¿Ha aumentado la incidencia del cáncer en el mundo?

WEBVTT

1
00:00:01.080 --> 00:00:06.599
The day to day is full of
urgent news, noise, polemics and fanfare.

2
00:00:06.599 --> 00:00:11.240
But for the quiet, the analysis
and what we like to call slow

3
00:00:11.439 --> 00:00:18.719
- cooking journalism are my questions.
A half- hurry program made by KFAM

4
00:00:19.079 --> 00:00:32.280
inspiring smiles. It is predicted that
by two thousand and fifty cancer cases will

5
00:00:32.320 --> 00:00:37.479
increase by seventy- seven percent.
Finding a cure for this disease seems to

6
00:00:37.560 --> 00:00:41.840
be the cause of the human species. What are the treatments that exist today,

7
00:00:41.960 --> 00:00:47.159
why we have not been able to
find a cure for this chapter.

8
00:00:47.479 --> 00:00:54.479
We spoke with radiologist Germán Arango,
with former Health Minister Alejandro Gaviria. Rafael

9
00:00:54.560 --> 00:01:00.560
Sánchez Paris, Executive Director of the
Center for Cancer Treatment and Research, Scarlos

10
00:01:00.600 --> 00:01:06.719
Sarmiento Angulo and Lina María Trujillo,
Deputy Director of Medical Care and Teaching at

11
00:01:06.760 --> 00:01:11.840
the National Cancer Institute. I am
Roberto Pombo and this is chapter seventy-

12
00:01:12.000 --> 00:01:19.359
eight of my questions. Welcome.
The human has taken all his history,

13
00:01:19.840 --> 00:01:25.760
understanding himself, the world around him
and the connection between all. Since the

14
00:01:25.879 --> 00:01:30.799
arbors of our conscience, we have
asked ourselves questions and it was not enough

15
00:01:30.879 --> 00:01:34.040
for us to be bipeds and to
have opposable thumbs. We have explored the

16
00:01:34.439 --> 00:01:38.840
world all its seas and depths,
volcanoes and its wild force and glaciers,

17
00:01:40.120 --> 00:01:47.519
jungle deserts. We study every species
with which we share the planet at some

18
00:01:47.599 --> 00:01:49.239
point in history. It wasn'
t enough for us what was around us.

19
00:01:49.760 --> 00:01:55.599
Then we looked up and looked for
explanations to what was beyond our reach

20
00:01:55.640 --> 00:02:00.920
at the time. So someone once
created a device to find out what those

21
00:02:00.040 --> 00:02:05.920
lights were all about, shining in
what we call heaven. We saw them

22
00:02:06.000 --> 00:02:10.800
moving at a pace we could predict. Then we gave them names, finding

23
00:02:10.840 --> 00:02:15.199
their characteristics. We realized our place
in the Universe, the immensity and infinity,

24
00:02:16.000 --> 00:02:23.000
of what was beyond the earth.
We have found explanations for the universe,

25
00:02:23.319 --> 00:02:28.879
its galaxies, black holes, nebulae
and stars. All that wasn'

26
00:02:29.000 --> 00:02:31.280
t enough for us. And just
as someone created a telescope to see and

27
00:02:31.360 --> 00:02:37.439
understand what was at distances and times
almost impossible to reach. Someone created a

28
00:02:37.479 --> 00:02:43.840
microscope to see what was inside us. So we did the same thing at

29
00:02:43.840 --> 00:02:46.159
quantum level, that is, not
outwards, but inwards, at the level

30
00:02:46.159 --> 00:02:52.560
of molecules and atoms. At one
point we said that that was the limit

31
00:02:52.560 --> 00:02:55.599
point, which was indivisible, the
micro thing that existed. However, as

32
00:02:55.840 --> 00:03:00.080
it seems, custom was temporary to
and someone else discovered that it could be

33
00:03:00.159 --> 00:03:07.159
seen beyond the atom and later divided
it. I am dazzled to see the

34
00:03:07.199 --> 00:03:09.960
level of knowledge we have acquired as
a species. It will seem that there

35
00:03:10.039 --> 00:03:15.120
is nothing impossible for this wonderful species
that we are, with its lights and

36
00:03:15.120 --> 00:03:19.000
shadows. And although out there,
in space so far and on a macro

37
00:03:19.120 --> 00:03:23.879
scale, there are aspects that seem
to overcome us and determine our existence,

38
00:03:24.080 --> 00:03:30.120
although around us there are depths and
elements that threaten our existence. It is

39
00:03:30.199 --> 00:03:34.479
at the atomic level within us that
there is a phenomenon that owns our fears

40
00:03:34.560 --> 00:03:42.560
and that today is a threat to
humanity, cancer cells. Cancer is not

