Cancer treatments
Currently, cancer treatments require an interdisciplinary approach so they can be tailored individually and precisely to each patient’s needs.
At the GCCC 360 Centre of Oncological Excellence we have specialists in all areas of cancer treatment and we have the most advanced technologies to offer personalised solutions for our patients. We study each case and determine the most appropriate techniques to apply, depending on the therapeutic goals to be achieved. We also perform a study of the type of each tumour and the stage it is in, as well as an assessment of the patient’s history and general health.
In addition to surgical techniques, the GCCC 360 Centre of Oncological Excellence has the following services:
Medical oncology
- Chemotherapy
- Targeted therapies
- Immunotherapy
- Hormone therapy
Radiation oncology
- MRI and CT planning
- 3D radiation therapy
- Intensity-modulated radiation therapy (IMRT)
- Volumetric modulated arc therapy (VMAT)
- Image-guided radiation therapy (IGRT)
- Surface-guided radiation therapy (SGRT)
- Stereotactic radiosurgery (SRS)
- Stereotactic body radiation therapy (SBRT)
Medical oncology
Medical oncology: comprehensive patient support
Our priority is to provide comprehensive care of the cancer patient, accompanying the patient from diagnosis to completion of treatment, through personalised therapies and offering emotional support for both patients and their families.
When a cancer diagnosis occurs, everyone experiences a feeling of fear and uncertainty.
The patient needs extensive support and information on the disease and treatment options.
At the GCCC 360 Centre of Oncology Excellence, we are very aware of this and of the importance of treating patients with cancer in a global manner. Therefore, the Medical Oncology Department works to accompany our patients throughout all stages of the disease.
We are a multidisciplinary team of specialists focused on comprehensive and personalised care of the cancer patient from diagnosis to cure.
To provide personalised therapies tailored to each patient’s needs, our medical oncologists conduct a comprehensive tumour analysis to determine the most appropriate treatment by integrating therapies such as chemotherapy, targeted therapies, immunotherapy, or hormonal therapy.
Chemotherapy
What is chemotherapy?
Cancer cells usually grow and divide faster than normal cells. Chemotherapy effectively damages or kills “chemo-sensitive” tumours. In addition, these cancer cells damaged by chemotherapy recover poorly (or less effectively) than normal cells, which can also be damaged by chemotherapy because they grow and divide rapidly (such as cells in various epithelial tissues or blood).
How can chemotherapy help the cancer patient?
In chemotherapy treatments, we administer drugs to the patient indicated to kill tumour cells and/or shrink the tumour. So chemotherapy can be administered with curative or palliative intent, or even “preventive” (or adjuvant) to prevent the growth of micro-metastases.
Treatment may include administration of a single type of drug or a combination of multiple drugs, depending on each tumour type.
Chemotherapy is also used as part of combination treatments with surgery or radiotherapy.
How is chemotherapy given?
The routes of administration of chemotherapy treatments vary depending on the individual patient and the type of cancer and its location:
- Intravenous
This route involves administration of the drug by injection into a vein. Some drugs require continuous infusion for a few days or even weeks by implanting a small infusion pump.
- Oral
Treatment is given as a tablet, capsule or liquid to be taken by mouth, following the schedule prescribed by the doctor.
- Intraperitoneal or abdominal
This type of treatment applies to patients with tumours involving the peritoneum (tissue covering the abdominal wall and covering most of the organs in the abdomen) and is given by subcutaneous implantation of a device connected to the inside of the abdomen using a catheter.
- Topical
Topical chemotherapy is administered by applying cream treatment to the skin.
What side effects can chemotherapy cause?
Chemotherapy may cause some side effects such as:
- Fatigue
- Nausea and vomiting
- Constipation or diarrhoea
- Dry skin
- Hair loss
- Blood disorders
- Increased risk of infections
These may vary depending on the patient’s health status, tumour type and location, as well as drug type, and doses administered. At the GCCC 360 Centre of Oncological Excellence, we are very aware of how these effects can negatively impact the emotional state of our patients, so we want to offer you the support you need every step of the way. Our specialist nurses will be here to listen to you and provide you with the right support. They will also advise you on how to manage and reduce these side effects and so minimise their impact on your mood.
How will I know which treatment is best for me?
