Berichte Über HC

We welcome Dr. Teresa Moreno Ramos to the HC Marbella team.
[Weiterlesen]

El cáncer de pulmón es junto al cáncer de mama y cáncer de colon uno de los tumores con mayor prevalencia y por tanto supone un reto en el manejo terapéutico, así como una constante búsqueda de estrategias diagnósticas con el fin de mejorar las tasas de curación.

El tabaco es el mayor factor de riesgo.

De entre las causas sabemos que el tabaco ha sido y sigue siendo un problema fundamental en el desarrollo de esta enfermedad, por ello es importante buscar modos de deshabituación que nos ayuden a disminuir la incidencia del cáncer de pulmón y otros tumores que también se relacionan con el mismo.

Los tratamientos contra el cáncer de pulmón

Al enfrentarnos al cáncer de pulmón, sabemos que en los estadios iniciales elegimos el tratamiento quirúrgico como pilar fundamental para lograr la curación, y en función del estadio aplicaremos un tratamiento adyuvante o complementario con quimioterapia que permitirá conseguir mejoría en la supervivencia de esta enfermedad.

Por otra parte, en los últimos años, en el mundo de la oncología se han ido desarrollando fármacos con una perspectiva en el mecanismo de actuación frente al tumor muy diferente al tradicional. Si clásicamente la principal arma de la que disponíamos para el tratamiento en los estadios localmente avanzados no candidatos a cirugía o avanzados era la quimioterapia sola o en combinación con radioterapia en función del tipo de tumor y estadio, en la actualidad además contamos con un arsenal terapéutico basado en fármacos que son capaces de actuar sobre la respuesta inmunitaria y que sea nuestro propio organismo el que luche contra el tumor.

El poder de nuestro sistema inmunitario

La inmunoterapia supone un avance en el tratamiento del cáncer, incluido el cáncer de pulmón, consiguiendo modificar el pronóstico y la calidad de vida de los pacientes, entre otras cuestiones por el hecho de mejorar la supervivencia asociado a un cambio en los efectos secundarios que son tan temidos en ocasiones con la quimioterapia.

Dentro de los fármacos en inmunoterapia destacaríamos:

• anticuerpos monoclonales que interaccionan contra reguladores de la respuesta inmunitaria como los inhibidores que bloquean CTLA-4, cuyo uso permite incrementar la actividad del sistema inmunitario contra el tumor.

 

• fármacos dirigidos anti PD-1 y PD-L1 que van a conseguir que el tumor no evada la respuesta inmune que se ejerce contra él y por tanto van a facilitar la destrucción de la célula tumoral.

La inmunoterapia mejora la supervivencia y la calidad de vida de los pacientes.

En la actualidad disponemos de distintos ensayos clínicos que han demostrado que la inmunoterapia, en ocasiones sola y en otras ocasiones combinada con quimioterapia, mejora la supervivencia y además con un perfil de toxicidad para la inmunoterapia muy favorable si lo comparamos con los efectos secundarios de la quimioterapia.

Por tanto, podemos estar ante una era de cambio en las estrategias de tratamiento del cáncer, ya que la inmunoterapia no solo ha demostrado su beneficio en el cáncer de pulmón, sino que son muchos los tumores que se benefician de la misma consiguiendo una mejor supervivencia y calidad de vida de los pacientes.

En HC Cancer Center contamos con tratamientos de inmunoterapia como parte del tratamiento multidisciplinar que ofrecemos al paciente, con el fin de brindarle el mejor tratamiento para su tipo de cáncer. Todo el un mismo sitio y con las mismas caras.

Dr. Victor Navarro
Especialista en Oncología médica.

November is the month dedicated to men’s health awareness, a movement known as movember

In Spain, prostate cancer is the most frequent tumor diagnosed in men according to the cancer figures for the previous year. In Europe, it is estimated that prostate cancer causes up to 7% of cancer deaths in men.

Localized prostate cancer is radically treated with local therapy, generally surgery and / or radiation therapy, while advanced / metastatic prostate cancer is treated with hormone therapy, chemotherapy, and / or targeted therapies, requiring radiation therapy in some cases to alleviate symptoms or improve. local control.

Radiation therapy is an essential treatment for the multidisciplinary management of this tumor.

This treatment has been gaining importance over the years as it presents excellent disease control figures, comparable to surgical treatment1, with the advantage of being a non-invasive treatment.

The prevalence of prostate cancer reaches almost 60% in men> 80 years. In this more fragile population of patients, the ideal is to be able to count on a treatment that avoids the patient having to undergo surgery with the risks that this may entail.

