Chemotherapy, radiation therapy, surgery, hormonothérapies or even the very recent immunotherapies.
.. In support of cancer, the medical research has undergone many changes in recent years. The therapeutic arsenal has expanded and the care becomes more complex, requiring more and more often the combination of several treatments. And it is not always easy to find. Le Figaro has interviewed several health professionals in order to make the point about the treatments available. Surgery: a therapy very répandueLa surgery is the treatment most frequently used against cancer. . In 2017, 465.
.643 surgeries for this indication in France, according to the national cancer institute. “This is not the case we are talking about the most, but more than half of patients are cured with surgery,” says Dr. . Sylvie Bonvalot, head of the department of surgery of sarcomas at the Curie Institute in Villejuif (Val-de-Marne). “A multidisciplinary approach with radiologists and radiation oncologists is one of the best prospects for improved treatments.
” Sylvie Bonvalot, a surgeon When a tumor is detected, a biopsy is performed: the cells are collected to be analyzed to determine if it is indeed cancer.
If this is the case and that the tumor is accessible, surgery is scheduled. It is often accompanied by radiation therapy or chemotherapy. “A multidisciplinary approach with radiologists and radiation oncologists is one of the best prospects for improvement of cancer treatments,” says Dr Bonvalot. But the surgery also has its limits.
According to their location or their stage of evolution, it does not treat all tumors. This is the case when a tumor is located in an area that is inaccessible or even if it is a particular type of cancer, such as leukemia (blood cancer). In addition, some of its adverse effects are troublesome: fatigue, loss of appetite, easy bruising, oozing, swelling, but also reactions to certain drugs and infections.
.. ” READ ALSO – reconstructive Surgery after breast cancer: the women are too badly informed Chemotherapy: a treatment emblématiqueVéritable weapon all-terrain, chemotherapy is the treatment that is emblematic of cancer, in particular, are known to cause the loss of hair. Developed since the 40s, the “chemo” target simultaneously cancer cells and normal cells. It is for this reason that the side effects of chemotherapy are often very heavy: hair loss, extreme fatigue, vomiting.
However, there are a wide variety of chemotherapies that target the weak points of each cancer. For example, a breast cancer may be treated with a drug, said alkylating.
These molecules have the ability to bind to the DNA molecules, preventing cell replication.
Healthy cells are also impacted, but as they multiply less rapidly, they will suffer less. Chemotherapy may be given before surgery, in order to decrease the size of the tumor prior to its removal, or after, to minimize the risk that there are still cancer cells in the body.
Especially, chemotherapy helps fight against metastasis, which correspond to the deployment of a tumor mother in other places of the body. . In 2017, 324. .000 patients have follow-up chemotherapy in France, according to the national cancer institute. ” READ ALSO – advanced colorectal Cancer: chemotherapy shortened to the half of the patients Radiation therapy: a treatment history but still very much used radiation therapy is the treatment history of cancer.
Discovery in a formal manner at the beginning of the 20th century by Pierre and Marie Curie, radioactivity is to bombard the tumor with photons and electrons (particles of light or matter). When these small balls of energy strike the DNA, they cause break-outs.
Gold as well as cancer cells repair themselves less effectively than normal cells, they are more likely to be destroyed. Like chemotherapy, radiotherapy can reduce the size of a tumor before surgery (called neo-adjuvant), but also reduce the risk that cancer cells remain in the body after surgery. It is sometimes used in synergy with chemotherapy. It can also be used in palliative care, that is to say, when there is no forgiveness possible for a patient, but that treatment is still necessary in order to avoid too much suffering. . In 2017, 196.
.000 patients were treated with radiation therapy.
” ALSO READ – breast Cancer: the continuing progress of the radiation therapy Hormone therapy: a treatment against the recurrence In the case of certain cancers, such as those which affect the uterus, the prostate or the breast, the tumor may grow more rapidly under the effect of hormones. Hormone therapy is used to block hormone production or their action in order to prevent the growth of tumour or metastases, or even to slightly decrease. “This is a treatment that involves sometimes rethink his way of life. .” Dr.
. Claire Willow, gynecologist, There is generally an adjuvant therapy, that is to say, it accompanies surgery or radiotherapy or chemotherapy. “It is not very appreciated by patients because it is a long treatment, between 5 and 10 years, which sometimes implies to rethink its way of life,” says Dr.
. Claire Willow, a gynaecologist at the Institut Curie. In fact, for breast cancer, for example, tamoxifen, prescribed to premenopausal women, causes some of the hot flashes, cycle disorders, vaginal discharge, or thromboembolic events.
As for the anti-aromatases, prescribed to post-menopausal women with breast cancer, they may be at the root of muscle pain, mood disorders, excessive cholesterol levels and increase osteoporosis. “It is an essential treatment which helps reduce the risk of recurrence and metastasis,” says the specialist. For example, in the case of breast cancers are hormone-dependent (70% of all breast cancers), tamoxifen decreases 40% the risk of relapse. The anti-aromatases can reduce to 20% the risk of relapse compared to Tamoxifene. ” ALSO READ – breast Cancers: where are the treatments? Immunotherapy: the spearhead of the research against the cancerL’immunotherapy represents a genuine change of paradigm in cancer management. Rather than trying to hit without distinction to all cells – cancerous or otherwise – as do the radiotherapy and chemotherapy, he is here to strengthen the immune system, helpless in the face of cancer cells that manage to block it. . For the moment, these innovative therapies are used alone or as an adjunct to radio – and chemotherapy, particularly to treat cancers inoperable or metastatic stage. “There is a real hope of cure for metastatic patients.
” Aurélien Marabelle, immunologist “there really is hope for cure of metastatic patients for whom forgiveness seemed impossible. Immunotherapies are used to help us reduce the risk of relapse,” enthuses Dr.
. Aurélien Marabelle, immunologist at the Institut Gustave Roussy. For the moment, certain cancers of the lung, kidney, ENT and melanomas can be supported with this new approach.
Four permissions placed on the market have been issued in France, but other immunotherapies are currently being tested could be allowed soon.
” READ ALSO – Cancer: immunotherapy provides a sustainable outcome at a quarter of the patients A study published in 2019 in the journal of the american society of clinical oncology showed that patients treated with immunotherapy have 2. .3 times the probability of durable remission than those treated with chemotherapy or targeted therapies. Another strong point: the scarcity of their side effects: “While the chemotherapies are toxic to all patients, only 1% of the patients on immunotherapy are affected by toxicities severe”, says Dr. . Marabelle.
“But we must remain cautious because of the side effects can appear long after the beginning of the treatment: the immune system can turn against some of the healthy tissue. ” The main problem of these treatments is their very high cost. For example, Sipuleucel-T, a treatment indicated in the cancer of the prostate costs approximately 89.
.000 euros. Another approach, called CAR-T cells could cost up to 360,000 euros per patient. . .