At the GCCC 360 Centre of Oncological Excellence, we believe that cancer patients should have access to the best possible treatments. Therefore, our main goal is to develop treatment regimens that are as personalised as possible to obtain the best results with the least impact on the patient.
Accurate and detailed analysis of the molecular and genetic characteristics of each tumour, as well as its resistance and pharmacogenetic studies, allow us to define tailored treatments for each patient to achieve better tolerance.
At the 360 Centre of Oncology Excellence GCCC, we have a multidisciplinary team that conducts a comprehensive individualised study of each case to establish the administration guidelines for chemotherapy, surgery or radiation therapy.
The medical oncology area of the GCCC 360 Centre of Oncological Excellence, founded in 2017, has extensive experience in the management of this type of approach, and all chemotherapy treatments are performed following specific protocols according to the criteria established by the most important national and international scientific societies.
Targeted therapies
What is targeted therapy?
Targeted therapy is a type of cancer treatment that involves using specific drugs that target the tumour in a controlled way, without affecting healthy cells.
Advances in research into the appearance and development of different types of cancer show that cancer cells undergo molecular and/or gene changes, which tell them to perform certain functions. When a cell has certain genetic changes, it does not behave like a normal cell.
This knowledge has allowed us to develop target drugs that act on specific key points vital for tumour maintenance or growth.
How does targeted therapy work?
Targeted therapies are designed to target specific points or substances in cancer cells, such as proteins that are only present in cancer cells or proteins that are overproduced or mutated, or also genetic changes that are not in a normal cell.
They are also used to prevent metabolic processes that promote tumour cell growth.
Why is it different from chemotherapy?
Unlike chemotherapy, targeted therapies have a specific target and act only on cancer cells without generally affecting healthy cells.
Are we talking about personalised medicine?
These drugs form the basis of personalised medicine of the GCCC 360 Centre,of Oncological Excellence since they allow us to individualise and tailor-make treatments for each patient and achieve more selective anti-tumour activity, obtaining the greatest efficacy with the fewest and better controlled side effects. In the Medical Oncology area of the GCCC 360 Centre of Oncological Excellence, we are pioneers in the use of this type of treatment from the start and have long experience in its application.
Immunotherapy
What is immunotherapy?
The growth and control of tumours is directly related to the immune system of people affected by cancer.
Immunotherapy is one of the most current treatments in the approach to cancer, since its mechanism of action is based on the stimulation of the body’s natural defences of the patient’s own immune system, helping it detect and eliminate cancer cells more efficiently.
How does immunotherapy work?
Immunotherapy, unlike chemotherapy or targeted therapy, is not directed targeted at cancer cells, but rather works by stimulating the patient’s immune system to reject these cells.
Stimulation of the patient’s immune system can be performed by different procedures, to be determined by the oncologist according to the characteristics of each tumour.
Some of the most common are:
- Chimeric antigen receptor (CAR) T-cell therapy.In this therapy, some T cells (a type of white blood cell) are removed from the patient’s blood and mixed in the lab with a virus that “teaches” T cells to bind to tumour cells and then re-inoculated into the patient. In this way, T cells, back inside the patient’s body, can recognise and destroy cancer cells. (This technique is not presently used in GCCC and is only indicated for haematological tumours).
- Cytokines, low molecular weight proteins essential for intercellular communication and produced primarily by the immune system, are used in this treatment to stimulate immune cells to attack the tumour.
- This group of medicines is used to treat certain types of cancer because it stimulates only parts of the immune system.
- Cancer vaccines.Some vaccines can help prevent or treat cancer.
- Monoclonal antibodies. These are immune system proteins designed in the lab to attack a very specific part of a cancer cell.
- Oncolytic virus. They are viruses modified to infect and kill certain tumour cells. This technique is not presently used in GCCC and in any case it is only indicated for haematological tumours or some solid tumours in experimental phase and under regulatory control).
From the Medical Oncology area of the GCCC 360 Centre of Oncological Excellence, we offer our patients the full range of these immunostimulating treatments with the aim of offering the greatest and most modern therapeutic efficiency and offering customised solutions for each need.
Hormone therapy
What is hormone therapy?
Hormone therapy is a treatment of cancer with hormones (or anti-hormones) that is very effective in slowing the growth of certain tumours, including breast and prostate tumours.
