"Radiotherapy can expect to cure 40 per cent of cancer patients"

Jorge Contreras, in the oncological radiotherapy department at the Regional Hospital in Malaga.
Jorge Contreras, in the oncological radiotherapy department at the Regional Hospital in Malaga. / MIGUE FERNÁNDEZ
  • Jorge Contreras, President of the Spanish Radiation Oncology Society, wants to ensure that every patient in Spain who needs radiotherapy treatment is able to have it

The new president of the Sociedad Española de Oncología Radioterápica (SEOR) is Jorge Contreras, a doctor from Malaga. He says his top priority is to give greater visibility to radiotherapy and ensure that every patient who needs this type of treatment receives it. Radiotherapy is becoming increasingly more effective and can aspire to cure up to 40 per cent of cancers, says Dr Contreras, who is a radiation oncologist at the Regional Hospital (previously called the Carlos Haya) and coordinator of the GenesisCare Malaga medical centre.

-What has it meant to you, being appointed president of SEOR?

-For me it is an honour, a challenge and an opportunity for professional development. Heading a scientific society is a great responsibility. I'll be the elected president for two years, and then president advisor for another two.

-A National Plan against Cancer is currently being drawn up. What do you believe needs to be done to improve your speciality?

-One of the top objectives of the project, which I want to develop during my presidency, is to give visibility to radiotherapy treatment, because it is one of the most effective and efficient weapons we have to beat cancer. It can aspire to cure 40 per cent of oncology patients. However, there is still a large percentage of patients who don't benefit from the treatment or aren't offered it. That fits in with what you have said about the national cancer strategy. One of my missions is for there to be equality in the offer of radiotherapy, in the whole country.

-Does the situation in Spain vary much, depending on where you live?

-In Spain there has been a delay and a critical situation with regard to resources and radiotherapy treatments because of a lack of means. Thanks to the efforts made by the Administration, donations and actions within the private health sector, in recent months Spain has almost reached the same level as other countries in Europe. What we need to do now is give visibility to radiotherapy so that the whole of society can benefit from it. I am calling on all professionals who treat cancer patients to find out about the latest advances and everything that radiotherapy can do.

-You're saying there are patients who should have radiotherapy but aren't given it?

-There is a work carried out jointly by the SEOR foundation and the Francisco University of Vitoria, to see how many cancer patients are diagnosed in a year and how many are given radiotherapy. It was found that one-third of patients for whom radiotherapy was indicated in this country are not receiving it.

-And why does that happen?

-Because Spain doesn't have enough technical resources or accessibility to radiotherapy treatments. That has meant that many professionals in the oncology sector don't offer it because it isn't available for their patients. We can say there is an inequality and a lack of homogeneity when it comes to radiotherapy in Spain. That is what I want to change, so that every patient, no matter where they live, has access to these resources.

-So we can definitely say that one-third of patients in Spain who should have radiotherapy are not given the treatment?

-I would say they are patients who are suitable for or could benefit from radiotherapy treatment. Radiotherapy has developed so much in terms of technology and quality that the treatments are much more efficient and effective now, from the point of view of the results, and they are much less toxic. For me, what is most important is that although we have a very effective weapon against cancer, a third of patients are not receiving it or do not have access to it.

-Is that also the situation in Malaga, that patients do not have access to this type of treatment?

-In Malaga there is a before and after situation, because of the donation of electron accelerators from the Amancio Ortega Foundation. We can say with satisfaction that we are not in a worse situation that other regions. In radiotherapy there is a large margin for improvement, because many specialists who could apply or recommend the treatment have still not entered into the dynamic of being able to prescribe it for patients. In Malaga the message is one of tranquility: we have enough resources and sufficient professionals to attend to patients who need radiotherapy.

-Which tumors is radiotherapy most used to treat?

-With the technological development, and because we now have a much more precise radiotherapy, we are treating tumors which five or ten years ago we would not have been able to. Any tumor situated in an organ can be treated with radiotherapy as an alternative option to surgery. And we do it with greater precision and in fewer sessions. But to answer your question, we treat cancers of the prostate, lung, brain, larynx etc.

-Do surgery and radiotherapy complement each other?

-Radiotherapy is an alternative for tumors which are localised. Surgery is still an excellent weapon in fighting cancer. There is also complementary radiotherapy, for cases where the surgeon has not been able to remove the whole tumor or there is a microscopic illness.

-Will proton therapy, in other words a way of treating cancer with protons, be available in Malaga soon?

- As a scientific society we have drawn up a document about recommendations and indications which would justify the use of a technique which is as complicated, costly and sophisticated as proton therapy. We believe that radiotherapy with protons could benefit between two and five per cent of cancer patients, especially pediatric tumors or where there is a need for a new irradiation. Madrid is going to have two proton units and there are two other very advanced projects, one in Santander and the other in Barcelona. Also, it looks as if the Andalusian Health Service intends to develop a project for proton treatment in this region, and they are currently looking at which cases would benefit from the technique. From the point of view of strategic needs, though, it doesn't look as if proton therapy is going to be available in Malaga in the near future.

-Are you managing to reduce the side effects of radiotherapy?

-Yes. Radiotherapy is much shorter now (fewer sessions are needed) and it is much more efficient and precise than it used to be. That means the treatments are quite a lot less toxic, with radiation guided by image. As radiotherapy is so effective, it is also starting to be used in benign pathologies.