We know this because we can see the molecular alterations of tumors. What we see now is that you can have a breast tumor that may look more like a lung tumor than other breast tumors - it may possibly have to be treated differently than from how a conventional breast tumor is treated. It’s no longer a breast adenocarcinoma, but a breast adenocarcinoma with the presence or absence of hormone receptors, with the presence or absence of alterations in an oncogene such as HER2, and so on. In recent years, we’ve learned to give tumors surnames. So those aren’t the only gendered cancers?Ī. And I’m not merely referring to the fact that there are breast cancers that are overwhelmingly female or prostate cancers that are male. Thanks to that research, we’re beginning to see that there’s a clear gender difference, even within the same tumor. All the research that’s been done since the 1980s began to bear fruit in the 2000s. But in recent years, things have changed a lot. Our patients died after just a year, because, beyond chemotherapy, there wasn’t much that could be done for them. Lung tumors were number one in terms of mortality. I came to my field in the 1990s -, specialists said that we dedicated ourselves to lung cancer because nobody else wanted to do it. This is one of the things that we’ve learned. Certainly, cancer is different in men and women. A few days ago, in a lecture, you said that cancer is different in women and in men.Ī. This isn’t about treating diseases… it’s about treating people who have a disease. That’s the part of this profession that has advanced the most in recent years. Once that’s done, you have to worry about the person. Our job is to be very technical and very professional to make the best diagnosis and choose the best treatment. It’s useless for me to give you a treatment and tell you that it’s going well if your life has changed (for the worse), if you can’t improve, if you have side effects that don’t allow you to have an adequate quality of life. Now, after many years in the profession, I understand this disease from a 360-degree perspective. I believe that, in medicine, you must be serious in your work, but you must also have a very large component of empathy. When I meet someone, in any environment, it’s very common for them to tell me (in so many words): ‘Oh, how sad, the further away from you I am, the better.’”Īnswer. “As it’s such a serious disease, it seems that oncologists have to suffer a lot, that our work must have a lot of emotional impact. Javier de Castro says that the stigma that cancer still carries also clings to the people who treat it. And, when I had to do any kind of project, I did it on cancer.” My path was so clear to me that, during my time at school, I focused on science. You may say, ‘what does a 10-year-old know about cancer?’ Maybe I was influenced by the fact that a friend of mine had acute leukemia at the time. but I knew that was what I wanted to be.”Īt the age of 10, de Castro not only knew that he wanted to dedicate his life to medicine, but he also knew what he wanted to specialize in: “Cancer fascinated me. A specialist in lung cancer - “the one with the highest mortality rate,” he points out - he always knew that what he wanted to do in life was become a doctor and treat cancer. Javier de Castro, 57, is head of Medical Oncology at La Paz University Hospital in Madrid, his hometown.
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