How does hormone therapy work?
Hormones are substances secreted by specialised cells located in the endocrine glands, among other parts, that act as the body’s chemical messengers via the bloodstream and influence cell function.
Certain types of tumours have hormone receptors on the surface of their cells that usually work as growth stimulants.
Hormone therapy is a treatment that, by modifying these hormones, aims to prevent their production and block the hormone receptors of tumour cells. In this way we are able to reduce their effects on cells and stop the growth of the tumour.
For which types of cancer is hormone therapy most effective?
Hormone therapy is mostly applied to those types of tumours in which hormones play a key role.
The most common are:
- Breast
- Prostate
- Endometrial
- Ovarian
- Neuroendocrine
At the GCCC 360 Centre of Oncological Excellence, we have the most innovative hormone therapies that ensure greater treatment effectiveness and better patient tolerance.
Hormone therapy and breast cancer
Approximately 60-70% of breast tumours have estrogen and/or progesterone receptors on the surface of their cells. The estrogen receptor is the most important of these as it mainly determines treatment sensitivity.
Our specialist oncologists identify hormone receptors to determine the administration of hormone therapy against other therapeutic pathways, also taking into account other factors such as age, metastatic location, rate of tumour growth, etc.
Hormone therapy and prostate cancer
The application of hormone therapy in patients with prostate cancer aims to reduce the level of testosterone in the blood, which is the hormone responsible for stimulating the growth of tumour cells.
Although hormone therapy facilitates a reduction in the size of the tumour or the speed of its growth in patients with prostate cancer, other therapies are needed to cure it, such as radiation therapy.
Radiation oncology
What is radiation oncology?
Radiation oncology is a medical specialty dedicated to the diagnostic, clinical and therapeutic aspects of cancer patients and which uses ionising radiation to eliminate the tumour. This radiation kills cancer cells and can be applied in both early and later stages. In certain cases, it is also used for palliative purposes, to relieve pain and discomfort.
In order to provide the most optimal solution for each patient, radiation therapy can be applied alone or combined with other therapies such as chemotherapy, hormone therapy, immunotherapy and surgery.
Within the area of radiation oncology, there are also various differential treatments that allow the oncologist to establish tailored approaches for each type of tumour and adapted to the patient’s needs.
At the GCCC 360 Centre of Oncologic Excellence, we offer our patients the most advanced radiation therapy treatments that include:
- 3D radiation therapy
- Intensity-modulated radiation therapy (IMRT)
- Volumetric modulated arc therapy (VMAT)
- Image-guided radiation therapy (IGRT)
- Surface-guided radiation therapy (SGRT)
- Stereotactic radiosurgery (SRS)
- Stereotactic body radiation therapy (SBRT)
- High-Dose Rate (HDR) Brachytherapy
What side effects can radiation therapy cause?
Radiation therapy is a treatment that can cause some discomfort in some patients and cause unwanted side effects such as:
- Fatigue
- Skin changes and inflammation
- Swelling and fluid accumulation
- Hair loss in the irradiated area
- Stress, anxiety and other similar problems
These may vary depending on the patient’s health status, tumour type and location, as well as type of radiation therapy, and doses administered.
At the GCCC 360 Centre of Oncological Excellence, we are very aware of how these effects can negatively impact the emotional state of our patients, so we want to offer you the support you need every step of the way. Our specialist nurses will be here to listen to you and provide you with the right support. They will also advise you on how to manage and reduce these side effects and so minimise their impact on your mood.
MRI and CT planning
What is MRI and CT planning?
At the GCCC 360 Centre of Oncology Excellence, before starting radiation therapy treatment in each patient, it has a team, composed of the radiation oncologist who indicates and prescribes the treatment, the radiation therapy nurse who supervises the patient’s care, the radiophysicist who calculates the treatments and ensures the correct functioning of the linear accelerator, and the radiation therapy technician who administer the daily radiation, who are responsible for ensuring the patient’s adaptability to the treatment.
This team carefully plans the application of the treatment, prior to administration to the patient, in a process called treatment simulation. Thanks to this process, specialists can determine the exact amount of radiation the patient needs and where it will be directed.
During the treatment simulation, the team performs an assessment of the patient’s medical history, study results, and images of the shape, size, and precise location of the area to be treated, obtained by imaging tests such as a CT or MRI.
