Scientists at the forefront of the European fight against cancer: "Cars must be removed from cities"

Cancer usually develops in silence, without pomp or noise.

It is enough that a few tiny cells get out of hand, and begin to multiply without control, to make progress one of the most devastating diseases on the planet.

This disease, which kills 10 million people each year, has already become the leading cause of death in the world and its incidence continues to grow.

Europe, with less than 10% of the world's population, registers a quarter of all cancer cases in the world and the European Commission has conspired to neutralize it with a project, the Cancer Mission, which plans to "save more than three million of lives” until 2030.

The challenge is ambitious and there are thousands of minds working on it.

Three of them are the oncologist Josep Tabernero, the researcher Anna Bigas and the French scientist Eric Solary, who coordinate the group of experts appointed by the Commission to set the strategic lines in cancer research for this decade in order to improve the understanding of cancer. .

A few days ago they met in Barcelona with several hundred European specialists to begin to establish priorities.

“The idea of ​​the cancer mission is to gain a new level of understanding of cancer.

It is a complex disease, with many factors involved, and the idea is to reach a new level of understanding of the mechanisms of the disease”, explains Solary,

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We will have to prioritize, warns Tabernero, director of the Vall d'Hebron Institute of Oncology (VHIO).

The oncologist admits that, although all cancer research is important, they will have to choose those areas "that will have the most impact."

The oncologist is not very optimistic about achieving the challenge proposed by Brussels, but they strive for it: "What the Cancer Mission has as its objective - which is not achievable, but it is good to have objectives that inspire you - is to increase the survival of the cancer to 70% in 2030 and reduce tumors by 30%.

Currently, survival is 58% in men and 62% in women;

and, theoretically, 45% of tumors are preventable.

With these numbers, we have focused on six areas to increase awareness.

One is prevention: there is little funding and more study needs to be done on how cancer can be prevented.

Secondly, early diagnosis, because there are tumors that are probably not going to be prevented, but if we diagnose them early, such as pancreatic cancer, we will improve survival”.

The other strategic areas in which to focus efforts are resistance to treatments, childhood tumors, the role of aging in this disease and how to treat survivors.

One of the plans of the UnCan project is to refine the roadmap to create a European cancer data center with contributions from all countries: biomedical information will be integrated with other types of data, such as geographic or lifestyle observations, to make them available to the scientific community and advance in the understanding of the disease from all possible angles.

“We probably don't know what we're going to find, but that's the investigation.

One of the big questions is understanding how cancer interacts in all organisms, what allows tumors to grow.

You need some kind of clearance from the body for cancer to grow in the body, and we hope, by collecting many types of information, to understand how the tumor is growing and interacting with its environment," Solary says.

The French doctor emphasizes the urgency of deciphering this disease in more depth.

“Cases of cancer are going to increase by 20% in the next 20 years due to the aging of the population and due to exposure to compounds that are not even known or understood.

Therefore, it is necessary to better understand the mechanisms by which we can prevent or diagnose cancer.”

Collaboration between countries will be key to improving this knowledge of cancer, points out Bigas, scientific director of the Cancer Network Biomedical Research Center (Ciberonc): “There is a lack of coordination, above all, at the level of supranational structures.

A team can go to a certain point and be the best in the world.

But there are things that have to be addressed in a multidisciplinary way and from different groups, ”she defends.

Scarce resources for prevention

In prevention, an area that always lacks resources and research, according to Tabernero, there is a lot of room for maneuver.

“The incidence of cancer is increasing due to aging and because we are increasingly exposing ourselves to harmful lifestyle habits.

We must continue working on the decalogue of healthy habits [quitting smoking, exercising and avoiding ultra-processed foods, among others], but there are things that are not so obvious and that have to be studied, such as the influence of microplastics or the role of the microbiome.

We do not know everything ”, warns the oncologist.

The director of the VHIO assures that "cars must be removed from the cities", for example, but there are other measures that require more research to be able to make recommendations:

“To begin to reduce environmental pollutants or denounce the influence of prepared food on the microbiome, the first thing that is required is knowledge.

You cannot legislate or limit what you do not know”.

The oncologist also pays attention to improving technological tools to facilitate early detection.

For example, liquid biopsy, a technique that makes it possible to detect, through a blood test or other body fluids, traces of tumor DNA.

“Liquid biopsy is going to help us a lot, but we still don't have it sufficiently advanced to diagnose tumors early.

It's a technical problem, but it will work out.

You have to go further, ”he points out.

Just reading the DNA, he admits, will not be enough, and knowledge about how proteins work and about epigenetics (the chemicals that surround DNA and can modify its function) will have to be integrated to fine-tune detection techniques.

“Looking only at the DNA does not provide everything we wanted because many tumors, when they are very small,

they do not secrete enough abnormal DNA.

For tumors that are not easily preventable and have a poor prognosis [such as that of the pancreas, for example], the only way to improve will be to identify populations at risk and make an early diagnosis with new technologies, such as liquid biopsy or others”.

Between the possibility of curing cancer or controlling the disease as a chronic ailment, Solary sees both options as feasible.

“Probably, we will be able to cure some of the tumors, especially the ones that we diagnose early,” he says.

But in other oncological processes, more associated with age and suffered by older patients who cannot tolerate strong treatments, perhaps "it is better for their quality of life to control the progression of the disease" without aspiring to end it.

To improve on these two pathways, in any case, more research will be needed, the scientists insist.

“The cancers that are already here are an emergency.

But we have to look to the future and what we have to do is be able to prevent and diagnose before”, reflects Bigas.

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