41
00:03:42.599 --> 00:03:46.560
something new. Human beings and other
animals have had cancer throughout history and there

42
00:03:46.599 --> 00:03:53.599
are records of that disease in fossils
and most holy scriptures. Some of the

43
00:03:53.680 --> 00:03:59.159
first cancer tests are among fossilized bone
tumors, human mummies from ancient Egypt,

44
00:03:59.520 --> 00:04:05.120
and ancient manuscripts. For example,
mummies have been found with growths that suggest

45
00:04:05.199 --> 00:04:13.240
bone cancer called hostium sarcoma. The
oldest description you have did not include the

46
00:04:13.280 --> 00:04:16.800
word cancer was discovered in Egypt and
dates back to the year three thousand BC,

47
00:04:16.959 --> 00:04:21.800
in a papyrus known as Papyrus Edwin
Smith, which is part of a

48
00:04:21.920 --> 00:04:27.879
book on trauma surgery and is said
to be the first surgical treatise in history.

49
00:04:29.959 --> 00:04:34.920
This document describes eight cases of breast
tumors or ulcers that were removed by

50
00:04:35.000 --> 00:04:42.639
cauterization with a tool called a fire
drill. The paper says about the disease

51
00:04:43.240 --> 00:04:47.160
there is no treatment. It was
not until the 19th century, when the

52
00:04:47.160 --> 00:04:53.240
anesthesia appeared that the first surgeries were
performed to remove some types of cancer.

53
00:04:53.839 --> 00:04:57.800
But, even though this disease has
shared so much time with humans, understanding

54
00:04:57.800 --> 00:05:02.079
it has not been easy. One
of the many statements that have been made

55
00:05:02.120 --> 00:05:08.800
on the subject is that we all
have cancer cells, but that' s

56
00:05:08.920 --> 00:05:13.959
how we go about parts. This
disease arises from random genetic changes, called

57
00:05:14.040 --> 00:05:20.079
mutations within healthy cells acquired over time. These mutations can occur for several reasons,

58
00:05:20.240 --> 00:05:25.839
such as lifestyle choices, family predispositions, long- term existing health conditions,

59
00:05:26.040 --> 00:05:32.279
or even exposing hazardous chemicals. As
mutated cells build up, they become

60
00:05:32.360 --> 00:05:40.000
cancerous. A cell that is able
to grow without control accumulates errors in its

61
00:05:40.079 --> 00:05:46.199
DNA code, which makes a gene
or set of genes malfunction. If the

62
00:05:46.279 --> 00:05:50.480
cell also loses certain safety mechanisms this
pushes it toward cancer. In other words,

63
00:05:51.199 --> 00:05:56.879
several factors need to come together to
make a cell cancerous. And any

64
00:05:57.000 --> 00:06:00.600
cell in the body has the potential
to do so. It can be divided

65
00:06:01.040 --> 00:06:06.160
if it accumulates errors with certain genes
and if these failures cause it to grow

66
00:06:06.160 --> 00:06:12.519
out of control. According to doctors
Hugur Shain and Oslem Duressi, founders of

67
00:06:12.519 --> 00:06:16.839
the biotechnology company Biontech, these random
genetic changes that occur in cancer cells arise

68
00:06:16.920 --> 00:06:24.120
two implications. The first is that
each cancer is as unique as the individual

69
00:06:24.160 --> 00:06:28.199
it affects, that is, that
even those people who are diagnosed with the

70
00:06:28.279 --> 00:06:33.680
same type of cancer have only a
fraction of shared mutations. And the second

71
00:06:33.759 --> 00:06:39.480
implication is that each tumor is a
intricate tapestry of billions of different cells that

72
00:06:39.480 --> 00:06:45.279
constantly learn to adapt, to evade
the immune system and to resist the therapeutic

73
00:06:45.319 --> 00:06:50.240
strategies that medicine and technology has investigated
And it is that possible cures therapies,

74
00:06:50.879 --> 00:06:58.040
varying shock treatments have not been lacking
in history. Since surgeries to remove tumors,

75
00:06:58.240 --> 00:07:00.639
the use of radiation and official artis
intelligence have been part of human innovation

76
00:07:00.639 --> 00:07:09.759
to combat that inner enemy. I
looked for Dr Rafael Sánchez Paris, Executive

77
00:07:09.879 --> 00:07:14.360
Director of the Cancer Treatment and Research
Center, Juis Carlos Sarmiento Angulou, to

78
00:07:14.399 --> 00:07:18.680
better answer the big question why is
it so difficult to find a cure for

79
00:07:18.759 --> 00:07:26.399
cancer? This he told me,
cancer is not just a disease. It

80
00:07:26.480 --> 00:07:34.399
is a group of really different diseases, caused by factors sometimes different from each

81
00:07:34.519 --> 00:07:41.639
other. Therefore, at the outset
there are some more curable than others.