3D radiation therapy
What is 3D radiation therapy?
At the GCCC 360 Centre of Oncological Excellence, we have the most advanced technology to offer the most appropriate procedures, tailored to the needs of each patient.
3D radiotherapy is a technique that allows the dose of radiation required for each type of tumour to be administered precisely by visualising a three-dimensional image of the tumour obtained using computerised axial tomography (CAT) equipment.
This treatment makes it easier for the specialist doctor to apply the radiation dose intensively to the tumour, preserving and protecting healthy tissue.
How do we do it?
By computerising the tumour parameters and the doses established by the physicians, a dosimetric report is obtained that simulates the optimal treatment based on the application of various algorithms. This report provides concise information to the specialist doctor about the appropriate dosing combination for each location, and the appropriate doses for the protection of healthy organs that are located near the tumour to be irradiated and should be avoided.
Intensity-modulated radiation therapy (IMRT)
What is intensity-modulated radiation therapy?
Intensity-modulated radiation therapy (IMRT) is a highly accurate and highly controlled tumour treatment technique.
IMRT is based on advanced technology that allows the amount of radiation to be modulated three-dimensionally, allowing higher doses to be administered to the tumour and minimising damage to adjacent healthy tissue.
This technique can reduce treatment toxicity and side effects compared to conventional techniques.
How is treatment given?
IMRT is performed using a machine called a linear accelerator (LINAC). The patient will generally not feel any discomfort or sensation during treatment. The patient will only hear the noise the equipment emits.
The duration of each session is between 10 and 15 minutes, during which the patient will be in the room alone and will be constantly monitored by radiation therapy technicians from an adjoining room.
Volumetric modulated arc therapy (VMAT)
What is volumetric modulated arc therapy (VMAT)?
Volumetric modulated arc therapy (VMAT) is a modality of intensity-modulated radiation therapy (IMRT) that is supplied with high precision and maximum control thanks to the continuous 360° rotation of the treatment apparatus.
What benefits does VMAT provide?
VMAT radiation therapy offers the possibility of increasing the radiation dose to the tumour without increasing the short- and long-term side effects thanks to a reduction in the overall dose to the patient and the administration time.
Is this technique right for me?
VMAT radiation therapy can be used for any type of radiation therapy treatment and for any location. In our GCCC centre, this technique is used in up to 90% of treatments due to its benefit in precision and speed of treatment.
It is also suitable for patients who have an extensive skin cancer field such as non-melanoma skin cancer (mainly basal cell and squamous cell cancers) and have previously tried other treatments, such as skin creams or photodynamic therapy, without satisfactory results.
VMAT is used to safely treat the surface of the skin without affecting healthy tissue and is useful in treatments of curved areas such as arms or legs, and to protect organs under the skin, in areas such as the head and neck.
These types of cancer start in the upper layer of the skin (epidermis), and are often linked to sun exposure, so they are most often found in areas that have been exposed to sunlight, such as the neck, head or arms, although they can occur anywhere in the body.
Image-guided radiation therapy (IGRT)
What is image-guided radiation therapy (IGRT)?
Image-guided radiation therapy (IGRT) is a technique that incorporates imaging of the area to be treated during radiation therapy to improve the precision and accuracy of treatment administration.
At each session, IGRT allows the position of the organ to be treated and the surrounding healthy organs to be verified and a comparative assessment is made with the theoretical location where these organs should be located. This makes it easier for the specialist to change the patient’s position and/or radiation beams to hit the tumour more precisely.
Is this technique right for me?
IGRT is a highly effective technique that facilitates and improves the treatment of tumours that are mobile during the radiation therapy session or between sessions, such as lung cancer (by breathing) or prostate cancer (by bowel movements).
This technique allows for high irradiation accuracy and minimal involvement of healthy tissue, thereby improving the severity of potential side effects.
Surface-guided radiation therapy (SGRT)
What is surface-guided radiation therapy (SGRT)?
Surface-guided radiation therapy (SGRT) is a novel technique based on 3D cameras that help the specialist position the patient accurately, using the patient’s body surface as a guide, thus avoiding the impression of permanent marks on the body, such as the classic tattoos, used in conventional therapies.
