Cancer: treatments and supportive care

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The main strategies used in the treatment of cancers are surgery, radiotherapy, chemotherapy, targeted therapies, hormonal therapy and immunotherapy. For certain blood cancers, a bone marrow transplant is sometimes necessary.

Allowing increasingly individualized treatments depending on the type of tumor and its molecular markers.

Surgery

The treatment of cancers by surgery involves removing the tumor. We speak of excision or resection. It is used in approximately 80% of cases and therefore remains the main treatment for cancer. Its aim is curative (when it allows 100% of tumor cells to be removed). But it can also be carried out for diagnostic purposes (the removed tissue is analyzed to clarify the nature of the lesion and facilitate the choice of additional curative treatments) or for palliative purposes (to relieve the pain linked to the size of the tumor, to facilitate the functioning of the affected organ…). In certain cases, interventions can be carried out on an outpatient basis, that is to say on a scheduled basis, without an overnight stay. It allows the patient to leave the hospital the same day they enter, when safety conditions are met.

Early detection of many cancers allows for less invasive interventions on smaller tumors, with micro-incisions helping to reduce trauma.

Radiotherapy

This sheet from the Understanding and Acting provides reliable and accessible information to patients, their loved ones and all people affected by the disease.

Radiotherapy is based on the use of ionizing rays whose high energy destroys cancer cells. Two types of radiotherapy exist: external radiotherapy and internal radiotherapy (or brachytherapy). In the case of external radiotherapy, the rays are emitted by an external source placed overlooking the lesion. They pass through the Cancer patient’s skin to achieve their goal. During internal radiotherapy, radiation is emitted by a source which is introduced onto the site of the tumor itself. These are generally beads, microspheres or wires composed of iridium or radioactive cesium.

Radiotherapy, alone or in combination with chemotherapy, is generally curative. It is sometimes used as a palliative treatment, to reduce local symptoms associated with the tumor. Radiotherapy sessions are carried out in the majority of cases on an outpatient basis, that is to say without staying overnight in hospital. At the end of the treatment, which lasts approximately thirty minutes, the patient returns home. The radiotherapy team ensures follow-up.

Chemotherapy

This sheet from the Understanding and Acting collection provides reliable and accessible information to patients, their loved ones and all people affected by the disease.

Chemotherapy involves the administration of so-called “cytotoxic” drugs which will destroy tumor cells. These drugs can act on different processes involved in cell multiplication. A chemotherapy protocol often uses a combination of several drugs that act on these different processes. Each course consists of treating the patient for several days, then observing a period of rest during which healthy cells can regenerate.

Chemotherapy is administered intravenously on an outpatient basis in the vast majority of cases, that is to say during the day in hospital. Some centers also offer home chemotherapy but only for certain treatments with short infusions and which do not expose you to the risk of significant adverse effects. Chemotherapy is also now available orally in tablets to take at home and has equivalent effectiveness.

Chemotherapy is often feared because of its side effects (hair loss, nausea, vomiting, drop in blood cell count, etc.). Indeed, chemotherapy drugs attack not only tumor cells but also healthy cells which are actively multiplying, such as those of hair, blood or digestive mucous membranes.

This sheet from the Understanding and Acting collection provides reliable and accessible information to patients, their loved ones and all people affected by the disease.

Targeted therapies constitute another family of cancer treatments most often available orally. By specifically targeting certain molecules in the body, they block mechanisms which are essential for the proliferation of cancer cells or, more generally, for the development of the tumor. Some act on the cancer cells themselves and others on the cells of the tumor microenvironment, for example by blocking the formation of blood vessels which irrigate the tumor (anti-angiogenic drugs) or by activating immune cells (immunotherapy).

For example, in breast cancers overexpressing the HER2 receptor, the prognosis of the disease has been significantly improved by the discovery of trastuzumab, a targeted therapy molecule which blocks the functioning of this receptor. Today, there are around fifty targeted therapy molecules, indicated in the treatment of nearly 20 cancers. A companion test makes it possible to look for the presence of the drug’s target molecule within the tumor in order to know if the patient is eligible for treatment.

Depending on the cancer, targeted therapies can be prescribed alone, in combination with each other or with other treatments. By primarily eliminating cells carrying the targeted molecular abnormality, these therapies are generally better tolerated than conventional chemotherapies but they are not free from adverse effects (gastrointestinal disorders, skin problems, metabolic problems).

This sheet from the Understanding and Acting collection provides reliable and accessible information to patients, their loved ones and all people affected by the disease.

The growth of certain cancers is favored by sex hormones produced by the body: thus, certain tumors of the breast or uterus grow under the action of estrogens or progesterone, and certain prostate cancers progress under the influence of estrogen or progesterone. action of testosterone. Sex hormones act on tumor cells by binding to their surface at specific receptors. Hormone therapy drugs block the synthesis of these hormones or prevent them from binding to receptors. They are administered mainly orally.

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