82
00:07:41.680 --> 00:07:47.160
In addition, today the number of
patients with advanced disease is higher than with

83
00:07:47.279 --> 00:07:55.639
early disease. When cancer is diagnosed
early, the cure percentage is higher and

84
00:07:55.720 --> 00:08:01.480
this is directly related to timely access
to health services and self- care.

85
00:08:05.759 --> 00:08:13.759
Finally, the genomic changes within the
disease are dynamic and progressive. That is,

86
00:08:15.639 --> 00:08:20.680
cells learn to survive the treatments given, which complements treatment over time.

87
00:08:26.120 --> 00:08:31.279
A recent report was published in the
journal b m Jota Oncology, which concludes,

88
00:08:31.720 --> 00:08:35.759
among other things, that the global
incidence of early- onset cancer increased

89
00:08:35.879 --> 00:08:39.120
by seventy- nine comma one percent, and the number of early- oncology

90
00:08:39.159 --> 00:08:45.879
deaths increased by twenty- seven comma
seven percent between one thousand nine hundred ninety

91
00:08:46.240 --> 00:08:50.080
- two thousand nineteen. In more
concise terms, the number of people under

92
00:08:50.120 --> 00:08:54.639
the age of 50 diagnosed with this
disease worldwide has increased by almost eighty percent

93
00:08:54.879 --> 00:09:01.080
in the last three decades alone,
and the findings of the study do not

94
00:09:01.080 --> 00:09:07.360
stop there. Projections indicated that the
overall number of incidences and deaths from early

95
00:09:07.879 --> 00:09:11.759
- onset cancer would increase by thirty- one percent and twenty- one percent

96
00:09:11.879 --> 00:09:16.519
by two thousand thirty, respectively.
And excuse me for all the bad news.

97
00:09:16.600 --> 00:09:20.840
But, according to the World Health
Organization, more than thirty- five

98
00:09:20.879 --> 00:09:24.480
million new cases are predicted for two
thousand fifty, an increase of seventy-

99
00:09:24.000 --> 00:09:28.799
seven percent, compared with the estimated
twenty million cases for two thousand twenty-

100
00:09:28.279 --> 00:09:35.399
two. All these figures of the
rapidly growing global burden of cancer reflect the

101
00:09:35.519 --> 00:09:41.639
ageing and growth of the world population, as well as changes in people'

102
00:09:41.759 --> 00:09:45.720
s exposure to risk factors of which
several are associated with socio- economic development.

103
00:09:48.879 --> 00:09:54.320
All these numbers for the future are
not encouraging A little over a month

104
00:09:54.320 --> 00:09:58.600
ago, the International Agency for Cancer
Research published the latest estimates of the global

105
00:09:58.679 --> 00:10:05.000
burden of cancer, in which they
found data like First, in only two

106
00:10:05.080 --> 00:10:09.039
thousand twenty- two there were twenty
million new cases and nine seven million deaths

107
00:10:09.039 --> 00:10:16.600
from this disease. Second, about
one in five people develop cancer throughout their

108
00:10:16.679 --> 00:10:20.600
lives and finally, about one in
nine men and one in twelve women die

109
00:10:20.799 --> 00:10:30.279
from the disease. All these numbers
of such impressive proportions leave me with many

110
00:10:30.279 --> 00:10:35.639
questions, but especially one way to
reverse all these estimates about the future incidence

111
00:10:35.720 --> 00:10:41.159
of cancer. I looked for arina
María Trujillo and assistant director of medical care

112
00:10:41.200 --> 00:10:46.120
and teaching at the National Cancer Institute. To answer this, he told me

113
00:10:46.200 --> 00:10:50.360
the first thing is to declare that
cancer is not a single disease. It

114
00:10:50.440 --> 00:10:56.159
is a word that groups different diseases
that have different origins, different causalities and,

115
00:10:56.399 --> 00:11:01.440
by that of different approach, not
only of annassic treatment, then there

116
00:11:01.440 --> 00:11:05.919
is no common strategy. The only
thing we could talk about is that we

117
00:11:05.039 --> 00:11:11.480
could change in a relatively feasible time
frame according to the calculations of interim neck

118
00:11:11.480 --> 00:11:16.600
cancer, cancer whose torino has a
global elimination strategy that, in fact,

119
00:11:16.759 --> 00:11:22.200
Cartagena is the headquarters of the Global
Forum on the Elimination of Cervical Cancer,

120
00:11:22.440 --> 00:11:26.559
in which three strategies are proposed.
Thanks to the fact that with terino neck

121
00:11:26.639 --> 00:11:31.120
cancer we know who produces it,
we have tools to diagnose it before it

