Abelardo Meneses García, General Director at the National Cancer Institute of Mexico (INCan), explains the evolution of cancer’s footprint in Mexico and showcases how the institute has been investing in enlarging its capabilities to become the national and regional reference for cancer treatment.
Could you please introduce to our international readers the key activities and responsibilities of the institute?
“Throughout its history of more than 70 years, the institute has always aimed to be the leader in setting national public policies affecting the diagnostics, treatment, palliative care, and rehabilitation of cancer.”
The National Cancer Institute of Mexico was founded in 1946 and since its creation has been fully devoted to four main goals: medical assistance, medical education, human resources generation, and medical investigation.
Throughout its history of more than 70 years, the institute has always aimed to be the leader in setting national public policies affecting the diagnostics, treatment, palliative care, and rehabilitation of cancer. I am proud to confirm that the institute is already considered as the national and regional reference in oncology because of its cutting-edge equipment, infrastructure and oncology professionals in several areas such as surgery, chemotherapy, radiotherapy, oncology pathology, and radio diagnosis.
During the last five years, the National Cancer Institute of Mexico has grown 70 percent in terms of its infrastructure and occupation while growing by 60 percent its servicing capabilities. Indeed, the institute has currently more than 220 oncology professionals attending around 210,000 cancer patients annually and 5,500 new oncology patients’ cases every year.
Dr. Abelardo Meneses, you started this journey approximately 3 years ago, what have been your biggest accomplishments that have maintained the national and international leading position of the institute since your appointment as General Manager?
One of my biggest accomplishments has been to enlarge the reach of the institution from local to regional as well as to improve our operations from the institution and patients’ standpoint offering a better and more efficient service. Thus, we have been heavily investing in developing our capabilities as well as implementing the best practices in medical assistance, medical education, human resources generation, and medical investigation.
In addition, the National Cancer Institute of Mexico is also playing a crucial role in enhancing national capabilities to treat cancer patients in Mexico. The country has around 26 oncology centers distributed in the territory but still not enough to attend the national need. In this sense, we have been visiting different states that do not have oncology centers in order to develop the population access to high quality treatments for patients that are suffering cancer in those areas.
Just to showcase some obtained results in the national oncology assistance arena, a decade ago only four percent of our patients had social health coverage to receive oncology treatment and 40 percent of our patients had to abandon their treatment because of a lack of resources. Nevertheless, looking at updated figures, 50 percent of our current patients have social health insurance and only one percent of our patients abandon their treatment; thus, we have been able to reduce the mortality of some type of cancers by 40 percent, especially for cervical cancer.
In terms of medical education, the National Institute of Oncology has drastically increased its capabilities to train cancer professionals in the main 35 areas of cancer such as surgery and radiotherapy. Furthermore, we have been actively involved in fostering oncology education amongst all the Mexican medical universities since only 10 percent of those are actually teaching cancer to their students. Consequently, there is an existing shortage of human capital in Mexico to treat cancer patients since there are around 1,600 oncology professionals in the country and Mexico needs more than five times more; furthermore, it is important to mention that 70 percent of the patients suffering cancer are diagnosed too late, two years being the average of cancer’s detection.
The government has recently announced budget cuts of more than 30 percent in oncology; quite an alarming statistics considering that cancer is the third most prevalent cause of death of Mexico (80,000 deaths annually) and that cancer cases in the country are increasing (190,000 new cases every year). What is our action plan to overcome such a big challenge?
The world economic crisis has affected Mexico and therefore, the National Cancer Institute of Mexico has adapted its operation to help the government while maintaining the quality of the institute’s activities. In this regard, we have designed three strategies to raise funds: pharmacology investigation, cyclotron capabilities and biomarker services.
The pharmacology investigation unit was created with the support of Cofepris, to help the pharmaceutical industry develop clinical trials of new molecules that are going to be introduced in Mexico to treat cancer. Therefore, as we already have the infrastructure and the physicians, the National Cancer Institute of Mexico will be able to carry out clinical trials from phase I to phase IV.
We are also expecting to inaugurate the cyclotron, which is an ion medical accelerator that will allow the institute to produce radioisotopes for diagnostic and research practices. Indeed, there are only seven cyclotrons in Mexico: five are in private institutes, one in UNAM and the last one is going to be in the National Cancer Institute of Mexico. We are one of the pioneers and we expect to obtain resources from serving the pharmaceutical industry in this area.
The global trend is to increasingly focus on personalized medicines and treatments and to develop such personalized therapies a specific biomarker is needed. No public institution in Mexico owns a proper biomarker. In this sense, we are developing a national reference laboratory with properly use these biomarker capabilities to validate such tailor-made medicine in order to captivate the demand in such segment.
Innovation seems to be the path of development to improve efficiency and oncology centers’ national coverage, as well as to homogenize cancer treatments. In fact, two of your strategic guidelines are “territorial health care coverage” and “resources management”, which are quite related to telemedicine, technology upgrades, etc. Could you explain to our international readers how the institute is advancing in this direction?
We have recently received visits from a group of experts in telemedicine working in projects with Seguro Popular, to help us enhance the interconnection of our entire network. Indeed, we aim to improve the interconnection amongst all our 26 different oncology centers distributed in the territory to homogenize the information as well as the oncology treatments.
Dr. Narro Robles told us that there is already a strategic plan for the National Cancer Institute of Mexico to implement a national cancer registry in order to understand more accurately the dynamics of the disease in Mexico. What have been the advancements so far and what is the expected impact?
We have two important projects with the government, which are the integral program of prevention and control of cancer, and the national cancer registry, population based. Throughout the institute’s history, it has had its own hospital and histopathological records but such records only address local institutes’ demands. We need a national oncology registry in order to design public policies that will target oncology challenges; therefore, we have already started to build up such database supported and advised by IARC (International Agency for Research and Cancer). It is very important to mention that thanks to such database we are going to be able to homogenize the oncology treatment as well as to know the prevalence, incidence, risk factors, and mortality of all the different cancer cases in Mexico.
Other one of your strategic guidelines is to strengthen oncology research. How is the institute partnering with the industry and other institutions to enhance oncology research in Mexico?
The National Cancer Institute of Mexico has approximately 250 investigation protocols of oncology and half of those are run in partnership with the pharmaceutical industry; the remaining other half is managed by our own initiative. Furthermore, we are actively involved in helping leading pharmaceutical companies such as Roche, Sanofi, Bristol Myers Squibb and Novartis to run clinical trials to launch new drugs in Mexico.
What key objectives would you like to achieve in the upcoming three years?
First, I would like to consolidate the national program of prevention and control of cancer. Secondly, I want to ensure the successful implementation of the different investigation initiatives and strategies to generate own resources of the institute and ensure it will be self-supporting and less dependent of public funds. Finally, I want to position us as the leading national institution in the selection and management of oncology drugs being the main precursor of cancer research programs.