Dr. Marco Varini has overcome and conquered many challenges in his career as a specialist, and now he is about to face his final one, well past retirement age. Since May, a direct collaboration has been established between Swissoncology, the private oncology practice he founded in 1986, the Oncology Institute of Southern Switzerland (IOSI), and the Cantonal Hospital Authority (Ente Ospedaliero Cantonale - EOC), with mutual benefit.
Why this decision?
Over nearly forty years, the firm had expanded, also benefiting from the collaboration of two other partners, and the issue of my succession was something I had been pondering for some time, knowing full well that sooner or later I would have to resolve it. The decision of one of the partners, Dr. Christinat, to join the new firm in Ticino Brust Zentrum AFFIDEA, born from the collaboration with the Brust Zentrum in Zurich, and to dedicate myself exclusively to breast cancer treatment brought the question back to the forefront: who would continue the practice? I quickly realized that it wasn't easy to find a specialist capable of taking the entrepreneurial risk and embarking on such a venture. After several options, I finally chose to combine a small practice like ours with the resources of a large specialized practice, which has direct access to high-level specialist consultations within an international network of excellence. I was careful to maintain our commitment to personal patient care, with a single oncologist as the primary care provider throughout the entire treatment process.
You were the first to open a private oncology practice in Ticino. What has changed for oncology since then?
"A lot, everything. Back then, surgeons, with the help of the pathologist, decided whether the patient was operable or not, whether the tumor was malignant or not, and what treatment to use, while oncologists were marginalized and not consulted, even if they timidly made suggestions to try this or that new remedy. Aside from often heroic surgical interventions, treatment options were limited, and we couldn't always offer effective treatments. Today, everything is different. Over the last twenty years, the oncology landscape has changed completely, not only in terms of diagnosis and treatment, but also structurally and organizationally. Diagnostic tools have evolved dramatically. At the beginning, CT scans were just arriving, then MRI, today we use PET and even more sophisticated technologies. The pathology itself has also transformed: it's no longer enough to say, 'It's breast cancer,' because each tumor has unique characteristics that influence prognosis and treatment.
We still make traditional biopsy diagnoses, but today we analyze the tumor's DNA to identify specific therapeutic targets. Ultimately, it's a job that requires an entire team. The oncologist needs the support of specialists, but he or she remains the person responsible for interpreting the information, determining what's relevant and what isn't, and ultimately developing a thoughtful and personalized treatment plan that may include surgery, radiotherapy, chemotherapy, immunotherapy, and other highly sophisticated therapies.
However, a well-reasoned, rational treatment plan, based on a diagnosis and a staging of the disease, may not be suitable for the hypothetical Mrs. Bernasconi, because the lady in question has personal problems or other illnesses that mean the established therapy cannot be easily applied."
Then?
The formulation of a therapeutic program for a patient must therefore be tailored to the individual, their individual characteristics, their social context, and so on, and obviously this must be taken into account. But who does this? It can't be the twenty specialists consulted for histological examinations, or for the CT scan results, etc., which is why I believe it's essential that the same oncologist always be the primary physician. He or she, in close contact with the team that supports him or her, remains the trusted contact for all treatment decisions and management.
Once the decision is made, what happens?
This is just the beginning of a process that may be very intense in the initial phase and then more spread out over time. It's a process that must have its own logic and feasibility, and must take into account that the patient can't be repeatedly moved from one doctor to another, each time different. At Swissoncology, we know we continually need all the necessary specialist support. On the other hand, we firmly believe that patients need personal, direct guidance from someone who truly understands them throughout their journey and their suffering, who will follow them over time, who will talk to them and understand the reasonable and appropriate therapeutic range for them, and who, ultimately, knows how to find the right balance between what is scientifically correct and what is humanly sustainable.
Has the collaboration with IOSI changed anything for the Swissoncology Practice?
Dr. Vittoria Espeli, oncologist, deputy head physician at IOSI, and head of the oncology outpatient clinic at the Ospedale Italiano in Lugano as well as the inpatient ward at the S. Giovanni Hospital in Bellinzona, will coordinate the collaboration between the two entities with me. This doctor, who has extensive experience with all types of cancer, will treat all oncological conditions, although she also specializes in ENT tumors. She will be present at our practice regularly, both for consultations and to manage her own patients. The practice will continue to treat patients with all therapies as before, but we will focus specifically on lung, gastroenterological, urological, and dermatological cancers.
Do the successes being achieved in oncology give us hope for the future?
"Certainly! Soon we'll be able to look at cancer like we look at any other disease, no longer referring to it as a hidden disease, but rather as one we can address and treat."
Dr. Marco Varini and an important therapeutic alliance
Most people think that practicing medicine in the oncology field cannot be easy, due to the fear of the disease, which evokes a wide range of emotions in patients and their families.
This isn't what Dr. Marco Varini thinks, having spent a lifetime with them and for them, constantly encouraging and almost protecting them. Since graduation, his fight against cancer and his patients has consistently escalated. He has been at their side, from Zurich to Baltimore to Milan, at the most advanced oncology hospitals, until opening his first private oncology practice in Lugano in 1986. He has always combined this with hospital work at the Clinica Luganese Moncucco and the Clinica S. Anna in Sorengo, where he served as head of the oncology department until 2014.
Co-owner of the professional firm in the following years “Swissoncology Varini Calderoni & Partners”, today, thanks to the agreement with IOSI, he finds himself giving a further turning point to his professional career.
Member of the Swiss Society of Medical Oncology, of the Italian Association of Medical Oncology (AIOM), of the European Society for Medical Oncology (ESMO) and of the American Society for Medical Oncology (ASCO), and former President of the
He still holds important positions, including that of the Swiss Society of Senology, as a founding member of the Triangolo Association, Volunteering for Cancer Patients, of which he is president of the Sottoceneri section. But that's not all! Numerous initiatives, both well-known and lesser-known, are innumerable, such as the annual seminar series he has promoted for over twenty years on the topic of "patients and cancer." These seminars are attended by the elite of the medical and non-medical intelligentsia, and attract a large following of interested members of the public.