122
00:11:31.200 --> 00:11:33.080
becomes cancer and we have how to
treat it properly. Once it' s

123
00:11:33.159 --> 00:11:37.720
a cancer, which we have to
prevent, vaccines against the human papillomavirus,

124
00:11:37.039 --> 00:11:41.320
which is the causal people, which
we have to diagnose in a timely manner

125
00:11:41.360 --> 00:11:46.000
before it' s a cancer,
papilloma virus tests and psitologies and we have

126
00:11:46.080 --> 00:11:50.919
how to treat it. Colombia has
enough staff and enough technology to cope with

127
00:11:52.039 --> 00:11:58.159
the different stages of cancer of Colombian
women, although cancer, as it already

128
00:11:58.200 --> 00:12:03.440
says, is an anti- disease
to what this alarming increase is due to,

129
00:12:03.639 --> 00:12:07.799
According to the authors of the study
published in bm J, oncology.

130
00:12:07.120 --> 00:12:11.279
Genetic factors are likely to influence,
but diets rich in meat, red and

131
00:12:11.399 --> 00:12:16.320
salt and low without fruits and milk, in addition to alcohol and tobacco consumption,

132
00:12:16.440 --> 00:12:20.240
are the main risk factors behind the
most common cancers among those under 50

133
00:12:20.360 --> 00:12:24.440
years of age, in addition to
physical inactivity, excess weight and high blood

134
00:12:24.480 --> 00:12:31.720
sugar levels. According to this research, I quote the changes in diet,

135
00:12:33.159 --> 00:12:35.799
lifestyle and environment since the beginning of
the 20th century that have led to an

136
00:12:35.799 --> 00:12:43.840
increase in rates and obesity. Physical
inactivity, Westernized diets, and environmental pollution

137
00:12:43.879 --> 00:12:48.279
may have affected the incidence of early
onset cancer. In addition, alcohol,

138
00:12:48.639 --> 00:12:56.480
smoking and harmful exposures during pregnancy may
also have affected closing quotes and make a

139
00:12:56.559 --> 00:13:01.120
lot of sense. Just think about
how I change the human' s life,

140
00:13:01.159 --> 00:13:03.639
his work routines, or the way
we feed or consume products such as

141
00:13:03.720 --> 00:13:11.000
alcohol, nicotine, or ultraprocessed edibles. On the latter, a study by

142
00:13:11.000 --> 00:13:16.600
the University of Viennam in collaboration with
the International Agency for Cancer Research found that

143
00:13:16.600 --> 00:13:20.279
the higher the consumption of ultraprocessed foods, the greater the risk of suffering a

144
00:13:20.399 --> 00:13:28.279
combination of chronic diseases such as cancer, diabetes or heart disease. Another of

145
00:13:28.320 --> 00:13:33.240
these changes in modern life that have
helped to increase cases of this disease is

146
00:13:33.279 --> 00:13:39.919
air pollution, as if global warming
was no longer enough. At the presidential

147
00:13:39.000 --> 00:13:45.919
symposium itself two thousand twenty- two, Professor Charles Schanton of the Francis Creek

148
00:13:45.919 --> 00:13:50.080
Institute, a biomedical research center in
London, presented an investigation that highlighted that

149
00:13:50.159 --> 00:13:56.440
the same particles that contribute to climate
change are impacting human health through an important

150
00:13:56.440 --> 00:14:03.360
mechanism that causes cancer in lung cells. The Lancet Commission on Pollution and Health

151
00:14:03.679 --> 00:14:07.120
established that all forms of pollution cause
forty- three percent of lung cancer deaths.

152
00:14:09.720 --> 00:14:13.679
Air pollution alone causes twenty- nine
percent of all lung cancer deaths and

153
00:14:13.679 --> 00:14:18.399
clear estimates give, according to WHO, ninety- nine percent are breathing unhealthy

154
00:14:18.399 --> 00:14:26.399
air. As Dr Emmanuel Ricard told
him by the voice of the French League

155
00:14:26.600 --> 00:14:31.759
against Cancer in the medium Frans van
Cat, it is mainly about pollution by

156
00:14:31.840 --> 00:14:37.440
fine particles and the gases emitted by
the saying are one of the main sources

157
00:14:37.440 --> 00:14:41.480
of these particles. However, a
study published in the British journal of cancer,

158
00:14:41.960 --> 00:14:48.440
the greatest risk factor for most cancers
is simply aging. According to the

159
00:14:48.519 --> 00:14:54.200
study, more than three quarters of
all people diagnosed with this disease in the

160
00:14:54.320 --> 00:14:58.559
UK are sixty years of age or
older, and this is because cancer is

161
00:14:58.639 --> 00:15:03.559
a disease of our genes. Fragments
of the DNA Code that contain instructions for

