Luis, Pedro Pablo, Eugenio, Olga and Ramona receive their lung cancer vaccine treatment cycle at the Benéfico Jurídico Pneumological Hospital in Havana. Each states that they have an active social life, with a survival rate of over three years since being diagnosed with the disease.
Another patient, Virginia Mustelier Laborde, aged 59, is just starting the treatment program. She lives in the Havana municipality of Cerro, and was referred to the hospital by the doctor attending her workplace, a children’s home.
She explains that she has already concluded chemotherapy and radiation treatments, and will now see how she progresses with the therapeutic vaccine.
None of these patients know the price of the drug, nor have they asked. They note the conscientious care they receive from doctors, nurses and hospital workers.
Before the vaccine is applied, they wait in an air conditioned room with TV, armchairs and varied literature, where they talk about anything but the disease.
On first beginning the treatment, Dr. Manuel Díaz Toledo, a pulmonology specialist and head of Hospital Services, requests that patients stop smoking, follow a healthy diet with plenty of fruits and vegetables, use medicinal brews, which help the airways, and be very attentive to their reaction following treatment, although the vaccine has low toxicity and minimal side effects.
Patients arrive at the hospital on their own, or following a referral from their family doctor. An initial consultation takes place before they are transferred to the chemotherapy service area, where the majority are treated with vaccines. All are evaluated by a multidisciplinary team of specialists to verify their diagnosis and determine appropriate treatment programs, Díaz Toledo notes.
Clinical trials on a Cuban drug of this type date back over 25 years, until CIMAvax-EGF® and VAXIRA® (also known as Racotumomab), which strengthen the body's immune response to the disease, were first registered in Cuba in 2008. The vaccines have featured on the Cuban public health system’s basic drugs list since 2012.
CIMAvax-EGF® is currently registered in Peru, Paraguay and Colombia.
“It is not a curative medicine, but stabilizes the tumor and makes the illness a chronic non-communicable disease,” the pulmonologist explains, adding, “It is a treatment with durability over time and is administered to the patient as long as the body allows. At the end of the first cycle a good general condition is observed, with greater participation in social activities without significant adverse reactions.”
Meanwhile, Dr. Sergio Fernández García, 2nd degree specialist in respiratory medicine, notes that treating a patient with lung cancer is very difficult, with a conservative prognosis offered, as metastasis usually occurs in another part of the body.
“When they arrive at the service, patients enjoy watching television, we bring movies and music to distract them. We hold joint consultations with psychologists and practice group dynamics. We exchange as a family to convey experiences, support and to alleviate depression,” the doctor explains.
The hospital enjoys National Reference status, as such all staff are inserted into a research program dedicated to pulmonology. Undergraduate and postgraduate classes are offered to national and international students, especially those training as future pulmonologists.
In turn, working agreements are implemented with several countries, among which are Venezuela, Colombia, Ecuador, and several African nations.
“To outside specialists we explain our experiences according to the level at which they are studying. We teach therapy and management of these cases. We offer our acquired knowledge and explain how to find more in the current literature, in addition we tutor their research. At the same time, we participate in national and international events, inside and outside the country, where the topics of cancer are treated and we share scientific results. We are interested in majority learning among all professionals so that each contributes to knowledge,” the doctor highlights.
His research is undertaken in conjunction with the Biotechnology and Pharmaceutical Industry Group, BioCubaFarma, particularly with the Center for Molecular Immunology, where the vaccines are produced.
In addition, the research is developed with the National Center of Medical Genetics and other Cuban entities dedicated to science.
As part of their care, patients are subject to clinical, imaging and hemochemical analysis, to determine whether they are vaccine candidates. The medication is then applied and they are carefully observed to assess the immediate clinical response.
Patients are frequently consulted and respiratory symptoms are measured, seeking to determine whether there is stability or progression of the disease. According to the response of each patient, the medication time is readjusted. “We are undertaking a research project concerning patient survival rates and we have concluded that the response is encouraging,” Dr. Fernández García states.
He also argues that the drug is “an innocuous product, it is easily assimilated. It is injected by a specialized nurse and subject to observation for two hours. The mark left on administration, the immediate reaction, are evaluated, and the telephone service is always available. We immediately attend to any call. We schedule a pneumo-oncology consultation once a week. In short, we appreciate cooperation between them (patients) and us, until we become like family.”
Nurse Teresa Zambrano Argumedo, with more than 40 years in the profession and a founder of the lung cancer vaccines program, is responsible for applying the injections and also participates in courses and workshops on the subject.
“Vaccines are applied to the muscles of the arms and buttocks in the morning shift. We have chosen Mondays to apply this type of treatment, in four cycles every 14 days. Later cycles are extended to once every 28 days and the injection should not be applied outside medical institutions. I have seen very few adverse reactions, perhaps some trembling for about five minutes. We recommend that the patient not touch, massage or scratch the area,” she explains.
These professionals agree on highlighting smoking as the leading cause of the disease and recommend people do not take up the habit, even out of curiosity. They note that those who lead a conscious and responsible lifestyle are more likely to be healthy and live longer.
