2023-10-09 17:11:24
In mid-May, Emmanuel Macron announced the creation of twelve new university hospital institutes (IHU), including a new IHU for women’s cancers. Currently being established, it should be launched in the first quarter of 2024. Interview with its director Anne-Vincent Salomon, head of the diagnostic medicine center at the Institut Curie, very committed to the fight against breast cancer and other female cancers .
Why was there a need for an IHU (University Hospital Institute) dedicated to women’s cancers?
20,000 women die each year from female cancers and 80,000 women report one. There are cancers that we never hear about that remain very deadly cancers. Ovarian cancers are always caught too late, and their five-year survival is only around 60%. We talk very little about cancers of the vulva or vagina, which are very mutilating.
Are there any specificities other than their location?
After cancer treatment, 56% of women suffer from chronic fatigue compared to 36% of men. There is a specificity that we do not understand, and which has an impact on daily and professional life.
The IHU brings together the Institut Curie, Inserm and PSL University (ENS, Paris Dauphine, Mines, Inria, etc.). You place a lot of emphasis on exchanges between disciplines.
In Curie, we have internationally renowned caregivers for the care of cancer-related wounds. We have much to expect from their association with chemical engineers and physicists. But one of the originalities will be to strongly associate itself with the social sciences, with the aim of more holistic, more global care of patients. I am an anatomopathologist (visual examination of tumors), I see tumors live every day. But for me, as for the entire team that I manage, we do not treat cancers but patients.
The more we advance in our knowledge of cancers, the more their complexity appears?
We cannot talk about triple negative breast cancer (the most aggressive), there are many types. But within the same tumor, there is also enormous heterogeneity of cells, which is really a problem (because they are not necessarily all sensitive to the same treatment). Precision medicine seeks to dissect this heterogeneity and invent new strategies. For example, combined antibodies, which release the chemotherapy molecule into the targeted cell, and which destroy the surrounding cells.
Can you cite new avenues against aggressive breast cancers?
The combination of immunotherapy which awakens the immune system, combined with targeted chemotherapies gives results on “triple negatives”. But this is still not enough for metastatic triple negatives. Research on the tumor microenvironment, particularly fibroblasts (cells that the tumor diverts to promote its development) is very promising. Clinical trials will begin next year.
Is radiotherapy still relevant?
Researchers at Curie have made fantastic discoveries, such as flash radiotherapy: applying high intensity but very briefly. Bringing 85-year-old patients in just once would be really positive. Having accompanied my mother twice, for breast cancer then endometrial cancer, to her daily radiotherapy, I know how trying it is.
Are you strongly in favor of HPV vaccination?
It protects against cancers of the throat, anal canal, vagina and vulva and cervix. The vaccine hurts for 30 seconds, but when you have your anal canal, throat, vulva amputated or you have a third less vagina, you really don’t live well. We are working to ensure that these patients experience the after-effects better, but above all we must prevent these cancers.
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