SEOM diagnosis: "Tumor biomarkers by you and for you"

“Molecular diagnoses by means of massive sequencing (NGS), tumor biomarkers in oncology, are the true protagonists of the revolution that we are experiencing in cancer treatments”, they report from the Spanish Society of Medical Oncology (SEOM).

SEOM diagnosis: “Tumor biomarkers by you and for you”

Its two scientific secretaries, doctors Isabel Echavarría Díaz-Guardamino, medical oncologist at the Hospital General Universitario Gregorio Marañón, and Mónica Granja Ortega, medical oncologist at the Hospital Clínico Universitario San Carlos, highlight this great clinical and molecular advance in “SEOM Diagnosis”.

Precision oncology, which allows the specialist to make personalized decisions during all phases of treatment, is achieving data never seen before.

For example, survivals greater than five years in patients with lung cancer; and in some mutations, these values ​​are even exceeded in 50% of cases.

For countries like Spain, in 2022, a total of 280,101 new cases of cancer (160,066 in men and 120,035 in women) compared to 276,239 in 2021.

The most frequent cancers will be those of the colon and rectum (43,370), breast (34,750), lung (30,948), prostate (30,884), urinary bladder (22,295), non-Hodgkin’s lymphomas (9,514), pancreas (9,252), kidney (8,078 ), oral cavity and pharynx (7,779), stomach (6,773) and liver (6,604).

In men, prostate cancer (30,884), colon and rectum (26,862), lung (22,316) and urinary bladder (17,992) will be diagnosed; while in women those of the breast (34,750), colon and rectum (16,508) and lung (8,632).

Calculations made by the Spanish Network of Cancer Registries (REDECAN).

“To the continuous increase in new cases, we must add the impact of the delay of other undiagnosed cases during the different waves caused by the COVID-19 pandemic,” they point out from the SEOM.

What are tumor biomarkers and how are they obtained?

Biomarkers are tumor-specific molecules, whether they are abnormal proteins or mutated genes, that allow tumors to be subdivided and classified, even within the same location, in biologically different diseases, as may occur in patients with lung cancer or breast cancer. Dr. Ortega Farm

But you always have to get a sample of tumor tissue first, usually through a biopsy or blood sample for DNA extraction.

These samples will be sent to the corresponding laboratory, where they will be analyzed using specific staining techniques and visualized under a microscope, or molecular tests will be carried out to determine the gene or genes involved.

In addition, these biomarkers make it possible to group patients with tumors that behave in a similar way and, from the perspective of analysis, guide cancer treatments much better.

Specialists have two types of biomarkers: predictions and forecasts.

Predictive biomarkers are those that inform us about the probability of response to a specific treatment, and, therefore, allow us to guide treatment. These predictive biomarkers are what make precision medicine possible.

For their part, prognostic biomarkers are those that inform us about the evolution of the disease, and in particular, offer us more precise information about the expected survival for our patients, depending on their presence or not.

A present with a future of biomarkers “for everyone”

The tumors most likely to be treated in precision oncology are lung, breast, colorectal, gastric or cervical cancers. prostateso it is essential to share knowledge among all research groups so that the benefits quickly reach each and every one of the cancer patients. Doctor Echavarría Díaz-Guardamino

In relation to tumor biomarkers, the Spanish Ministry of Health reports that it is working, together with the Autonomous Communities, the scientific societies and the Carlos III Health Institute of Madrid, on the specification and updating of the common portfolio of services in the area of ​​genetics.

Currently, a group of experts is preparing the corresponding catalogue, as well as its updating procedure, including the area of ​​oncological biomarkers.

The planned objective will effectively and homogeneously implement precision medicine in the National Health System (SNS), guaranteeing the excellence of the provision and equity in its access to all people in the national territory.

From the SEOM, underline its scientific secretaries, a true revolution in oncology is verified by the hand of Precision Medicine.

This has been possible thanks to an ever deeper understanding of the biology of cancer through the identification of biomarkers, systematic molecular analyzes that condition the individuality of targeted treatments.

In this sense, the Spanish Society of Medical Oncology invites us to share this video:

Tumor Biomarkers

A comprehensive diagnosis of viral hepatitis with a single test

A group of experts has agreed on a document with an algorithm for the comprehensive diagnosis of viral hepatitis from an analytical extraction. Additional recommendations are established for patients with this pathology

Early diagnosis of hepatitis is key to patient survival. EFE.

The Spanish Society of Digestive Pathology (SEPD), the Spanish Association for the Study of the Liver (AEEH), the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and its Viral Hepatitis Study Group (GEHEP), with the endorsement of the Alliance for the Elimination of Viral Hepatitis in Spain (AEHVE) have joined forces to achieve a comprehensive diagnosis of viral hepatitis (B, C and D), from a single analytical extraction.

This document, called “Recommendations for the comprehensive diagnosis of chronic viral hepatitis in a single analytical extraction”, has the objective of facilitating the recognition of the disease and its treatment.

For this, the scientific committees establish an algorithm so that the positive result in antibodies against the hepatitis viruses (B, C and D) and the human immunodeficiency virus (HIV) activates the analysis of the rest of the virus from the same serological sample.

Operation of comprehensive diagnosis for viral hepatitis. Image courtesy of the AEEH.

Follow-up of the subsequent disease will be adapted to each patient and the characteristics of their condition.

The study includes two additional recommendations for patients. First, the need to rule out a previous infection with the hepatitis A virus (HAV). And then proceed with vaccination in cases where the antibodies against this virus are negative and where the vaccine is indicated.

Second, the practice of a serology of antibodies against HIV. Later, if the result is positive, epidemiological monitoring must be activated and the primary care physician or the requesting physician must be informed.

