The Ligue contre le cancer defines it as all the care and support necessary for patients during and after illness, in addition to treatment. As important as radiotherapy, chemotherapy and hormone therapy, consider caregivers, supportive care is essential in the management.
A study by the League against Cancer, published on the occasion of Pink October, indicates that only 26% of patients suffering from chronic fatigue are directed towards adapted physical activity, the best recommended treatment, that 19% give up treatment. support for financial or accessibility reasons.
Deep inequalities that the Montpellier Cancer Institute is trying to overcome. 18 months ago, it opened within its walls a pioneering and innovative support care platform, unprecedented in its ambition, with 1,200 m2 dedicated and 60 professionals mobilized. Doctor Héloïse Lecornu coordinates the unit. Gaëlle Barre is an advanced practice nurse in the department.
Why supportive care?
UK : Because, once the treatment is over, the doctor gives an appointment in six months, the patients who have been treated for breast cancer have the impression of jumping into the void: they still have the after-effects of the treatments, and the three quarters of women are on hormone therapy for five years, with many side effects. They feel abandoned, lost.
How would you define supportive care?
HL : I use the definition of the Inca, the National Cancer Institute: active care and support during treatment and after, which will allow patients to manage side effects, to have a certain quality of life. Eleven supportive care has been identified: management of pain, nutrition and undernutrition, social life, psychology, adapted physical activity, onco-sexology… For a long time, there was no no comprehensive support. Psychological follow-up was offered.
Are they accessories?
HL : No, it is one of the mainstays of cancer treatment, along with chemotherapy, surgery, radiotherapy and hormone therapy.
“40% of patients retain treatment sequelae”
When do you offer them in the treatment?
UK : From the start and throughout treatment, and even from the first biopsy, the announcement of cancer. And two months from the end of the treatment, we propose an assessment with the supportive care doctor.
Is breast cancer a “model” cancer to demonstrate the interest of this type of care?
UK: It is one of the pathologies that brings the most patients to us.
HL. : Yes, it’s our largest active file, we have a thousand new patients each year, and 40% keep treatment sequelae.
How do you intervene, very concretely?
HL. : We build a post-cancer program with patients, and it takes place here, at the ICM, or at home, or close to home. There are collective workshops and individual times, with very varied things. This week, we set up a fencing workshop, for example. Sport is very important for reclaiming one’s body, and we don’t choose fencing by chance, we rehabilitate the shoulder, it takes a lot of concentration, which our patients complain of having lost, it’s an activity that often, they did not practice, like a new start, with new perspectives, a new impetus… Yoga has another interest, it is very effective against joint pain, frequent in hormone therapy. Art therapy and music therapy help to better manage anxiety. But some women also need an aesthetic check-up, others are relieved that we are addressing the issue of sexuality… There are no taboo subjects, and they are the ones who guide us, we don’t not a “questionnaire”.
The League against cancer has just made a study on the inequality of access to this support care, do you confirm it?
HL : Yes, there are “white areas”. But with the League, and motivated professionals, we try to build a network so that there is more equity. These are 100% covered treatments.
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