Laureano Molins: "Cancer is cured with research"

Laureano Molins is one of the leading experts in lung cancer. He knew he wanted to dedicate himself to medicine since an illness forced him to be surrounded by doctors for a long time when he was a child. Following this decision, with which he ruled out linking himself to the family business Cementos Molins, he opted to specialize in thoracic surgery. Hundreds of patients have passed through his hands, including one he operated on for a lung nodule in 2010 and for whom he is still remembered: Juan Carlos I.

Laureano Molins has taken his commitment beyond the operating room. He coordinates the international project Lung Ambition Alliance, focused on combating lung cancer, which kills the most worldwide. Since 2018, he has presided over the Association Against Cancer in Barcelona. The entity, which has a hundred workers and 2,200 volunteers in Barcelona, is part of the Spanish Association Against Cancer (AECC), which has an annual budget of about 10 million euros, 70% of which comes from its members. The association works with a triple objective: to promote research, prevention, and accompany people with cancer and their families.

— Laureano Molins, the AECC was founded in 1953 to confront cancer. What has changed since then?

— In these years there has been a transformation of the association. At first, it was distinguished by collecting for research, and then it added two more pillars, in addition to research: ensuring accompaniment and support for people with cancer and their families, and promoting prevention.

— Where is cancer research heading now?

— We have one goal: to achieve a survival rate of 70%. Now we are around 50% on average, ranging from 90% for a skin tumor to 10% for pancreatic cancer. Lung cancer has a rate of 20% and, being more frequent, it is the one that kills the most worldwide.

— What measures are being taken to advance towards this 70%?

— We know that cancer is cured with research. Every euro in research is an improvement in survival, and also in early diagnosis, which plays a decisive role. The sooner you diagnose, the greater the capacity for cure.

— How can this diagnosis be advanced?

— It is crucial to promote screening projects. Currently in Spain, they are carried out for breast cancer, colorectal cancer, and cervical cancer, and at a European level, we have understood that the next one we have to include is lung cancer. Although 80% is caused by tobacco and emphasis should also be placed on prevention and on people quitting smoking, we must not stop advocating for screening.

— How could such a program materialize?

— With a low-dose CT scan for people at risk, first annually and, if negative, every three years. Out of every 100 people, cancer would be detected in two, and other conditions in many others. But survival in lung cancer increases from 20% to 70% in the case of early detection. Each CT scan costs 80 euros, how much is a saved life worth?

— And could this screening program be a reality in the short term?

— I have been working on this issue for 23 years. The scientific societies dedicated to lung cancer are promoting a screening program at a scientific level, and we want to carry out a pilot test to demonstrate that it is possible and effective to implement it. However, we lack funds from the administration to launch this pilot test to facilitate its future incorporation into the service portfolio. This is where we have the struggle, and we are addressing it with the Government.

— What influence does the AECC have in this struggle?

— The association is a main actor, and it has already been so in launching other screening programs. In fact, the colorectal cancer program originated from research initiated by Dr. Antoni Castells 15 years ago with a 1.2 million euro grant from the AECC. We have become the private entity that contributes the most to researchers, through grants that are awarded annually based on an evaluation by a technical committee.

— In addition to colorectal cancer screening, what are the main projects that have emerged with AECC funding?

— To name a few, we have contributed to the development of CAR-T cell therapy and to liver cancer research with Dr. Josep Maria Llovet, and to epigenetic therapies with María Berdasco.

— What advances can we expect in the future based on these investigations?

— The focus is on how to prevent tumors from metastasizing and, once it occurs, how to attack cancer cells in a targeted way with personalized treatments, both with chemotherapy and immunotherapy, increasing the capacity of our own immune system to destroy these cells.

"As long as we cannot eradicate cancer, which is our goal, we have to find the means to be able to live with it," Laureano Molins

— In fact, our system already eliminates 90% of tumor cells circulating in our bloodstream. The problem is that 10% that is not eliminated and that will nest in organs and tissues of the body where it develops. We know that by strengthening the immune system we can get it to fight these cells, and here is the new challenge of immunotherapy.

— A challenge that could increase survival rates.

— Although we are not curing it yet, we are extending the survival rate and the years one can live after being diagnosed. Some say we are chronicizing cancer; I prefer to say we are learning to live with cancer. Diabetes, psoriasis, are diseases that are not cured, but with which we coexist. As long as we cannot eradicate cancer, which is our goal, we have to find the means to live with it.

— And before all that, there is prevention.

— And the priority here is tobacco. 30% of cancers would be avoided if people did not smoke. It is also crucial to follow healthy lifestyle habits, with physical exercise, no alcohol, and an adequate diet, such as the Mediterranean diet.

— With prevention and research, this 70% survival rate has been set as a goal. Is it the ceiling to which one can aspire?

— We set this figure as a goal for 2030 to have a clear objective and focus all maneuvers and actions towards it. Cancer will persist, but we trust that a time will come when it will be overcome, just as diseases that decades ago caused thousands of deaths in Spain, such as tuberculosis, are now overcome.

— What role does Barcelona play in the advancement of research?

— Throughout the State, from the AECC we have 140 million euros invested in research. Of these, more than 50 are in Barcelona. We have top-level researchers, and almost 40% of the aid granted by the AECC is allocated to Barcelona. And it is relevant that, although many projects start in Barcelona, they are actually multicentric and reach several hospitals at the state level.

— And that allows progress towards territorial equity.

— We want the most advanced treatment to reach patients in any town or city, just like patients at Vall d'Hebron or Clínic. The hub is Barcelona, but it is open to patients from other provinces, and that is a relevant factor. We have always said that the postal code should not be a factor of poor prognosis, and often the postal code affects more than the genetic code.

— Does this Barcelona hub have an international role?

— In fact, at a European level, the so-called Comprehensive Cancer Centers are beginning to be created, which certify that a center includes all the necessary areas to address cancer: oncology, surgery, patient associations, research… From the AECC, we are offering to collaborate so that hospitals in Barcelona, such as Vall d'Hebron and Clínic, can join.

— In addition to promoting research and prevention, the role of the AECC goes further.

— People with cancer are very well cared for in terms of hospital services, but most require something more, and support that is beyond public healthcare. From the association, we want to offer this support, not only to the person with cancer, but also to their families, with a special emphasis on vulnerable people.

The association proposes to open a center for long stays for patients and families who must travel from other cities, Laureano Molins

— With psycho-oncological support and social aid. We have agreements with the Red Cross and Cáritas, who refer people with cancer in vulnerable situations to us, such as homeless people. In addition, we go to the various neighborhoods of Barcelona to spread awareness of our work.

— Is the support limited to patients, or also to their families?

— We also assist families through the association. For example, we have an agreement with the Hotel Guild to house relatives of low-income patients who have to travel to Barcelona for their treatment. Now, in addition, we are studying the possibility of opening a center for those who have to make long stays, of more than 15 days, so that they feel more stability.

— Finally, Laureano Molins, is there an estimated opening date for this new center?

--- This is one of our goals for 2025, in which we will continue to prioritize, in addition to research and prevention, support for people with cancer and their families. And we offer this support through the nearly 100 professionals and more than 2,200 volunteers we have in Barcelona and in 28 of its hospitals.