Read the Conversation
EF: If 2020 was the year of diagnostics and 2021 the year of vaccines, what do you think will be the key talking points for 2022 in healthcare in Colombia?
RSP: 2022 will be about a combination of things, the pandemic isn't over yet, and we are looking closely at what is happening in Colombia. Post-pandemic, a backlog of diseases needs attention; for the last two years, many patients haven't been in the system, creating a difficult situation for the health system, hospitals, and insurance companies. The problem is repeated in many other countries; it will be a concern for the year. Besides Covid, we are more and more concerned about new disease conditions. Specifically, in cancer, many patients haven't been to a doctor, and their prognosis is not good.
EF: What was the mission you set for yourself when appointed Executive Director for this exciting new project?
RSP: I was appointed in July 2021 to lead a very exciting project, from its operation design, construction, equipment installation, hiring people, and opening for business as soon as possible. The mission was to open the hospital in July 2022 in Bogota, and we managed it.
EF: How was the gap for a new cancer centre identified in the market?
RSP: There is a lot of room for improvement in Colombia. There are many general hospitals, but very few are dedicated wholly to the highest care for cancer. We have a highly specialized facility that attends to people's specific needs, and only one other hospital is dedicated to cancer in Colombia. Many small providers offer fragmented care to patients, but we have a specialized hospital for cancer with everything the patients need in one place. It is not uncommon in Colombia to have surgeries in one facility, radiotherapy in another hospital, and chemotherapy in yet another installation. We cover diagnosis and all its ramifications with the latest and best technologies available in the market in one physical space. It can take hours to go from one part of the city to another, so having everything in one building makes things much easier for the patients. We have a multi-disciplinary model, a group of physicians, nurses, and other people in each disease area. For example, we have a surgeon, oncologists, radiotherapy doctors, and nurses in the breast cancer area. We employ navigator nurses in contact with the family and work with the doctors and all services to ensure the patients have what they need. We have a patient, and family-centric model, the best science and technology and are strong in a human aspect as well, treating patients with the dignity they deserve and giving them a good hospital experience.
EF: When building the team for the new centre, how did you attract the best physicians and doctors?
RSP: CTIC has been an opportunity to bring together clinical attention and research. Many doctors wanted the chance to work with us; in Colombia, hospitals and clinical care centres usually do not have a research centre on the premises, and we have both in one centre. Research and clinical care are important in cancer because they allow patients more options. The name is descriptive: CTIC stands for Treatment & Research Cancer Center Luis Carlos Sarmiento Angulo. Many people are interested in working with our cancer research team and this group of diseases. The founders strongly support the organization, and our patients' future is safe in our hands.
EF: You recently did your first event on oncology; what were the key takeaways from the event?
RSP: It was an amazing experience; about 200 types of cancer are treated differently depending on the patient. It is a new way to see the disease and offer options to future patients. More than 450 people work with us on cancer, which will be a huge challenge in the future. The main takeaways were:
- The need to work within networks; otherwise, we are isolated from the world. We understand this and have put it into practice.
- Approximately 65% of world investment in medical research is in cancer. The focus is on discovering the cancer code and the people who have cancer. Areas such as genomics are already important but will become more.
- The microbiome concept: our bodies are full of bacteria, especially our bowels. The bacteria work together and are more related to body functions than we realize. There will be more and more interrelations between our bodies and the bacteria that live in them, which will be huge in the future, not only for cancer but for other diseases as well. Immunotherapy is very important in cancer treatment, and some patients are resistant to immunotherapy. But a relationship has been discovered between the microbiome and a better response to the treatment. It is possible to do a transplant with faeces, taken as pills to change people's bacteria and microbiome, for a better body response to immunotherapy.
- Immunotherapy: when I became a doctor many years ago if a patient was diagnosed with advanced melanoma, it meant that person would die within the next year. But today, it is amazing what can be done in immunotherapy and other types of cancer.
- Personalized medicine: every day, there is more information on the types of cancer, the patient's genotype, and how to treat each patient according to their genotype. It will become more common in the future -we are advancing in giant steps in this area.
EF: What is CTIC's role in boosting Colombia's local innovation and research capacity?
RSP: We are in contact with many international pharmaceutical companies, some with plans to have a hub in Colombia for research and innovation. A centralized CTIC is excellent for the field we cover and the research we do, both basic and clinical. We will find a way to collaborate in clinical research, bring many clinical protocols into the country and apply them to patients for better health and have new knowledge on cancer treatments. Our organization's research is important for Colombia; we cover phases 1 to phase 4 and have research labs and the people to make it all possible. Our Research Director, Dr. Cardone, is very active in cancer research and is building a program to take clinical research to basic research. We aim to be a partner of choice to companies that want to invest and have local production in Colombia. We can be strategic partners with multinational companies coming into the country and collaborate to benefit all Colombians.
