Q: One of INCan’s objectives is applied research. Where are you investing your efforts in this area?

A: INCan performs both basic and clinical research. A few years ago, we started the practice of translational research to benefit patients. It is designed to go from the lab to the hospital bed and research is applied from the prevention to the palliative care stages. Soon we’ll also apply it to cancer survivors and our goal on the clinical side will be to obtain molecular and genetic responses and also best practices, while also gathering patient success stories related to the different treatment protocols and clinical stages.

We are focusing prevention research on populations suffering from hereditary cancers, such as malignant breast, ovarian, endometrial, colon and prostate tumors. Close to 10 percent of patients suffering from these have genetic mutations that aid tumor development. We have centralized genetic studies of the patients’ families for early detection and diagnoses of the asymptomatic relatives carrying the gene mutation that predisposes them to develop one of these tumors. Close to 90 percent of our patients suffer from breast, ovarian or colon cancer and in each of these patient’s families we have encountered three or four relatives at high risk of developing malignant tumors, known as asymptomatic carriers. We have started a hereditary and family cancer clinic to study people at high risk of carrying a genetic mutation and their relatives to provide them with genetic advice, follow-up and possibly diagnose them at an early stage.

Q: What are the needs of the Mexican population and how can we reduce mortality?

A: Developed countries have reduced the incidence of advanced cancer and of certain types of tumors. This is not happening in developing countries where cancer cases and mortality are on the rise. INCan took the lead in developing the Mexico Cancer Prevention and Control Program (PIPCCM), an integral part of which is the creation of cancer registries that are based on population and strategically located. It also promotes lifestyle, education and awareness to diminish exposure to risk factors.

Q: With Seguro Popular, 36 percent of the population is entitled to medical care, including for cancer. How have detection indicators increased and what states are the most afflicted?

A: Primary and secondary prevention efforts to reduce exposure to risk factors, such as high-calorie diets, adopting a healthier lifestyle, stopping smoking and exercise, do not happen overnight. Similarly, increasing early detection indexes for malignant tumors susceptible to early diagnosis takes considerable time and commitment. Both primary and secondary prevention require at least two decades of constant application to see results in the population.

Catastrophic coverage of neoplastic disease within the Seguro Popular has been available for about 10 years for breast and cervical cancer and for close to five years for testicular, prostate, colon and ovarian cancer and non-Hodgkin lymphoma. This is too little time to have measured relevant results.

Of all deaths in Mexico, about 13.7 percent are due to cancer. Every year 190,000 new cancer cases are diagnosed and mortality rates are around 60 percent. The most frequent malignant tumors are breast, prostate, cervical, colon, lymphoma and lung related. Malignant tumors show regional patterns in Mexico’s 32 states depending on sex, age, socioeconomic status, exposure to risk factors and lifestyles.

Generally speaking, there is a higher number of cases in the country’s north, with greater incidence of breast, prostate, colon, lung cancer and lymphoma. In the south, we have breast, cervical, gastric and liver cancer, with a higher mortality because of the advanced stages they are usually diagnosed at and the lesser access to healthcare.

Q: Which preventive measures can Mexicans implement in their daily lives to reduce the chance of falling victim to cancer?

A: There are several things people can and should do to reduce their chances of catching a chronic, non contagiousdisease such as cardiovascular afflictions, diabetes and some types of cancer. It is possible to prevent around 40 to 50 percent of malignant tumors if we adopt healthier lifestyles and remember to do detection studies. There are risk factors heavily linked to cancer, such as tobacco intake, high-calorie diets leading to obesity, heavy intake of sugary drinks and alcohol, lack of exercise, exposure to human papilloma virus (HPV) and Hepatitis B and C, high exposure to sunlight and UV rays and carcinogens in the environment and workplace.

Q: What other programs have been put in place to educate the population?

A: Together with civil organizations, some state governments and members of the chambers of deputies and senators, INCan has adopted specific programs for the diffusion of knowledge on breast, colon, stomach and lung cancer, as well as leukemia. Through these activities we seek to disseminate the concept of high-quality care, early adequate and effective treatment and the enhancement of palliative and rehabilitative care. INCan also has a permanent information program on tumors called Infocáncer.

This program has been much consulted and not only have patients and their families been able to obtain information but so have those who want to learn more on different malignant tumors, their behavior and treatment options.

Q: Having a preventive approach not only improves recovery chances of the patient but also has a lesser impact on public spending. What support has INCan received from the Health Minister to promote a preventive culture?

A: Fiscal and physical resources are engaged for the year on operation and investment plans. Nonetheless, through special programs INCan staff is able to manage resources for capacitation, diffusion, rehabilitation and research for the prevention and treatment of malignant tumors, specifically for breast, cervical, ovarian and lung cancer, HIV/AIDS and hereditary cancer. INCan also participates in breast and cervical/uterine cancer prevention programs with the Health Ministry.

Q: What are INCan’s future projects?

A: The National Institute of Cancer will continue to promote prevention programs that encourage lifestyle changes and the empowerment of cancer survivors to change the perception that cancer equals death and replace it with success stories. We will also promote the “Integral Program to Prevent and Control Cancer in Mexico” and develop three more population-based cancer registries in Guadalajara, Monterrey and Puebla, in addition to the existing one in Merida. 

We will generate research from the tumor bank INCan has developed over the past few years, which has preserved over 6,500 fabric samples of different types of tumors and over 9,000 samples of plasma for the purpose of researching biomarkers and to use the fabric in collaborative national or international research projects. The main objective of the INCan tumor bank is to create a platform for oncological research, preserving tumor fabric in an optimal condition and when conditions permit, we conserve the fabric of a recurring tumor. Even so, active participants in malignancy projects such as the breast cancer project are most often young women. The INCan tumor bank is supporting 10 translational medicine and clinical research projects. It also is participating in international projects such as the Regional Center for Research of Excellence and Non-Transmissible Diseases.

Within senior management’s program and with the finality of strengthening the culture of prevention, we will continue to undertake activities such as the Cancerton and to implement early diagnosis opportunities for the main tumor types in various Mexican states.

The road is long and ambitious but we want to change from being a reactive country to cancer, to a country with a preventive culture.