Likewise, guidelines for the diagnosis and general measures for patients with hepatitis B, C and D and patients with other chronic viral hepatitis are mentioned.

Advantages of the agreement

Experts agree that it is essential:

• The inclusion of results in the patient’s clinical history
• The integration of screening programs to detect the disease early
• The creation of prevention and awareness programs for professionals and citizens
• The implementation of an automated alert system for health personnel

Specialists believe that these measures will simplify the diagnostic cascade by limiting it to a single blood draw, reduce the number of visits to the medical center, faster diagnosis and access to more effective treatment.

A Scientific Committee has been involved in its preparation together with a Panel of Experts in gastroenterology and hepatology, infectious diseases, internal medicine, and microbiology.

A public health problem

Hepatitis is a disease that causes inflammation of the liver due to a virus (viral); drug, alcohol, or medication use, or a dysfunction of the immune system that causes the immune system to attack liver cells.

The diagnosis of this viral condition continues to be a challenge for public health because many people are unaware that they have the disease.

For this reason, the World Health Organization establishes as priorities to reduce new cases of infection by 90% and deaths by 65% ​​by 2030.

The documentreleased by the organizations that have promoted it, points out that the comprehensive diagnosis of viral hepatitis in a single extraction linked to treatment is “vital” to achieve the objective set by the WHO.

How to act before a diagnosis of dementia at home?

A diagnosis of dementia has a great impact on the family. After receiving it, it is important to learn to care for both the affected family member and oneself

A health worker with a mask holds the hand of a resident of an Alzheimer’s home in Pitkovice, Czech Republic. EFE/EPA/MARTIN DIVISEK

Some 50 million people live with a diagnosis of dementia in the world and every year about 10 million new cases are registered, underlines the World Health Organization (WHO). In fact, this entity forecasts that there will be 82 million people with dementia in 2030 and 152 million in 2050.

It is the elderly who mainly suffer from dementia. However, it is not an inevitable consequence of aging because “many older adults live their entire lives without presenting dementia”, emphasize specialists from the United States Centers for Disease Control and Prevention (CDC).

Alzheimer’s, the most common dementia

Alzheimer’s disease is the most common form of dementia diagnosis, accounting for 60-70% of cases. However, there are more types of dementia such as vascular dementia or Lewy body dementia, among others.

“Dementia affects memory, thinking, orientation, comprehension, calculation, learning ability, language and judgment. Impairment of cognitive function is often accompanied, and sometimes preceded, by impairment of emotional control, social behavior, or motivation.

World Health Organization

In this sense, it specifies that the first symptoms are usually the tendency to forget things, the loss of the notion of time and spatial dislocation, even in familiar places.

Nicolasa Santiago, a 74-year-old Zapotec indigenous woman who suffers from Alzheimer’s. EFE/ Daniel Ricardez

Nowadays There is no treatment that can cure dementia or reverse its progression. However, there are different interventions to facilitate the day-to-day life of people with dementia, which is why it is important to diagnose it early.

“Receiving a diagnosis of dementia is news that causes a great impact on the affected family. A wide variety of emotions and reactions can arise; Among the first, there is usually concern and insecurity due to ignorance of the new situation that arises. There may also be feelings of anguish at the thought that they will not be able to cope,” he says. Beatriz Canseco de la Rosa, psychologist at Accountants Room Center.

“On some occasions, especially when there is an early diagnosis, confusion and confusion appear, and they even minimize the symptoms and deny the seriousness of the problem. On the other hand, in others, the family feels calm when putting a name to what happens to their relative”.

Add the psychologist.

The specialist emphasizes that in order to assume the diagnosis it is necessary to know the disease. This involves learning about your symptoms and how they are progressing.

“It can be very helpful to contact people who are going through the same situation, as well as going to an association to learn strategies that help manage daily situations in relation to living together and caring for the affected family member,” he says.

Changes in routines, roles and some tips

Likewise, Canseco emphasizes that the new situation implies changes in routines, roles and functions within the family environment.

“The family will have to face the changes and alterations in the behavior and reactions of the affected loved one, in addition to modifying the care and communication guidelines throughout the process.”

Expresses the expert Canseco de la Rosa.

In this sense, the psychologist reminds that the progressive evolution of the disease will worsen the symptoms and the person will require more attention and dedication.

As he explains, for the family, “The most difficult changes to accept are those related to behavior and personality, as well as delusional reactions and behaviors due to episodes of memory loss. In addition, it is difficult to face that the family member will lose their faculties and abilities, ceasing to be themselves”, he adds.

Stock image of old people in a park. EFE/JL Cereijido

For all this, the psychologist offers some advice for caregivers of a person diagnosed with dementia.

1. Try to preserve the autonomy of the affected person in the activities that he is still capable of carrying out on his own.

“You have to adapt the necessary help to their limitations and avoid overprotective attitudes. For this, it is beneficial to establish a daily routine, simplify the instructions and enable the spaces”, he points out.

2. Stimulate the person with dementia with cognitive and leisure activities that are within their reach.

3. Involve the affected family member in the conversations and keep them informed of events to avoid isolation and disconnection with the environment.

“You must not speak for him or speak of him as if he were not present,” he warns.

4. Family members must adopt a flexible, patient and warm attitude towards the affected person.

“When they address the patient, they should use simple language with short sentences and easy-to-understand questions. They have to repeat the information with the same words and make use of non-verbal communication”, he details.

5. In addition, it is very important that family members know how to take care of themselves.

To do this, the expert recalls that there must be unity and cooperation between them.

“They have to be able to ask for help, seek support or delegate some functions among family members. It is necessary that they give themselves time, take care of their rest and preserve their social relationships”.

Concludes Beatriz Canseco de la Rosa.