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Dr. Candela Calle

General manager of the Catalan Institute of Oncology (ICO)

She holds an MD in medicine and surgery from the University of Barcelona, a degree in family medicine from the Autonomous University of Barcelona and a degree in business management from Esade. Since 2010, she has been at the helm of ICO, a public company created in 1995 and affiliated to the Catalan Health Service, which has an integral approach to fighting cancer.

The Catalan Institute of Oncology (ICO) is a global oncology care center that, in the same organization, integrates all the elements and efforts needed to fight cancer effectively and efficiently: diagnosis, treatment, prevention, research and training.

ICO is based at Duran i Reynals Hospital (L’Hospitalet de Llobregat, Barcelona) and has two additional centers, one in Girona at Doctor Josep Trueta Hospital, and the other in Badalona at Germans Trias i Pujol Hospital. Among other things, it is a benchmark in radiation oncology, psycho-oncology, early detection of cancer, low-frequency tumors, genetic cancer counseling and blood precursor transplants.

At the end of last year, ICO celebrated its 15th anniversary with a workshop that highlighted the interest of all those at the Institute in continuing to work towards the goals they have set over the years: treating and caring for patients, research, prevention and training.

What contributions define ICO and set it apart in its fight against cancer? 

ICO is a public company of the Catalan Health Service. It is a center that integrates specialized cancer prevention, care, research and training. It was the first center of its kind in Spain. One of the things that set us apart is our network model: we have three centers and a collaboration network of 17 county hospitals to foster equality and bring care to the patients. We are currently the benchmark oncology center for 40% of the adult population of Catalonia.

Over these 15 years, which of ICO’s projects stand out? And why?

Overall, we are very satisfied that ICO has become a model and an example to follow in oncology care. We are the benchmark in medical care, but also in our warm relationship with patients and rigorous resource management. In terms of specific projects, I would highlight, for example, that we are a benchmark center for the World Health Organization in two fields: epidemiology research into the human papilloma virus and cervical cancer, and in public palliative-care programs. We are also a benchmark in radiation oncology —we are the first public center to carry out radiosurgery in Catalonia— and in genetic counseling, which is the process of monitoring families with a suspected hereditary predisposition to cancer.

ICO is currently working on nearly 400 therapeutic trials, could you comment on one?

ICO is one of the most active centers in carrying out cancer clinical trials. In the near future we will start a highly innovative one, with an oncolytic virus, which is a virus designed to target only cancerous cells. It must be said that this experimental virus has been developed in ICO’s own research laboratories, in line with one of our premises: for our research to translate to clinical practice. Additionally, in recent years we have incorporated cutting-edge radiotherapy technology and we are now beginning clinical trials in this area as well. 

Could you explain this cutting-edge radiotherapy technology in more detail?

Among other techniques, we have one that uses an especially effective and innovative machine, the Truebeam, which there are only two of in Southern Europe. This is an extremely precise high-tech machine, both in terms of dosage given and the site to which it is applied. Thanks to the precise technology of the Truebeam, radiotherapy is directed towards the right spot without damaging cells not affected by cancer, or damaging them much less. And this, undoubtedly, offers quality treatment for the patient and guarantees success.

ICO’s oncology care model has shown to be extraordinarily effective. What has the center contributed to patient care?

We use an integrated, patient-centered care model, meaning that the circuits, protocols and activities are all designed according to patient needs. We have a multidisciplinary approach to Functional Units, in which different experts share space during appointments. All of this reduces diagnosis and decision-making time. It also yields more effective results and ensures decisions are made consistently, meaning that the treatment applied doesn’t vary depending on the doctor but rather is that which medical evidence recommends. In this line, we develop guides for clinical practice, the ICOPraxis manuals, to help in decision-making and provide evidence-based care.

So, what would a cancer patient find at the ICO centers?

From the first moment of their visit, the patient is seen by professionals specializing in different disciplines and receives integrated diagnostic and therapeutic care. The patient is seen by an oncologist, a surgical specialist, a rehabilitation specialist, a psychologist and a social worker. Plus, all our patients have what we call an assigned nurse, who accompanies them throughout the process and is by their side for whatever they need… with whom they end up developing a very close, personal relationship. This personalized care provides a number of benefits beyond those that are strictly medical.

As General Manager of a benchmark cancer center, how would you describe the evolution of oncology research?

Research has allowed us to better understand the molecular foundations of cancer and to develop new, more effective treatments with fewer side effects.  Now, for the first time in history, more than half of all patients beat the disease and this is in good part due to early detection and to research. Top-notch research is carried out in Catalonia, which has nothing to envy other countries. This can be seen, for example, in the SCImago Institutions Ranking World Report 2011, one of the most exhaustive rankings of institutions that carry out research around the world. According to this report, 37.6% of all papers published by ICO are part of the 10% of papers most commonly cited in the worldwide scientific arena.

In the middle term, where should this research be heading? What are the challenges that must be faced in order to move forward more decisively in this field?

The challenge now is to personalize treatment, which means offering a patient the most appropriate treatment based on their genetic make-up and the mutations it presents. This will allow us, for example, to avoid aggressive drugs in patients for whom we know they won’t work, and apply alternatives we know will be effective. In this arena, ICO Badalona, for example, is a pioneer in personalized treatment for lung cancer.

Can we win the fight against cancer? Or at least surpass the current 60% survival rate in the middle term?

We hope to be able to control the vast majority of tumors in the not-so-distant future, allowing patients to live many years without the disease progressing. To do this we must continue to invest in research and technology, and in professional training.

What can the general public expect from oncology research?

Research is what will lead us to less aggressive and more effective personalized treatments. Thanks to research we have reached a point where we can control many tumors that were incurable and slow the progress of others. Research will allow us to not only increase patient survival rates but also to improve quality of life. In our case, we work to bridge the gap between innovation and patient treatment, which means making any new breakthrough leading to an improvement in treatment available to patients as soon as possible.

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