Young Ecuadorian urologist develops important research in Spain that favors patients with bladder cancer

Chemotherapy can lower the risk of new tumors developing in the bladder of patients with bladder cancer after they have undergone surgery to remove these tumors; Nevertheless, only 50% of people in the world receive the treatment, explains the young Ecuadorian doctor Diego Carrion, who from Spain develops an important investigation that evidence of a new scheme for more patients to access chemotherapy and thus reduce recurrences.

Before finishing his studies in Medicine, which he did at the University of Cuenca, Carrión had already decided to specialize in Urology and set out to achieve that goal in Madrid, Spain. “I was able to get a grade that he gave me to do the specialty I wanted, Urology, in one of the large hospitals in Madrid, at the La Paz University Hospital, linked to the Autonomous University of Madrid,” he says.

In 2015 he began his training, which culminated in May 2020, and during that time in addition to fulfilling his academic obligations, he wanted to take advantage of it to do research. To do this, he contacted professors and urologists from the aforementioned hospital, who helped him in the process, initially developing simple and later more complex investigations.

The young doctor says that among those who guided him were Dr. Juan Gómez Rivas, whom he considers his mentor, and the head of the Urology service of the La Paz University Hospital, Luis Martínez-Piñeiro, who with his experience in treating cancer of bladder He raised the idea that gave way to the study in which Carrión works.

Bertha Jiménez, the Ecuadorian who triumphs in New York with her company that turns waste into raw material

“In the majority of patients, approximately 75%, bladder cancer presents as a small tumor that is easily removed. Nevertheless, bladder cancer has a tendency to re-develop again, and 15% to 60% of these patients may re-develop a bladder tumor in the future. To reduce this risk, a dose of chemotherapy is applied inside the bladder for a predetermined time and then it is eliminated with normal urination ”, explains the Ecuadorian.

He adds that it has been shown that the application of this chemotherapy, administered after surgery, prevents up to 35% the risk of recurrence (appearance of new tumors) in the first year, however, various factors arise that prevent all patients from receiving it.

“Right after surgery, many patients do not have the characteristics that would give the security to apply chemotherapy there because they have a very large wound, so it could cause complications or, simply, due to the logistics of the hospital, if it is not administered in time , so patients don’t get this benefit. In the United States it has been seen that more than half of urologists do not use it due to these problems. In a third of Europe they do not use it either and around half of the patients do not receive it ”, he details.

Ecuadorian created a successful company in Germany that offers specialized transportation and logistics services

These inconveniences led Dr. Martínez-Piñeiro to suggest the application of chemotherapy before surgery and not after, as has been done so far throughout the world. Carrión was interested in the subject. “In congresses and in meetings, many people told me that it was very interesting and that it had not been investigated yet, although it sounds that illogical, but no one had decided to do it, then there it occurred to me to get involved in a doctoral program, a Ph. D. from the university associated with my hospital, the Autonomous University of Madrid ”.

Research development

Because it was a study that involved chemotherapy in patients, to develop it required the approval of the Spanish Agency for Medicines and Health Products, among many other bureaucratic procedures, Carrión mentions. Meet all requirements It took them six to eight months, but they finally got all the approvals.

“We were developing the research, at the same time that I was developing the doctoral program since 2018, so it was very long, We had some bumps due to COVID, because of how hard COVID was here in Madrid, Hospitals were closed and the study had to go much slower than planned.

Ecuadorian Ana Liz Cordero conquers Dubai with her works of art

The investigation carried out by the Ecuadorian it includes 240 patients, of whom half are given chemotherapy and the other half do not. They are chosen at random by a random number generated in the computer, in order to avoid bias. The final conclusions of the study will be known in a couple of years, but currently, based on how many patients have had new tumors, there are already results on how many have received the benefit of chemotherapy and how many have not.

“The clinical trial had that, with an intermediate analysis, which was my doctoral work. There were 192 patients in this analysis and it had to have a minimum follow-up of three years. Then, We managed to close the 192 patients, in December 2020, despite all the delay caused by the coronavirus pandemic, we managed to close this analysis while continuing to recruit the other patients ”, the urologist details.