What are the benefits of SGRT?
As with other precision therapies, SGRT specifically affects the area to be treated, making it easier for this area to receive the maximum dose of radiation therapy without compromising the surrounding healthy tissue. In addition, SGRT allows constant monitoring of the patient during treatment administration and the ability to immediately adjust or stop radiation based on the tolerance limits of each patient.
Is this technique right for me?
SGRT can be used to treat any type of tumour, as it is a technique that works very effectively at any location. It is also given for high-precision treatments such as radiosurgery or extracranial stereotactic body radiation therapy (SBRT).
Currently, SGRT is the most modern option to administer radiation therapy, in combination with image-guided radiation therapy (IGRT) and with advanced radiation therapy techniques such as intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT).
Is SGRT safe for breast cancer?
One of the greatest concerns of patients receiving treatment for breast cancer is the impact that the dose may have on the heart and the risk of heart disease in the future, given the proximity of this organ to the breast.
SGRT represents a very significant advance in this regard, since it allows the treatment to be performed in the sustained forced inspiration position, which helps the heart move away from the chest wall and the breast on which the treatment is to be performed, so the dose the heart receives is practically zero.
Stereotactic radiosurgery
What is stereotactic radiosurgery (SRS)?
Stereotactic radiosurgery (SRS) is a treatment that, despite its name, does not consist of a surgical procedure (incisions) but of the administration of a high dose of radiation over small areas, allowing high doses of radiation to be precisely directed and in fewer sessions than traditional therapy, helping to preserve areas of healthy tissue.
The treatment unit directs various small beams of radiation to the tumour that act very mildly on the tissue they pass through but come together where they intersect, depositing the entire dose in a small area.
Is this technique right for me?
SRS is suitable for treating functional abnormalities and small tumours in the brain. It is commonly used for central nervous system tumours, either primary tumours or metastases, and can be applied in a single session. When this technique is used in the treatment of body tumours, it is called stereotactic ablative radiation therapy (SABR) or stereotactic body radiation therapy (SBRT).
How is SRS applied?
Before SRS treatment, a thermoplastic mask (constructed in mesh pattern to prevent the feeling of claustrophobia), personalised for each patient, is placed on the head and kept completely still throughout the procedure to avoid damage to nearby healthy organs, such as the eyes.
High-Dose-Rate Brachytherapy
What is High-Dose-Rate Brachytherapy?
Brachytherapy is a type of radiation therapy that involves inserting a radioactive source (implant or seeds) in the tumour itself or adjacent to it using very thin catheters. In the case of already operated tumours where treatment is indicated after surgery, insertion of the radioactive source is in the area where the tumour was previously located.
This technique allows higher doses of radiation to be applied to a more specific area than with external radiation treatment. Radiation thus affects as few normal cells as possible, causing fewer side effects.
How is brachytherapy administered?
At the GCCC 360 Centre of Oncological Excellence, we have various insertion techniques, depending on the type of each tumour, such as:
- Interstitial brachytherapy. The radiation source is inserted into the tumour or organ to be treated and is a highly suitable technique for the treatment of prostate cancer, among others.
- Endocavitary brachytherapy. The radiation source is placed inside a body cavity or a cavity created by surgery and is used, for example, in the treatment of cervical or endometrial cancer by inserting applicators that carry the radioactive source.
What types of brachytherapy are there?
Low-dose-rate (LDR) brachytherapy. In low-dose-rate brachytherapy treatments, the seeds inserted into the patient continuously release the radiation dose for several hours. There is a submodality called ‘ultra-low dose rate’ in which radiation is released very slowly over weeks or months, which involves the permanent placement of brachytherapy seeds in or near the tumour.
- High-dose-rate (HDR) brachytherapy.It is most common technique in current radiation therapy treatments. In high-dose-rate brachytherapy, the radioactive material allows the radiation dose to be released more quickly, in less time, in the order of minutes, and then the implant or applicator is removed.
This applicator is image-monitored to ensure correct placement and may remain located between treatment sessions, or be applied before each session, with or without anaesthesia depending on the area to be treated.
It is often an outpatient procedure, which means that each treatment session is short and does not require admission to the hospital.
This is a high precision technique that makes it easier to increase radiation dosing on the tumour without damaging the healthy tissue around it.