“It’s totally different from adults.”

Spain does not have a MIR in pediatric oncology. That is, there is no regulated specialty for this disease, as it does exist for pediatrics on the one hand and for oncology on the other. It is a situation general throughout Europe, with exceptions in Germany or the United Kingdom. “The main problem in childhood cancer is the lack of training: there is no regulated specialty in pediatric oncology, despite the fact that. childhood cancer is totally different from that of adults,” he tells this newspaper. Andrés Morales, welfare director of the Pediatric Cancer Center Barcelona (PCCB), attached to the Hospital Sant Joan de Déu (Esplugues de Llobregat).

Morales puts the spotlight on this reality taking advantage of the fact that these days in Barcelona the Congress of the International Society of Pediatric Oncology. The Minister of Health, Carolina Darias, has visited this very morning the PCCB (which was inaugurated last June) on the occasion of the event. “I want to acknowledge and thank all the healthcare workers who make it possible. We must continue to make progress in screenings that allow for early detection, also in childhood cancer”, said Darias in a press conference after her visit.

“We have been trying for some time now that in Spain there is a specialty in pediatric oncology. Centers such as ours, a reference center, have a formative process -a fellowship with 12 places- after the residency in pediatrics. It lasts three years and serves to train pediatricians in pediatric oncology,” explains Morales. This pediatric oncologist, who was trained in the United States, emphasizes that childhood cancer is a “set of diseases so diverse as to require a specialty.” For example, there are patients with leukemias at two years of age, others with bone tumors at 14, and others with brain tumors or 20. “All of them are patients with very diverse pathologies, who face very specific treatments with high toxicities.”

Carcinomas and developmental tumors.

This physician warns that childhood cancer is “totally different from adult cancer.” “They only have the word cancer in common.” precise. While adult cancers are related to the aging and the living habits (most are “carcinomas”: malignant tumors that form from the epithelial tissue of organs), cancer in children is related to. “developmental tumors”, that is, cancers linked to the “formative process”. “They occur from the age of zero until you finish forming in your early twenties. When you already have your organs matured, you have no chance of getting a developmental cancer,” explains the PCCB’s care director.

For this reason the research must be “specific” and should be carried out in centers such as Sant Joan de Déu. “All the research on adult cancers is of little or no use for childhood cancer,” says Morales. However, there is “much more investment in adult cancers because the prevalence is much higher (pediatric cancer is considered a rare disease) and research is much more developed. A fact that serves to illustrate the incidence between one and the other: worldwide there are about 400,000 cases of childhood cancer per year, while in Spain alone there are 300,000 cases of adult cancer per year.

“In countries like ours we can cure 80% of children. But in developing countries, where 80% of childhood cancers occur, only 20% of children are cured,” warns Morales. Thus, globally, most children with cancer in the world die. “But not because of the disease, but because of their ZIP code. We are in a very privileged context, but this is not the reality for most children. Congresses such as this one highlight the importance of collaboration.” Morales concludes.

Visit of the minister

During her visit to the Hospital Sant Joan de Déu, Minister Darias highlighted the high attendance of the Congress of the International Society of Pediatric Oncology, which has received more than 3,000 participants. Asked by the media about when the reform of the Spanish anti-smoking law (which will prohibit smoking on terraces or inside cars) will be approved, the minister replied that she expects to bring it forward “in this legislature”, but he did not specify dates.

As for the use of masks on public transportation, has stated that Health will continue to listen to its committee of experts and that any measure taken will be based on scientific evidence. At the moment, in Spain they are mandatory in public transport. And, as for the fourth dose of the covid-19 vaccine, which has already begun to be administered in nursing homes, he also said that it will be up to the vaccines committee to decide whether it will be necessary to administer this dose or not. fourth dose to those under 60. At the moment, it is only indicated for those over 60 or under 60 with risk and health factors.