162
00:15:03.639 --> 00:15:09.360
all microscopic machinery within our cells and
over time, errors accumulate in this code

163
00:15:09.600 --> 00:15:13.600
and scientists can now see them imprinted
on the cancer DNA, and it is

164
00:15:13.639 --> 00:15:20.200
these errors that can drive a cell' s journey. They are reached,

165
00:15:22.759 --> 00:15:26.720
but not all are bad news.
According to the nation' s annual report

166
00:15:26.720 --> 00:15:31.039
on the cancer situation in general,
mortality rates for this disease decreased by an

167
00:15:31.120 --> 00:15:35.679
average of two comma three per cent
per year among men and an average of

168
00:15:35.759 --> 00:15:41.399
one comma nine per cent per year
among women. The overall cancer mortality rate

169
00:15:41.480 --> 00:15:46.039
in the United States declined by one
third between one thousand nine hundred and ninety

170
00:15:46.279 --> 00:15:50.080
- one and two thousand nineteen.
This is largely because fewer people smoke and

171
00:15:50.120 --> 00:15:54.759
develop lung cancer, also because as
screening tests, prevention and treatments have improved

172
00:15:54.799 --> 00:16:00.039
for all types of cancer it is, this decrease has continued and even accelerated.

173
00:16:03.039 --> 00:16:08.039
The national cancer mortality rate is falling
by about two percent each year and

174
00:16:08.120 --> 00:16:15.639
in Colombia the survival of childhood cancer
is sixty percent. Early detection is one

175
00:16:15.720 --> 00:16:19.840
of the ways in which it can
help more people survive this disease and for

176
00:16:19.840 --> 00:16:26.120
this purpose, it seems that artificial
intelligence can play a key role. It

177
00:16:26.240 --> 00:16:30.559
couldn' t be used just to
make fake videos of politicians. And that

178
00:16:30.600 --> 00:16:36.720
' s because, according to research
published in The Lancet Oncology suggests that artificial

179
00:16:36.799 --> 00:16:41.960
intelligence could diagnose cancer with twice as
much accuracy as a doctor' s biopsy.

180
00:16:45.159 --> 00:16:48.360
I looked for radiologist Germán Arango,
who already uses this technology for medical

181
00:16:48.440 --> 00:16:53.519
purposes, and asked him how artificial
intelligence can help detect cancer in a timely

182
00:16:53.559 --> 00:17:00.120
manner. This he told me.
Artificial intelligence can be significantly helped in early

183
00:17:00.159 --> 00:17:06.279
detection of cancer through various methods and
applications. The first and most important of

184
00:17:06.359 --> 00:17:11.279
these is in the analysis of diagnostic
medical images, where, especially deep learning

185
00:17:11.400 --> 00:17:18.200
has shown remarkable effectiveness in the analysis
of diagnostic medical images. Like MRIs,

186
00:17:19.039 --> 00:17:25.759
CT scans, mammograms, X-
rays. Artificial intelligence algorithms can detect abnormalities

187
00:17:25.799 --> 00:17:30.640
in images that can be indicative of
cancer, often with the accuracy that equals

188
00:17:30.720 --> 00:17:36.599
or exceeds that of human specialists.
Here it is important to highlight a new

189
00:17:36.720 --> 00:17:41.519
technique, which is total body resonance
or diamar powder, which is an advanced

190
00:17:41.559 --> 00:17:45.160
imaging technique that allows you to obtain
detailed images of the whole body in a

191
00:17:45.160 --> 00:17:49.319
single exposure, being especially valuable in
the early detection of cancer. The editing

192
00:17:49.359 --> 00:17:55.799
of artificial intelligence to the diagnostic process
of this technique substantially increases its performance and

193
00:17:55.799 --> 00:17:59.559
accuracy, taking into account that it
generates large volumes of information. Other fronts

194
00:17:59.599 --> 00:18:06.039
where artificial intelligence contributes to the early
diagnosis of cancer. These are pattern analyses,

195
00:18:06.559 --> 00:18:11.720
assisted diagnosis, personalization of detection,
research and development, and continuous dying.