Radiation therapy is given with curative intent:

• In patients with localized tumor, either low, intermediate or high risk.
• In higher risk patients. Association with hormonal treatment is required for not only local control but also systemic control of the disease.
• In patients who after surgery have micro-disease or certain risk factors. The trend now in some of these patients is to actively monitor the possible recurrence / relapse of the disease, and if it occurs, treat the patient with early rescue radiotherapy 2,3

Radiation therapy to alleviate the symptoms of the disease

• In those patients in whom the disease is more advanced, radiotherapy can improve the symptoms derived from the disease, such as pain.
• Prostate cancer tends to have a predilection for bones, which is why metastases are usually located at the level of the bones of the spine and pelvis. Radiotherapy achieves an improvement in pain of up to 70% ⁴.
• When dissemination is limited, radical intention treatment can also be performed at the affected site / locations.

In summary, radiotherapy treatment is a fundamental part that can be offered in the different stages of the disease and always with a high level of evidence.

HC radiation therapy in prostate cancer:

Improve survival figures:

• The treatment of prostate cancer with tomotherapy achieves excellent control of the disease, reaching 5-year relapse-free survival rates of up to 98.9% without associating severe acute toxicity ⁵.

• In patients at higher risk (high or very high risk) after treatment with tomotherapy together with hormonal therapy, a relapse-free survival at 5 years is observed between 91-99%. Furthermore, tolerance to treatment was good, with 10% or less of the patients presenting long-term moderate-severe genitourinary or gastrointestinal side effects ⁶.

Radiotherapy that follows the tumor

• The prostate moves up to 12-15mm due to changes in the volume of the bladder or rectum (the organs next to it). Other more conventional radiotherapy systems do not detect this movement, with the risk of not treating the entire area well or of having to widen margins and therefore increase the volume that will receive radiotherapy.
• Our radiotherapy has a tracking system known as Synchrony, capable of following the movement of the tumor in real time during each radiation session.
• This is achieved after the placement of fiducials inside the prostate, which the system is capable of tracking and thus administering the treatment with high precision.
• This precision is ideal for those extreme hypofractionation treatments (SBRT) that manage to eliminate the disease with less treatment sessions^7,8.

Movember is here, join this movement of the hand of the most precise radiotherapy.

Learn about the new radiotherapy of HC Cancer Center

Reference:

1. Hamdy F.C, Donovan J.L, Lane J.A, et al. 10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer. N Engl J Med. 2016 Oct 13;375(15):1415-1424.
2. Parker C.c, Clarke N.W, Cook A.D, et al.Timing of Radiotherapy after Radical Prostatectomy (RADICALS-RT): a randomized, controlled phase 3 trial. Lancet 2020.
3. Kneebone a, Fraser-Browne C, Duchesne G, et al. Adjuvant radiotherapy versus early salvage radiotherapy following radical prostatectomy (TROG 08.03/ANZUP RAVES): a randomised, controlled, phase 3, non-inferiority trial. Lancet Oncol 2020; 21: 1331-40.
4. Spencer K, Parrish R, Barton R, et al. Palliative Radiotherapy. BMJ 2018;360:k821
5. Takakysagi Y, Kawamura H, Okamoto M. Long-term outcome of hypofractionated intensity-modulated radiotherapy using TomoTherapy for localized prostate cancer: A retrospective study. PLoS One. 2019 Feb 26;14(2):e 0211370.
6. Tomita N, Soga N, Hayashi N, et al. High-dose radiotherapy with helical tomotherapy and long-term androgen deprivation therapy for prostate cancer: 5-year outcomes. J Cancer Res Clin Oncol. 2016 Jul;142(7):1609-19.
7. Meier, R., Beckman, A., Henning, G., Mohideen, N., Woodhouse, S. A., Cotrutz, C. & Kaplan, I. D. (2016). Five-Year Outcomes From a Multicenter Trial of Stereotactic Body Radiation Therapy for Low- and Intermediate-Risk Prostate Cancer. Int J Radiat Oncol Biol Phys, 96(2), S33-S34.
8. Kishan, A. U., Katz, A. J., Mantz, C., Chu, F.-I., Appelbaum, L., Loblaw, A., Cheung, P., Kaplan, I. D., Fuller, D. B., Pham, H. T., Meier, R., Buyyounouski, M. K., Shaverdian, N., Dang, A., Yuan, Y., Bagshaw, H., Prionas, N., Kupelian, P., Steinberg, M. L. & King, C. R. (2018). Long-term outcomes of stereotactic body radiotherapy for low- and intermediate-risk prostate adenocarcinoma: A multi-institutional consortium study. Journal of Clinical Oncology, 36(6_suppl), 84-84.

