"The goal is that there is no relapse in cancer"

• Research: First prognostic indicators for more aggressive breast cancer
• Oncology: an 'explosive' drug against one of the most aggressive breast cancers

The first image before the interview with the renowned Spanish oncologist Ana Lluch defines by herself who she is. He leaves his office, to meet us, but stops to take care of a woman with a turban scarf. Another of her patients gets up to greet her and, before reaching us, she crosses into a third woman. He asks how he is while resting his hand on his shoulder.

Slow, close, empathetic, committed and very enthusiastic. She has been dedicated to breast cancer for 40 years, as a teacher, as a researcher and as a doctor . "At the beginning, we treated all patients with chemotherapy. We hardly knew anything. We needed to know more." At that time, the investigation was a great challenge and she decided to assume it without blinking. Today, she says she is "very excited because the future of cancer is hopeful."

When it started it was not an easy time, let alone for a woman in science. "We had to work twice as hard as a man to achieve the same." While her family was growing up (she has three children), she found opportunities to go to learn and study outside of Spain . For example, to the Tumor Institute of Milan or to the MD Anderson Cancer Center Hospital in Houston (United States).

Since then, she has been director of more than 30 doctoral theses, is the author of a dozen books and has published more than 300 scientific papers in national and international journals. But the most important thing is that more than 10,000 women with breast cancer have passed through their consultation. " To some I have been able to convey joy because of their chances of being cured , I have been able to take away from the head the idea that cancer is equal to death, and those that you cannot cure, you can help them make their lives have the highest possible quality ".

We must get all oncologists to send the tumors to the reference centers in order to plan the best possible treatment

Milestones in the last 40 years

In these 40 years of study and care work, Lluch has a very clear perspective on the recent history of breast tumors. One of the most significant milestones is undoubtedly the discovery of biological subtypes . This allowed the incorporation of monoclonal antibodies for the treatment of HER2 positive breast cancer . "I remember that about 20 years ago, we published a paper where we described that this subtype of breast cancer was very aggressive, progressed very quickly and women who had it relapsed in a very short time. The prognosis was dire [...] Today it is the subtype that heals the most and the one that has the most treatments. "

For tumors of luminal types , "today we have pills that have improved progression-free survival." In addition, "we already have treatment when they present the PI3K mutation." For metastatic breast cancer and with the presence of a mutation of the BRCA1 / 2 gene, PARP inhibitors have been shown to reduce the risk of progression compared to standard therapy. In the case of triple negative tumors, immunotherapy is revolutionizing the field of treatment. "We are participating in an international clinical trial with a drug that could reduce the risk of relapse in these patients."

A sum and continues that he has managed to change the cure figures thanks to the fact that no case is treated the same and hence "the importance of performing a good diagnostic process with all available technology, which includes the sequencing of genes to determine existing alterations. " These means, stresses the oncologist, "are in public medicine," which is declared faithful and strong advocate. "As it is an expensive procedure, it is not in all hospitals, so we must get all oncologists to send the tumors to the reference centers in order to plan the best possible treatment."

With all these advances and screening for early diagnosis , today, between 10% and 15% of women with breast cancer relapses at five years, when three decades ago, the percentage was double (30%). " Our goal now is for no one to relapse " and the key is to continue investigating. "Without science there is no progress in our society."

Young researchers without incentive

In Spain, for the resources that "we have had, the level of cancer research is great [...] What worries me is that young people are not joining as we would like . There is no incentive. Salaries are between 20% -30% lower than any other profession as a doctor, engineer or lawyer. " In addition, researchers "only charge per project and in Spain they are scarce."

At the moment, Ana Lluch is immersed in two works financed by the Carlos III Institute, the Ministry of Health and "there are also many supportive people who are helping us with careers, calendars, gifts of communions ...". The objective: to know the biology of breast tumors of young women and to delve into "triple negatives" . In short, the most complicated cases.

Look at the patient

Not only do you have to row in the field of research, but also in teaching and patient care. "I advocate to include a subject of communication with the patient. When the patient comes, he sees a dark tunnel. Our obligation is to light the road. Know your history, explain a road map and look at him or her, not at computer".

We also "would like the waiting time to perform the oncological surgery to be eight to 10 days (for the patient's peace of mind), that the radiotherapy had less delay and that the diagnosis could be made in 24-48 hours. It would be desirable." .

Lluch has been included in the Forbes list of the 100 best doctors in Spain and the ECO Foundation (Excellence and Quality of Oncology) has recognized its contribution in the development of Oncology. But her greatest achievements are her three children, her husband, her patients and, apart from her daily work in the hospital, research and university.

Surprised when in a world of men they said: "It is that you are almost as if you were not a woman" , she encourages everyone to "not give in or stop doing what we believe is important to continue progressing in our work".

You can't deny it, Dr. Lluch is passionate about her work. "I have no other hobbies. This is mine." He leaves his soul and his is vocational. So much so that with 70 years, he says, "I stay as an emeritus professor at the university, I continue to investigate and I continue to see patients, which is what I like the most".

He loves life and giving good news. He gives himself up to accompany his patients in his oncological process and recognizes that everything that happens to him is "thanks to them", who are the ones who teach him every day. For them, neither accepted nor accepted any political office. "I think that patients, apart from their voice, have ours and if ours is silent, we would have nothing to do. It's about fighting, not shutting up."

According to the criteria of The Trust Project

• Science and Health
• Health

Oncology New approach to advanced ovarian cancer

Boticaria García Ibuprofen-drama: why they no longer give you your favorite medication without a prescription

According to the UN, not every three children under five suffer from malnutrition or overweight