EF: Has collaboration between private and public sectors evolved since the pandemic? What can be done to increase cooperation between the public and private sectors and local and international companies?
RSP: Collaboration is key and has evolved and improved since the pandemic. Technology has made collaboration easier, has helped enormously in the disease area, and is a big positive from the pandemic, causing an impact on the population of different countries.
EF: Could you elaborate on the economic significance of CTIC for Colombia in creating jobs and having a healthy population?
RSP: Currently, 350 people work at CTIC today, but when we reach full operation, we will need about 1200 people directly working in the building and a few more part-time. Our multi-disciplinary integrated model can receive 10 thousand new patients per year. There are around 115 thousand new cancer cases annually in Colombia, and a new player that can attend 10 thousand of those cases yearly, will be a huge help to the system. There are reports from a government organization that show that it takes a patient, on average, 129 days to go from symptoms to treatment, which is too long, and we want to contribute to shortening that period.
Secondly, the quality of data in Colombia, especially on cancer, is not as good as it should be. We believe that with our resources, systems, and standardized procedures, we can gather better information for the system to make better decisions.
Thirdly, research: with clinical research, we can offer people new treatment opportunities to which they didn't have access before. Data will not only be good for the patients but to build knowledge for a better understanding of cancer in Colombia and the region. We have plans to expand in the region, Peru, Ecuador, and Venezuela, none of these countries has a lot of research in this field, and we could supply better information, clinical research, and expertise. In the future, we will have molecular cancer epidemiology information on the Colombian population, which is important because, in global cancer research, only 1% of the patients in research projects are Latin Americans. It is an exciting concept and information to bring to the table.
EF: Do you see yourselves as a future healthcare hub for Latin America?
RSP: Yes, we do. We will first concentrate on Colombia and its needs, but we plan to take to the region advanced technology, which is not available. We have the latest technology in many fields to benefit the region's patients. We have the first CyberKnife for radiosurgery in Latin America; high-tech equipment for precise, non-invasive treatment. Until now, patients had to travel to the US to access that treatment. We will also have robotic surgery in CTIC for Colombians and people in the region.
EF: What is your take on the future potential of AI? Is it something you look to implement in the future, and what benefits can technology and AI bring to health and cancer research?
RSP: We have equipment for a colonoscopy that alerts the physician to a possible problem -that used to go unnoticed- depending on the colour of the mucus in the colon. AI can identify potential life-changing issues physicians would never find. The same thing happens in radiotherapy. We have top-notch technology from the best global companies. When fed a case, we have software that suggests the best equipment for a specific case depending on the patient's size, weight, tumour type, or genomic. We are currently structuring databases to have and use all the information; the possibilities are limitless and will change how medicine is done in the future.
EF: Do you think Colombian physicians are willing to adopt technology and AI?
RSP: The healthcare world is changing in many ways; we are now very patient-centric, but to make the change to a patient-centric model, young people who are prepared and have the energy to do things differently are needed, and the rest of the team will follow. We have very experienced doctors that are not so young; we have doctors between 40 and 50 years of age with excellent clinical practices and a few under 40 years of age. Technology is easier for the two latter groups, but the older doctors will be willing to use it if the younger doctors do things right.
EF: What would you advise foreign investors interested in investing in Colombia?
RSP: When investing, long-term planning is required, and a country must have certain attributes. Colombia is possibly the best country in the region to invest in because of its stability. Our institutions, if not the best, are dependable, the economy looks good, and there is a base for good healthcare with very good doctors and nurses. 99% of the population has some insurance, and our clinical outcomes are comparable to other countries. I think it is a great country to invest in the healthcare system. There are, of course, some risks with political issues in the healthcare system's future, but with all we have achieved, I am optimistic.
EF: What impact are you hoping to have on the Colombian population? What would you like to celebrate when you look back on your first five years in operation?
RSP: I hope Colombians will recognize CTIC as the best place to treat their cancer. Secondly, we will be working for clinical outcomes and not only for costs. With five years of data, we will prove to the insurance companies that even if it is a bit more expensive to work for clinical outcomes, it is much better in the long term. We hope to be a hospital where physicians from all over the country will choose to work either for research or clinical practice. And, we must be sustainable from a financial point of view. We must grow consistently, offering services people need over the next five years and beyond. If we can do all this over the next five years, the results will be wonderful for CTIC and the country.
EF: Is there any final message you would like to share with our readers?
RSP: There are certain political issues at the moment, and the decision-makers need to take a long-term view. The long-term view is essential because what is important today will be even more so in ten more years and even more in twenty. In cancer alone, we expect to have many more cases diagnosed. Healthcare and education are fundamental to the country and correlated to bringing good services and research to Colombia.
