“We have the possibility to diagnose and treat all types of tumors”

Ten years ago, those in charge of the Clínica Ntra. Sra. del Remei in Barcelona decided to redirect the structure of the center’s Medical Oncology Service, orienting it to provide cancer patients with a comprehensive care environment in which, together with the availability of the most advanced oncological therapies, they and their relatives would be offered adequate and necessary personalized attention that would favor emotional stability. The head of this service is Dr. Alfred Millà Santos, an internationally recognized specialist with experience in both national and foreign centers and with well-known contributions in the field of oncology. Since its creation, the service has experienced an exponential progression, requiring successive extensions. It is undoubtedly influenced by Dr. Millà’s philosophy, which he has passed on to his entire group: to prioritize patient care as a person.

What is the differential value of your service compared to that of other centers?

As regards the treatments administered, none, in principle. We all follow standard treatment protocols and administer practically the same therapies. The main advantage of our service is that the patient feels very comfortable here. Even when oncological treatments are not easy to accept and tolerate, we try to create a very familiar environment so that the patient feels at ease. As an anecdote, I always explain the case of a well-known actor who gave up his participation in some episodes of a series in order not to change treatment groups and lose contact with his “colleagues”. The secret is to create a team with the right level, both scientifically and psychologically, to face this disease together.

As far as you can tell, teamwork is very important.

It is fundamental. I have always maintained that the “team” that treats a patient is made up of the doctors, the nurses and the rest of the care team from psycho-oncology and nutrition. To this large group of professionals must be added the involvement of the patient himself and his family environment. We have observed how the patients support each other and thus feel more confident in the process. Interestingly, the patients call our day hospital “club”, a place where they come regularly to receive chemotherapy treatments. In addition, we have also noted some curious facts. We know that patients spontaneously organize outings and get together for celebrations. We are all aware of the importance of establishing a very good relationship with the patient to help him overcome his fears. In short, it is a question of making the path easier. Proximity, accompaniment, creating a good atmosphere, good communication, making them feel welcome and taking special care of the process and its treatment are essential elements in our service.

What types of cancer can you treat?

In our service we have the possibility of diagnosing and treating all types of malignant tumors, both in the field of so-called solid tumors such as breast, ovarian, colon or lung tumors, as well as hematological malignancies, for example, Hodgkin’s disease, lymphomas…. Today we must emphasize that, considering all neoplastic pathology as a whole, between 50 and 60% of cures are achieved. In most of the remaining cases, survival and quality of life are increased.

What are the tumors with the highest incidence in the population?

In men, digestive tumors stand out, especially colorectal cancer and lung tumors. It is worth highlighting the decrease in the incidence of stomach cancer and the increase in the figures for pancreatic cancer, which is diagnosed more frequently than a few years ago. I believe that this is influenced by environmental and dietary aspects, since diets with little residue, the consumption of more refined foods – far from the so-called Mediterranean diet – act together with other factors in the increase in the number of diagnoses. In women, the first diagnosis is breast cancer, followed by digestive tumors, ovarian cancer, etc. A curious fact is that for years we have been observing an increase in the incidence of lung cancer in women, a tumor clearly related to smoking.

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Is it possible to recognize symptoms that allow an early diagnosis?

There are a series of symptoms, the so-called guiding signs of cancer, which can be used to guide us towards an early diagnosis. We all know our body and our habits well and so changes in the appearance of a mole, unusual bleeding, changes in coughing habits, a hoarse or more difficult voice in smokers, frequent feelings of indigestion, difficulty in swallowing, the appearance of a lump, or changes in the rhythm of bowel movements would place us in a scenario in which it would be possible to diagnose a tumor at a curable stage. It is important to know that it is possible to diagnose precancerous conditions such as cervical lesions with a simple vaginal cytology or intestinal polyps with a colonoscopy.

There is constant news in the media indicating advances in treatments. How should we consider this news?

With caution and hope. Caution because on most occasions news is published intentionally filtered and represents nothing or only a small positive aspect, and other times they translate results of preliminary research and with no possibility of use in human clinical practice. Hope for the realization that research is being carried out at all levels and that notable advances are being made that are leading to improvements in the results of treatments. For example, new molecules are appearing almost daily in the monoclonal antibody lines. Some of them are effective in tumors that were previously refractory to any treatment attempt, such as kidney tumors, melanomas, etc. All this is the result of an increasingly better understanding of the biology of the tumor cell.

Chemotherapy produces many negative effects. Is progress also being made in the way of mitigating them?

Yes, indeed. A relatively few years ago we used to administer chemotherapy treatments with a limited arsenal to palliate the secondary symptoms. Fortunately, today we have numerous drugs that avoid, in almost all cases, such unpleasant effects as nausea and vomiting. The support of our psychological and nutritional support units also contributes to better tolerance and, therefore, to a better quality of life. Unfortunately, effects such as hair loss cannot be avoided, although their psychological impact can be alleviated thanks to the advances in hair prostheses available to us.

What parameters define your care policy?

Clínica Ntra. Sra. Del Remei is a private healthcare center whose management team has always been committed to the highest technology in medicine and to the formation of new units within the center that make the offer bigger and better. With regard to medical oncology, we are equipped with the most advanced and cutting-edge means, once only accessible in the public sphere. In fact, the same treatments or actions can be performed in our service as in any public center. One aspect I would like to highlight is the agility we provide to each patient for personalized attention. A personal decision of mine is the non-existence, under any circumstances, of waiting lists, with patients being seen the day or at most 24 hours after requesting a consultation, starting treatments as soon as possible. Treatment decisions are made on the basis of protocols that are multidisciplinary in nature and assumed by all the professionals involved in the patient’s treatment at any given time. In fact, it has been fundamental the coincidence of my professional approach regarding the type of care that should be given in oncology with the vision of the Direction of the center and the Institute of the Religious of St. Joseph of Girona, to which the Clinic belongs and which gives great value to the human attention given to patients.