It is estimated that this year, 34,750 women will be diagnosed with breast cancer in Spain. Around 12,000 will suffer gynaecologic cancer (3,600 ovarian; 2,480 cervical; and 6,773 endometrial cancer). These are the four tumours involved in women’s cancers. If one sees the glass as half full, a giant step forward has been made in cancer treatment in recent years. To give an example, between 1980 and 2020 mortality due to breast cancer dropped by 40% in developed countries. This improvement stems from combining early detection with effective surgery-, radiotherapy- and pharmacotherapy-based treatment. To continue progressing in research and accompanying women diagnosed with cancer, Vall d’Hebron, together with Natura, are launching the fifth Mocador Solidari (Solidarity Kerchief) campaign, coinciding with the build-up to International Breast Cancer Day.

Since its first year, the initiative has been sponsored by the model, TV presenter and President of the Ared Foundation, Judit Mascó. For each campaign, the artist Clàudia Valsells reinvents the design of the kerchief, which this time is a versatile, unisex, XXL piece. All the profits from sales in the Natura stores and website go to supporting research into women’s cancers: funding two predoctoral researchers at the Vall d’Hebron Research Institute (VHIR) and the Vall d’Hebron Institute of Oncology (VHIO).

Current treatment for breast cancer can be highly effective, with the chances of survival at 90% or higher, especially when the disease is detected in its early stages. This is why Dr Cristina Saura, head of the Breast Cancer Unit at the Vall d’Hebron University Hospital and principal investigator in the VHIO Breast Cancer Group, is calling on women to attend their gynaecology visits and not be worried about visiting a professional if they notice changes to the shape or colour of their breast, pain or secretions.

Laboratory advances

“In just five years, the mocador solidari has become a symbol of the fight against cancer and helps ensure research into finding answers continues,” states Dr Antonio Gil, head of the Gynaecology Department at the Vall d’Hebron University Hospital and head of the VHIR Biomedicine in Gynaecology Research Group. In recent times, the research conducted by Carina Masferrer, the predoctoral research fellow with the VHIR Biomedicine in Gynaecology Research Group, has made progress in new therapeutic strategies for the treatment of endometrial cancer. This has been made possible by her thorough work into tumour inhibitors, such as ABTL0812, which have been assessed in preclinical models of endometrial cancer. In this regard, the research group has developed one of the largest European platforms for preclinical endometrial cancer models. As Carina Masferrer acknowledges, “Being able to work in a hospital setting is a major advantage, as it means you can do research using samples from patients.” She also highlights the optimisation of patient-derived organoid generation, an in vitro experimentation platform that facilitates such actions as screening therapeutic compounds. She claims that “The advantage of organoids over animal models is that they provide an understanding of the intrinsic characteristics of each tumour and allow different therapies to be tested until the most appropriate one is found.” Thanks to her work, ABTL0812 has already been assessed and shown a high degree of efficacy in a clinical trial with patients with endometrial cancer. The therapy is now also being tested as a possible treatment for pancreatic cancer.

Emotional accompaniment for women with breast cancer

Dr Cristina Saura, who accompanies many women from the moment they are diagnosed, has not been oblivious to the emotional tsunami patients experience upon being informed about their disease. One of the lines for research funded by the mocador solidari helps by offering psychological accompaniment and treating anxiety and emotional distress from the moment of receiving the news and during treatment, while also giving recovered patients the tools to return to their work and personal lives. This is the Therapeutic Support for Survivors (STEPS) project. The researcher is Alejandra Cano, a psycho-oncologist in the VHIO Breast Cancer Group. She explains how they have identified three phases in the disease which require special attention. The first is the moment of diagnosis. The second is upon completing treatment, when patients return to their normal lives and the disease is socially understood to be over. And the third is among women who have to live with metastasised disease, affecting other parts of the body, among whom different feelings and worries are involved.

With the initial idea of offering broader psychological care, Alejandra Cano explains that she examined the scientific literature on what types of therapy produce the best results, and then adapted an intervention protocol for the second phase at Vall d’Hebron. The first group of women started in January 2021, working on the tools to return to their normal personal and professional lives after treatment. Since then, over 100 women have participated in these therapy sessions. The psycho-oncologist works with groups of up to eight patients who meet on-line two hours a week for three months. Once finished, they are monitored for a further three months. As Alejandra Cano explains, “Their average age is 50, many of the women have children to look after, some join the meetings with their babies, so the online format helps balance their lives.” The women in this group are referred internally. “We sometimes find patients who have finished treatment and their families and friends consider the disease to be over, but the women do not feel they have recovered; this is when we can refer them to this group,” explains Dr Cristina Saura. “These patients might join as soon as they finish treatment or two years later,” points out Alejandra Cano. “They feel different, emotionally unstable, as if they no longer have the same control over their lives as before the disease; they might feel anxiety, have problems sleeping, feel sad or nostalgic.... We give all of them tools and it helps them to share their experiences with others who have gone through the same process,” she comments, further adding, “We help them see the experience as a process of personal growth, and to not be ashamed of feeling different, to listen and to integrate their new reality into their lives.”

After the success of this first workshop last February, another therapy group was started with women who had just received the impact of the diagnosis. These are online workshops that last two hours and are held once a week for a month. As the psycho-oncologist explains, “In this case, they arrive via information we leave in the waiting room and, more than just a therapy group, we offer psychotherapeutic intervention where we work on specific strategies to control anxiety and stress. These are strategies backed up by scientific evidence, adapted at the Vall d’Hebron.” Finally, work will begin in 2023 on therapy groups for women with advanced cancer, who have other requirements.

Judit Mascó encourages collaboration in research into this disease that “affects almost everyone, to a greater or lesser extent.” She stresses that “With this simple gesture, we can help, and feel part of the progress in research into women’s cancers.” From over the five years that project has been running, she remembers the stories of patients with whom she has shared the campaign. “They have been, and still are, the driving force for the mocador solidari. And some, who are now recovered and who have a newfound sporting energy and spirit that is almost scary, have even stayed in touch as friends,” she admits.

To help ensure these project can continue, you can buy a mocador solidari kerchief at the Natura shops, via this link or by making a donation on the Mocador Solidari website. Whereas last year the design was intended for men, Clàudia Valsells explains that this year she has opted for a palette of contemporary colours that young women will like. She admits that, “I would love it to be worn by very young girls, older women and men too,” further adding, “There is a clear intention for the new colours to serve as an injection of energy for everyone.”

Sergio Durany, the founder of Natura, encourages people to buy “a kerchief, which is a wardrobe essential; it can be used as a scarf, as a beach wrap while also supporting a good cause.” He concludes by saying “We are delighted to be able to contribute our grain of sand to research into women’s cancers.”