According to the results collected, in the primary objective of the study, which was to determine if the treatment worked in all the patients included, a benefit was not found in all, however, “in the secondary objective, which was to find benefit in a subgroup of patients who would not receive chemotherapy in the following months or years, in those a fairly good benefit was found: 34% decrease in the recurrence rate and a decrease in the relative risk of 80% within the first year ”, explains Carrión.

Carrying out this work has been a great challenge for the young Ecuadorian and it has required effort and dedication to develop it.

“As these results came out, I was having more hope, always with a bit of impatience, but in this you have to wait for the patients to go to the check-ups. As we see that each patient in each revision does not have a new tumor, and they are from the group that had received chemotherapy, I was getting a little more excited, to the point that in March when I did all the statistical analyzes, and it was very time consuming and very tedious, I already found that this group really benefited and that was already a very great joy ”, manifests.

The significance of the study

Have patients receive chemotherapy before surgery would contribute to reducing the risk of new tumors in more people, avoiding that they undergo more surgical interventions or more chemotherapies, improving the quality of life, says the urologist.

In Spain in 2020, according to statistics from the World Health Organization, bladder cancer is the fifth most frequent, so it plays an important role. “In Ecuador it is the 11th position, It is not one of the five most important cancers, but in the end, patients with this disease can benefit from optimal treatment (based on the results of their study) ”, according to Carrión.

Once the study is completely completed, in a couple of years, Carrión hopes that its scientific publication will be considered and analyzed by experts from recognized medical associations, who make the recommendations that health professionals around the world take into account for the application of new treatments.

“All the experts meet to see all the works that have been published and ours will arrive there. The main thing we want is that it be considered as an alternative to what is proposed now, that arrives in the recommendations that they disseminate every year that, to patients in whom it is anticipated that chemotherapy cannot be administered later, there is evidence that administering it earlier is good, “he says.

Bladder cancer and its relationship with cigarettes

Bladder cancer is more common in men than in women and, in at least 50% of patients, an association has been seen between this disease and cigarette smoking. In the other half of people with this type of pathology, various causes not related to this product were found.

“When you smoke, part of the toxins in cigarettes are absorbed into the circulation through the lungs, part and many of those toxins will go into the blood, they will filter through the kidneys and they will fall into the bladder, What about the bladder? It is a reservoir of fluid, if that fluid is full or at least has toxins, there will be the fluid with toxins acting on the walls of the bladder for an hour, two hours, three hours. , the time that you are without urinating, But it’s acting like this for years and years”, Details the expert.

Ecuadorian Daniela Fernández received the 2020 World Young Entrepreneur Award in Germany

Carrión also explains that most bladder cancers will not kill the patient, but they are going to make him undergo chemotherapy and high costs to heal the disease. The patient should take into account that if the tumors are not treated or removed in time, they will invade the entire bladder and will be incurable.

“A person who has had bladder cancer has to undergo reviews for more than ten years or throughout his life to detect new tumors of these, because there is a risk and you have to review it all the time, because the smaller the tumor is, it will be easier to heal, but if the patient is lost and has a tumor growing for several years, in a moment it will be incurable “, he adds.

Collaborate in Ecuador

On Carrión’s work, several articles have already been published on specialized websites. The most recent is already in the prepublications section of the magazine Spanish Archives of Urology (indexed in PubMed) and It will appear in the magazine’s November volume.

In Spain, this Ecuadorian doctor has been member of international relations of the working group of residents and young urologists of the Spanish Association of Urology, since 2017; President elect of the European Society of Urology Residents (ESRU), since 2017, within the European Association of Urology, and associate member of the urothelial tumors research group of the Young Academic Urologists, since 2020, within the European Association of Urology.

Nativus, the venture of a group of Ecuadorians that seeks to popularize cassava bread in the United States.

Among his next plans is not to return to reside in Ecuador, although it is something that he would like to do later. In the meantime, points out that it would like to collaborate with hospitals or universities in our country, as well as participating in research with urologists and national residents. (I)