cases treated in its first year in other hospitals around the world.
It is a very valuable public resource that is being wasted because the device has been seen as a paradigm shift by replacing X-rays with magnetic resonance to obtain more precise images of the cancerous area where radiotherapy is then applied.
The hospital argued to EL PAÍS last week that there is a two-year "learning curve" that has prevented the MR-Linac Unity from still being fully operational, but La Paz had plenty of time to prepare before the premiere.
He acquired the machine in 2019 and had to carry out a complex work supervised by the Nuclear Safety Council in the nearby Carlos III attached hospital to accommodate the device, which was only ready at the end of 2021. It was the time when Fuertes was trained in the abroad, along with four other radiotherapy technicians, who were to be under his command, and traveled to northern Italy to learn about the experience with the device at the Sacro Cuore di Calabria Hospital, in Negrar.
The new head of the seven-person team linked to MR-Linac was Isabel Rodríguez, a doctor about to retire who presented a project linked to the new machine to prolong its employment at the hospital.
According to the department's sources, she received only a week's training given to her at the La Paz hospital by technicians from Elekta, the Swedish company that manufactures the machine.
She made the mistake of focusing on tumors that were not suitable to be treated with this machine, such as the rectum, uterus, or endometrium.
The field of view of the MR-Linac is limited to 22 centimeters, which discourages its use in tumors of a certain size.
Rodríguez soon returned to his usual dedication, coordinating the brachytherapy team, a radiotherapy technique that consists of placing radioactive implants near the tumor.
This explains why between mid-April and early November not a single patient was treated at the MR-Linac, according to internal records to which EL PAÍS has had access.
Only 12 people received sessions in all of 2022. Meanwhile, almost 1,500 patients were treated in La Paz in three other less advanced radiotherapy machines.
EL PAÍS has not received a response to the two emails sent to Morera and Rodríguez.
Nor have they responded through a request to the hospital's press officer.
The head of the Radiotherapy Oncology service, Rosa Morera (left) presents the MR-Linac Unity to a group that includes: the manager of the La Paz hospital, Rafael Pérez-Santamarina (in a gown);
the Madrid president, Isabel Díaz Ayuso;
the then Deputy Minister of Health Antonio Zapatero;
and the then General Director of Hospitals, Fernando Prados. HOSPITAL LA PAZ
The sidelined physician, Fuertes, was an interim oncologist who had won a hospital excellence scholarship to train at MR-Linac.
La Paz gives this aid annually to the best of its residents in order to encourage the winner's incorporation into the hospital once their training period is over.
But when Fuertes finished that stage, in December 2021, the hospital did not retain him, to the surprise of other members of the radiation oncology team who speak that he was "none".
Since March 2022, Fuertes has been working as an oncologist at the Torrejón Hospital.
Fuertes, who has declined to speak to this newspaper, reports on his LinkedIn that he was the winner of the REX 2019 Project (Excellent Residents Incorporation Program) in La Paz, with the project "Molecular precision radiotherapy guided by Magnetic Resonance."
In addition, he enjoyed other scholarships to finance his training: one provided by the European Society of Radiation Oncology (ESTRO) and another by the Spanish Society of Radiation Oncology (SEOR).
He spent his stays at two leading British hospitals in cancer treatment that already had the MR-Linac: the London Royal Marsden and The Christie, in Manchester.
Failure on the first day of the pilot project to limit the number of patients in 22 health centers in Madrid
The doctor wrote about his experience at the Royal Marsden in a 2019 article for the European Society for Radiation Oncology (ESTRO).
He then wrote: “Thanks to this short but intense visit I have learned some essential aspects of MRgRT (resonance guided radiotherapy) which will be very useful to start clinical activity in my center”.
The premiere of the MR-Linac has coincided with a high number of sick leave due to psychosocial risk in the department of radiotherapy oncology, where some fifty people work, including doctors, physicists and technicians.
According to the Comisiones Obreras union, "a good number of workers" have left the center or have requested leave after receiving psychological care.
CC OO has reported that the hospital is aware of this situation but has not acted.
La Paz recruited a female doctor in the fall who has direct experience with the machine from a stay at a Canadian hospital.
However, even at the beginning of January, only two people were being treated, including a senior hospital official whose identity has been omitted by this newspaper in compliance with health data protection laws.
After the appearance of the article in EL PAÍS last week about the little use of the MR-Linac, there has been "a race to fit patients" into this device, according to the sources consulted.
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