Antonio Pérez, pediatrician and director of the CRIS Advanced Therapies Research Unit at the University Hospital of La Paz, says it’s not very common for teenagers with cancer to go to medical school: only “brilliant students” enter the race and the Treatments are very difficult for them to reach the cut-off grades in the middle of the study period. Lucía de la Torre and Jaime Fernández were successful. Both, after being treated by Pérez himself, are studying the course with the aim of helping patients who are going through their situation with a perspective that many doctors lack: those who have suffered the disease in their own flesh.
In a classroom at the Autonomous University of Madrid, where Pérez teaches and Lucía welcomes them (Jaime studies at the Complutense University), the three reflect on what the illness means at the beginning of life and what it will mean to graduate. “They will be great professionals who have also lived through the disease. They will become researchers who know the important needs that are there and they will really be the great speakers and the ones who make visible what we need,” says the doctor.
And what they need, Lucía adds, is more support for research so that one day cancer can be 100% cured. “Without an investigation, I would be dead now. If you see a traffic accident, people will stop to help, but they won’t if they don’t know what’s happening,” he says, calling for attention for foundations like CRIS Against Cancer , which has a lot to do with him treatments.
Childhood cancer is still a rare disease, affecting 14 out of 100,000 children in Spain. But it is also the most common cause of death in childhood and adolescence (according to INE, 272 children under the age of 19 died of tumors in 2021). Leukemia accounts for about a third of the total, and although the five-year survival rate in Spain is 84%, according to the latest report from Spain’s Childhood Cancer Registry, the small percentage of relapses has a very poor prognosis: you get about half beyond that .
Pérez talks to the two patients he treated for leukemia who are now studying medicine: Álvaro García
Jaime and Lucía’s leukemias were, according to their doctor, “very, very aggressive”. Jaime, who is now 20, was diagnosed when he was 12 when he “wasn’t yet very aware” of what such an illness means. He had “Philadelphia positive” acute lymphoblastic leukemia, a subvariant that accounts for about 3% of cases of the disease. Although conventional therapy went well, he suffered a relapse two years ago, for which he underwent a bone marrow transplant. He now gets third line treatment (used when two have already failed).
Although the illness changed everything in his life, he is optimistic today. He is convinced that he will succeed, although the consequences are already irreversible. “One of the things I would like to improve is the more accurate monitoring of side effects. I have hip necrosis and it may have been a year or more before I had the response and so on. I don’t know if anything could have been done, but until you’re diagnosed there’s no way to change it.”
Today Jaime can lead an almost normal life, but with limitations:
– I can’t exercise, but I can walk, although sometimes it flares up and I need crutches.
“If they put the hip prosthesis in you, you’ll feel much better and the pain will subside,” says the doctor.
Pérez admits there is a challenge with the consequences of the treatments. Medicine is focused on ensuring the survival of children, and there have been tremendous advances in this area in recent decades, but the price is mostly side effects that accompany patients for life, which affect more women and which often remain invisible through the statistics of remissions and survival.
22-year-old Lucía also considers the aftermath to be central. Probably because they affect her directly and prevent her from living like any other girl her age (she also can’t play sports, for example). Like Jaime, he received his cancer diagnosis at age 12: osteosarcoma of the right distal femur. Although the tumor disappeared with chemotherapy and surgery, the treatment resulted in a refractory secondary acute myeloid leukemia (unresponsive to conventional treatments), which occurred after five years.
She was saved by a bone marrow transplant from her brother. But then came the aftermath again. He suffered from the so-called “graft-versus-host disease” that often occurs after this type of procedure. At first he had it acute, with “constant blood diarrhea, sores in the mouth and difficulty swallowing”. “I took a lot of corticosteroids, which make you hungry, but I was very scared because I could hardly eat,” he says. Then the same disease manifested itself in a chronic form with skin rashes. After several treatments, he managed to control her with an experimental therapy. “Now I’m pretty stable,” he says, fresh from an anatomy exam that went “very well.”
growing up with cancer
Both Lucía and Jaime were children with cancer, spent part of their youth in treatment and began their youth relapsing. What was previously seen by the pediatrician will at a certain point be treated by the oncologist (in Spain the specialty of pediatric oncology is not recognized).
Pérez teaches at the Autonomous University of Madrid, where Lucía is a student Álvaro García
At Hospital La Paz they are working on this transition, not only for cancer but also for other complex diseases. “We’re always producing more survivors, more children who will conquer the disease and who still need medical care or monitoring,” explains Pérez, who admits that this move from pediatricians to other types of doctors can be a bit abrupt for the youngster. “Paediatricians are, I don’t know if that’s the word, but more loving.”
With teams connected, that transition becomes more gradual in La Paz, where there’s a unit for teens with cancer that sits halfway between the Disney decorations of the kids’ rooms and the cold plants of the adults. “We are integrating psychologists, adult doctors, children, professionals from other fields to work on this change. And we are constantly connected to the new doctors who treat our patients,” emphasizes the pediatrician.
“It’s a humanization that’s part of the investigation. I always say that the best way to help Jaime and Lucía is to do some research and be kind to them. They will provide the answers to the questions that we don’t have today, because they have experienced it firsthand and are very committed and brilliant people,” defends Pérez.
You still have a long way to go. They are a few years behind their age in their first and second year of medicine, respectively, since both were away with the treatments for many months. After such a long time in the hospital, his calling is to continue helping others. Lucía says she had it before she got sick. “Later I even asked myself whether I idealized doctors and that’s why I wanted to study the profession.” Jaime is aware that he lost many things in his life due to cancer, but that without cancer he would not have gone down the path he took.