A National Cancer Prevention Center is being set up in Heidelberg 2

A National Cancer Prevention Center is being set up in Heidelberg

Cancer is responsible for most deaths across the country after cardiovascular disease. The "National Decade Against Cancer," released by the research and health ministries in January, is designed to change that. With one million in funding, strategies to combat tumors should be linked.

Prevention and early detection are crucial here. Research in this area must be given a much higher status than before, one of the goals. Among other things, there will be a "National Cancer Prevention Center", which will be presented this Tuesday in Berlin.

The two largest German oncology institutions for the new center are entering into a strategic partnership: the German Cancer Research Center (DKFZ) in Heidelberg and the German cancer program. The main goal is to advance cancer prevention research. A new building is being built in Heidelberg for this purpose. Perspectives are also planned in federal territory.

In an interview with Tagesspiegel, DKFZ CEO Michael Baumann described the project as "a pioneering institution for Germany, Europe and ultimately for the world." Currently, the money comes mainly from German cancer aid and DKFZ.

Applications for ministries and funding agencies are planned. He hopes to gather private donors behind the center. Otherwise you will not be able to "master the huge increase in cancer". The best strategy is thoughtful and well-made prevention.

What Is Cancer Prevention?

Cancer prevention generally means measures to prevent tumor disease. There are three main categories: Primary prevention should prevent the development of cancer, such as a healthy lifestyle and prevention of risk factors (see end of this article). Vaccinations also fall into this category, such as immunization against human papillomavirus (HPV) to protect against cervical cancer.

In addition, there are two other forms of prevention that are often not understood as such in the general population: Many tumors can be treated very well with currently available methods if they are detected at an early stage. If bowel cancer is diagnosed and treated in the early stages of colonoscopy, this counts as secondary prevention.

Tertiary prevention, on the other hand, can improve the prognosis of people who already have cancer, such as preventing relapse. "If you consider primary prevention and early detection together, you could avoid up to 70 percent of all cancer deaths," Baumann says. All three types of prevention will be investigated at the National Cancer Prevention Center.

Why do you need a national center?

"Prevention is hard work," Baumann says. Such measures would take a long time. Unlike successful new therapies, results are usually not seen until a generation later in the statistics. It also means that prevention is not yet high on the agenda of research organizations and politicians.

In fact, only seven percent of funding from governments and non-public institutions in Europe goes to prevention, while 57 percent goes to research and develop new therapies, according to a survey by the International Cancer Research Partnership 2018.

Effective prevention requires a long-term strategy and good communication between participating scientists, Baumann says. For this reason, for the first time on a large scale, basic researchers, epidemiologists and scientists from other disciplines work under one roof at the Cancer Prevention Center. Because to prevent cancer, one must not only understand the biology of the tumor, but also develop anti-cancer measures and integrate them into the health system.

Prevention needs to be improved

"It requires the insight and collaboration of all of us," Baumann says. The vaccination rate against HPV would be around 40 percent in Germany, although the vaccine is considered safe and protects against cervical cancer and its precursors. In some countries, such as Australia, Norway or the United Kingdom, some values ​​are over 80 percent because they are vaccinated there, among other things, in schools. "And the vaccine is just a sting. How much harder is it to stop smoking, give up alcohol and move?"

The new center should also have an outpatient clinic where you can get individual advice on preventative measures. In addition to changes in individuals' behavior, there is always a need for social debate about how preventive measures can be implemented as effectively as possible – and ongoing political support.

What can you do yourself?

Experts estimate that about 40 percent of all cancer cases could be prevented by avoiding risk factors alone. The most effective is giving up tobacco smoke. Not only does this reduce the risk of lung cancer, but also some other tumors, such as the bladder.

Strong overweight or obesity should also be avoided. Regular exercise and a few rules that follow a diet can help. Thus, a high-fiber diet that contains lots of fruits and vegetables is considered protective against colon cancer. On the other hand, with red meat, it is not entirely clear whether reducing consumption really reduces the risk. Highly processed animal products, such as ready meals and most sausages, should actually be consumed less.

The preventative effect of exercise is considered to be proven, even the rate of relapse and metastasis after cancer treatment is significantly lower in different types of tumors if they exercise regularly. Alcohol should not be consumed or only in small quantities. Enough sleep in dark rooms is also considered a protective factor.

Dermatologists warn of too much sunlight. However, the body does not disagree without bad, especially because with the help of UV light vitamin D is formed in the skin. So you should be moderately exposed to the rays. In this context, skin examination is also effective because the most common types of tumors caused by UV radiation are very easy to treat in the early stages, including melanoma.

The risk of breast and ovarian cancer is reduced in women breastfeeding their children. Menopause, on the other hand, is experiencing an increase in long-term hormone replacement therapies, which should be avoided as much as possible.

Generally, it makes sense to take the warning signs seriously and then consult a doctor. These include palpable sores and inexplicably rapid weight loss, as well as blood in the stool, expectoration of urine or lungs.

When it comes to cancer: What anti-cancer therapies are a new hope?

There have been significant improvements in this area in recent years. Chemotherapy or radiotherapy aims primarily at destroying rapidly dividing cells – usually tumor cells. Because not all cancer cells are affected so often, doctors have long been trying to activate the immune system against tumor cells. Or better yet, reactivate.

After all, the body’s defensive protection can determine whether or not a cell is degenerate. During cancer, the immune system loses that ability. Certain molecular checkpoints prevent immune cells from attacking cancer cells. A group of medicines (checkpoint inhibitors) works against these brake pads, including around the ipilimumab antibody (trade name "Yervoy"). Thus, patients with cancer such as cancer of the skin, prostate, bladder or kidney, whose cancer was previously considered incurable, have a good chance of recovery: About one in five can hope to permanently stop cancer.

Another treatment concept, which can be used to rescue previously treated blood cancer patients, also reactivates cancer immune cells: T cells. Doctors can filter these important defense cells from the blood and change them in the laboratory (in so-called CAR-T cell transformations) so that they recognize the typical protein on the surface of cancer cells. As a result, T cells reconnect to cancer cells and trigger an immune response against the tumor.

Two cancer therapies of this type have been approved so far, "Kymriah" and "Yescarta". However, the cost, especially due to complex production, is over € 300,000 per patient. With Yervoy costing € 65,000 per patient, it is questionable whether the healthcare system can fund these therapies for hundreds of thousands of cancer patients – another argument to advance cancer prevention and thus save expensive therapies.