196
00:18:12.759 --> 00:18:17.680
In short, artificial interedency is transforming
the field of ecological diagnosis, improving

197
00:18:17.839 --> 00:18:22.200
accuracy and efficiency in early scope detection, which can lead to better prognosis and

198
00:18:22.200 --> 00:18:32.319
higher survival rates for patients. Attempts
to overcome this disease do not begin or

199
00:18:32.440 --> 00:18:37.640
end with artificial intelligence. From surgery
to chemotherapy, treatments have become more friendly

200
00:18:37.640 --> 00:18:42.599
or less invasive. For example,
if someone was diagnosed with breast cancer 100

201
00:18:42.640 --> 00:18:48.079
years ago, doctors had to take
drastic measures, such as removing the entire

202
00:18:48.119 --> 00:18:52.039
breast, along with the underlying pectoral
muscles and all the lymph nodes in the

203
00:18:52.079 --> 00:18:57.799
armpit. However, in nineteen hundred
and sixty, a type of surgery was

204
00:18:57.920 --> 00:19:03.359
discovered that was less invasive or snomizing
the side effects. The same has happened

205
00:19:03.400 --> 00:19:07.680
with other treatments, such as radiation
therapy and chemotherapy, which over time have

206
00:19:07.839 --> 00:19:14.640
refined and refined their procedures to minimize
side effects. And, as I mentioned

207
00:19:14.720 --> 00:19:18.680
before, as well as our faces
and our actillary footprints, each case of

208
00:19:18.759 --> 00:19:23.559
cancer is unique. Researchers have discovered
many ways to reduce the negative impacts of

209
00:19:23.640 --> 00:19:29.960
treatments, adapting them to individual needs
such as modulated intensity radiation therapy, in

210
00:19:29.960 --> 00:19:33.960
which radiation rays vary in intensity strength, allowing them to shape to point to

211
00:19:33.000 --> 00:19:37.359
a precise area, either in the
exact form of a tumor, if used

212
00:19:37.400 --> 00:19:41.160
to reduce it before surgery, or
the immediate area around where there was until

213
00:19:41.359 --> 00:19:48.759
the last. In fact, the
pandemic left something good and it was that

214
00:19:48.799 --> 00:19:55.079
research to develop the vaccine against covid
nineteen inspired the use of this same molecule

215
00:19:55.160 --> 00:20:00.440
to create a vaccine against pancras cancer. Last year the results of the first

216
00:20:00.480 --> 00:20:03.880
trials in patients, a group of
sixteen people in a first batch of trials

217
00:20:03.920 --> 00:20:11.799
showed promising results. Fifty percent of
the patients had positive results for this trial

218
00:20:11.839 --> 00:20:18.599
had to create a personalized vaccine for
each patient. However, and even though

219
00:20:18.599 --> 00:20:22.160
different treatments have been tried for the
many types of cancer, accessing them is

220
00:20:22.440 --> 00:20:30.200
not always easy. The WHO Global
Survey on Universal Health Coverage and Cancer shows

221
00:20:30.279 --> 00:20:33.400
that only thirty- nine per cent
of participating countries covered basic aspects of cancer

222
00:20:33.480 --> 00:20:38.079
management as part of their basic health
services funded for all citizens, health benefit

223
00:20:38.160 --> 00:20:44.160
packages, and only 28 per cent
of participating countries additionally covered care for people

224
00:20:44.160 --> 00:20:48.359
in need of palliative care, including
pain relief in general, and not just

225
00:20:48.400 --> 00:20:59.079
cancer- related care. The case
of Colombia is not the worst, but

226
00:20:59.160 --> 00:21:02.519
neither is the best. According to
an article by the University of Rosario,

227
00:21:03.000 --> 00:21:07.519
cancer mortality rates are higher in Colombia
due to greater barriers to early diagnosis,

228
00:21:07.920 --> 00:21:11.599
which is that mortality rates are higher
in middle- and low- income countries,

229
00:21:11.799 --> 00:21:15.480
which shows that there are fewer preventive
actions and greater access barriers to diagnosis

230
00:21:15.599 --> 00:21:25.000
and early initiation of treatment. According
to the newspaper, La República with data

231
00:21:25.039 --> 00:21:29.720
from ASEMI, phase- cold and
feat, the patient with standard cancer in

232
00:21:29.759 --> 00:21:34.039
two thousand twenty a year is worth
twenty comma two million pesos, which today

233
00:21:34.279 --> 00:21:38.599
represents about twenty- six million average
of treatment per person per year. If

234
00:21:38.640 --> 00:21:44.759
the disease is already detected in metastases, it could cost up to$ 229

235
00:21:44.759 --> 00:21:48.200
million. According to Cruz, there
may be even higher costs, such as

236
00:21:48.319 --> 00:21:52.319
experimental treatments, which can cost$
10, 000 a month or last-

237
00:21:52.960 --> 00:21:59.319
line treatments. But in addition,
the country allocates nearly ten eight billion a

238
00:21:59.319 --> 00:22:04.039
year in resources to care for cancer
patients. According to figures from the National

239
00:22:04.119 --> 00:22:08.279
Cancer Institute. In Colombia, about
eighty- one thousand and five hundred ninety

240
00:22:08.759 --> 00:22:12.799
- six new cases of cancer are
detected each year and about forty- three