 
 

Dr. Paula Sedano Ferreras
Radiotherapy doctor
 

Día de la oncología radioterápica.

La radioterapia es uno de los pilares en el tratamiento del cáncer. Aproximadamente entre un 60% y un 70% de los pacientes oncológicos recibirán radioterapia durante el proceso de su enfermedad.

El tratamiento de radioterapia es un proceso muy laborioso, casi un baile sincronizado donde físicos, médicos y técnicos ensayan y preparan milimétricamente cada paso para que el haz de radiación incida de manera precisa en el volumen a tratar.

Actualmente contamos con una tecnología muy avanzada que en manos de un equipo humano altamente cualificado administra tratamientos eficaces y seguros. Pero para llegar hasta aquí ha habido un largo camino que otros iniciaron y a los que les debemos estos grandes avances.

[Weiterlesen]

La alcaldesa, Ángeles Muñoz, ha visitado esta mañana las obras de ampliación del nuevo centro oncológico de HC Marbella que albergará la Unidad de Radioterapia innovadora. [Weiterlesen]

October is the month dedicated to the fight and prevention of breast cancer, although for us the fight and awareness against this disease is every day of the year.

Breast cancer is the most common in women in both developed and developing countries. [Weiterlesen]

Thanks to this technique, a 3D mammography scan can be performed and the entire breast can be seen in a three-dimensional way, as if it were a CT scan. [Weiterlesen]

3 Schritte, die Leben retten.

Oktober ist der Monat des Kampfes gegen Brustkrebs. In HC Marbella möchten wir alle Frauen dazu ermutigen, diese  Untersuchung in ihre alltägliche Rutine zu integrieren, denn dies ist ein Maßnahme für die Früherkennung von Brustkrebs, die Leben retten kann. Unsere Brustkrebs Spezialiste a HC Marbella beantworten Ihre Fragen zur Brustuntersuchung.

[Weiterlesen]

Every year on this day we find ourselves reminding everyone how important it is to keep our heart strong. We talk about healthy food, physical exercise, stress reduction and the importance of smoking cessation.

However, 2020 is a special year, with all our interest and focus turned towards the COVID-19 pandemia, and indeed, cardiac patients are at higher risk for more severe infection and also long term side effects affecting the heart after acute disease. But the biggest impact of COVID-19 on our hearts has been the avoidance of medical attention out of fear of infection.

So we use the international heart day to remind everyone that we need a healthy heart to stay healthy! Your cardiac symptoms can’t wait for the new COVID-vaccine, and should anyone experience any symptoms, do not wait until you get a heart attack, don’t exhaust your heart with the wrong heart beat, see a cardiologist and get your heart fixed in time. This will save your life and help you stay strong fighting COVID!

Dr. Manuela Reisbeck

CardioCare International Heart Center at HC Marbella International Hospital

Shoulder anatomy and dislocation

The shoulder is the most mobile joint in our body. It consists of a ball known as the humeral head and a socket known as the glenoid. The high mobility of the shoulder requires a very shallow socket (glenoid). Around the socket there is a bumper (cartilage rim) called labrum which, together with a series of ligaments connecting the ball to the socket, prevent the ball slipping out of joint. These are called static stabilisers of the shoulder joint. On top of these structures there are four muscles called the rotator cuff connecting the scapula (shoulder blade) with the humerus (arm bone) and dynamically stabilising the shoulder when they contract. When the shoulder dislocates the traumatic force overcomes the blocking effect of the stabilisers and the labrum and ligaments can tear if the patient is young. Sometimes the rotator cuff muscles can tear if you are over 40 years of age. The shoulder can dislocate anteriorly (more common) or posteriorly. Shoulder dislocation is an emergency and requires urgent relocation under anaesthesia followed by a sling for 2 weeks and physiotherapy. A clinical examination by a specialised shoulder surgeon is recommended for active patients involved in sports activity.

[Weiterlesen]

Our genes may increase the risk of developing certain types of cancer, such as breast, ovary, colorectal, and prostate cancers. If you have any relatives who have been diagnosed with cancer, the oncologists at HC Marbella, experts in genetics, can help you learn more about the risk of developing a determined cancer. At HC we offer you a genetic assessment with specific genetic tests for different types of cancer, in order to help you make important decisions.

[Weiterlesen]