241
00:22:12.839 --> 00:22:18.599
hundred people die each year on account
of that disease. According to a report

242
00:22:18.680 --> 00:22:23.160
of the epidomiological panorama of anif cancer
and according to the data provided in the

243
00:22:23.240 --> 00:22:27.839
high cost account. It is evident
that for cancers with higher mortality and incidence

244
00:22:29.039 --> 00:22:34.119
mom and prostate, the national indicator
of early detection decreased. That same report

245
00:22:34.359 --> 00:22:40.000
shows another problem for Oro Comillas.
On the one hand, there are limitations

246
00:22:40.039 --> 00:22:45.039
in access for certain departments and that
in recent years the specific expenditure on detection

247
00:22:45.039 --> 00:22:49.400
has decreased, which is reflected in
a smaller proportion of cases identified in the

248
00:22:49.480 --> 00:22:56.680
early Cierro Comillas age. The document
concludes that Horo Comillas, Colombia, is

249
00:22:56.759 --> 00:23:00.920
a country whose expenditure on the disease
is mainly focusing on diagnosis and treatment but

250
00:23:00.039 --> 00:23:07.119
not on early detection. This has
a negative impact. Not only about the

251
00:23:07.279 --> 00:23:11.359
lives of patients with this disease,
but it ends up imposing high costs for

252
00:23:11.440 --> 00:23:18.039
stan closing quotes. Looking at the
picture, I have one question about how

253
00:23:18.119 --> 00:23:22.200
well or how badly Colombia is in
the fight against cancer. After that,

254
00:23:22.440 --> 00:23:26.000
I will give the question to the
former Minister of Health, Alejandro Gavilla,

255
00:23:26.599 --> 00:23:30.599
who was also a cancer patient and
he told me this. Colombia has a

256
00:23:30.839 --> 00:23:37.599
cancer prevalence of approximately 6 percent six
out of every 100 people suffering from cancer.

257
00:23:37.480 --> 00:23:42.759
This has been similar to the average
number of Latin American countries. Colombia

258
00:23:42.839 --> 00:23:48.720
to implement successful preventive policies against cancer. The most important, the most successful

259
00:23:48.799 --> 00:23:52.279
has been the anti- smoking policy, which has led to a reduction in

260
00:23:52.400 --> 00:23:56.240
the incidence of tobacco use by approximately
500, 000 people in recent years,

261
00:23:56.799 --> 00:24:02.079
a fact that has had a positive
impact, for obvious reasons, on cancer

262
00:24:02.079 --> 00:24:06.759
control. Colombia, with regard to
treatments, has also made decisive progress in

263
00:24:06.880 --> 00:24:11.200
what is known as financial protection.
Unlike in many Latin American countries, a

264
00:24:11.200 --> 00:24:14.880
low- income family in Colombia does
not have to borrow or sell its home

265
00:24:14.880 --> 00:24:21.440
to pay for cancer treatment. The
coverage of the system of more than ninety

266
00:24:21.799 --> 00:24:25.119
- five percent has, of course, been instrumental for this to happen.

267
00:24:25.480 --> 00:24:29.519
There are still difficulties and problems.
This should be recognized in the opportunity of

268
00:24:29.599 --> 00:24:33.440
treatment in two periods, the time
between the suspicion of diagnosis and the definitive

269
00:24:33.400 --> 00:24:40.839
diagnosis and the time between the definitive
diagnosis and the beginning of treatment. After

270
00:24:40.880 --> 00:24:45.279
finishing my treatment, against a non- hotking report, being Minister of Health

271
00:24:45.400 --> 00:24:48.119
and being an exercise that is anecdotal, but can be illustrative, we found

272
00:24:48.640 --> 00:24:52.799
two patients from the subsidized regimen,
a milkman from the municipality of ubate and

273
00:24:52.839 --> 00:24:57.640
a domestic employee who had been diagnosed
the same day by the same disease.

274
00:24:57.920 --> 00:25:02.759
I started treatment one hundred and twenty
days later they, on average, started

275
00:25:02.799 --> 00:25:08.039
treatment between forty and forty- five
days later the three of us finished treatment

276
00:25:08.160 --> 00:25:15.720
successfully and seven months after the treatment
started, we were declared on permission on

277
00:25:15.759 --> 00:25:22.319
February 4, World Cancer Day was
commemorated. A few days later a close

278
00:25:22.440 --> 00:25:26.160
friend died from this disease, but
he was not the first. I disagree

279
00:25:26.200 --> 00:25:30.119
with this claim that a dying cancer
patient lost the battle against the disease.

280
00:25:32.680 --> 00:25:37.000
I think it' s more of
a battle that we should all give as

281
00:25:37.079 --> 00:25:40.319
a species from the trench of science. It' s a cruel disease,

282
00:25:40.680 --> 00:25:44.720
but I' m sure that just
as we get to the moon and divide

283
00:25:44.799 --> 00:25:45.559
the atom, we' re also
going to be able to find a solution.

284
00:25:47.839 --> 00:25:51.440
But I don' t want to
leave without hearing the testimony of a

285
00:25:51.519 --> 00:25:53.079
person who has suffered from this disease. So I looked for Diana Buitrago,

286
00:25:53.440 --> 00:25:57.880
a cheerleader who' s been around
for several months with a fibroadenoma on her

287
00:25:57.920 --> 00:26:03.799
right zero, I asked her to
tell us how she' s changed her

288
00:26:03.920 --> 00:26:07.319
life to UFFF I feel the emotional
part is the strongest. Not because you

289
00:26:07.359 --> 00:26:11.319
barely read the word to Carcinoma and
googlea, because I thought I was going

290
00:26:11.359 --> 00:26:14.759
to die and I thought it was
my son. Nothing. The first thing

291
00:26:14.880 --> 00:26:18.160
he did was like starting a notebook
and I said" hue puche" if

292
00:26:18.200 --> 00:26:19.240
I remember, because I left something
for him and right now. I realize

293
00:26:19.279 --> 00:26:25.960
that since there are many treatments,
there are many researches and the chances of

294
00:26:26.079 --> 00:26:30.119
survival are too high. Look,
there was something very, very curious going

295
00:26:30.200 --> 00:26:34.599
on, and it' s that
the first week of the diagnosis I couldn

296
00:26:34.680 --> 00:26:37.960
' t sleep and I was feeling
a cold here on the back and I

297
00:26:38.000 --> 00:26:44.279
was saying poached egg is the death
that' s here next to me breathing

298
00:26:44.359 --> 00:26:48.519
in my back, but then I
really realized the simple fact of being alive

299
00:26:48.519 --> 00:26:53.119
means that death is there next to
whispering, because we can die coming down

300
00:26:53.279 --> 00:26:55.680
the stairs in the shower, a
car or a robbery. I don'

301
00:26:56.039 --> 00:26:57.640
t know there' s a thousand
ways to die. So I feel like

302
00:26:57.759 --> 00:27:02.039
cancer was like that cube, although
you' re gonna understand that, yeah,

303
00:27:02.279 --> 00:27:04.440
you' re here right now,
but you don' t know if

304
00:27:04.440 --> 00:27:07.480
you' re gonna be here tomorrow. Then I started doing the things I

305
00:27:07.519 --> 00:27:11.119
felt sorry for doing, I started
dressing the way I liked it. I

306
00:27:11.160 --> 00:27:14.039
would have liked to dress, but
I felt sorry because I said, because

307
00:27:14.079 --> 00:27:15.559
no one dresses like that. Or
and I started to do it because,

308
00:27:17.000 --> 00:27:18.759
because I die And what is it, because here it won' t matter

309
00:27:18.799 --> 00:27:22.240
to anything and to me it'
s the only one that I' m

310
00:27:22.559 --> 00:27:26.160
going to say garlic puja I didn' t and I started to think more

311
00:27:26.160 --> 00:27:30.839
about priorities. My priorities used to
be very focused on each other. They

312
00:27:30.960 --> 00:27:36.599
' re still there, but right
now, I' m before me then

313
00:27:36.920 --> 00:27:42.519
like the most important thing was to
prioritize myself and give the real importance to

314
00:27:42.759 --> 00:27:48.039
the things that deserve it time with
the people that I love not leaving anything

315
00:27:48.119 --> 00:27:49.519
for tomorrow, that is, I
know it sounds super cliche. I'

316
00:27:49.599 --> 00:27:53.720
m in that process that for medicine
and all that, because apparently, there

317
00:27:53.799 --> 00:27:57.559
is a tomorrow, but that'
s like giving the real importance here the

318
00:27:57.640 --> 00:28:06.160
time. I am Roberto Pombo and
this was chapter seventy- eight of my

319
00:28:06.240 --> 00:28:11.079
questions. See you in the next
chapter from now on. This chapter of

320
00:28:11.160 --> 00:28:18.599
my questions is available on all podcast
platforms. This episode was made possible by

321
00:28:18.799 --> 00:28:25.880
Kafam, inspiring Smiles. Dirección Roberto
Pombo, Producción General, juan Abel Gutiérrez,

322
00:28:26.279 --> 00:28:30.960
editorial advisor, Daniel San Pedro Espina, scripts juan Abel Gutiérrez and Johnny

323
00:28:30.039 --> 00:28:37.680
Rodríguez. Field production Marcela Salazar and
Lucía Beltrán. Post- production of audio Carlos Bernar