L’accompagnement des traitements adjuvants : les soins de support pour la phase adjuvante

To better support women with breast cancer during their treatment phase, supportive care offer and organization were modified. This is the result of new needs and the new organization of the patient’s follow-up between hospital and general practice care. Patient–doctor dialog involved especially in the development of therapeutic education. Also, patient’s abilities are motivated to manage for the best an illness which became chronic. Progressively, to fulfill the patient’s wishes to be leaded to a more global medical care, the offer in supportive care has changed to a wider concept of “self care”.     

Les enjeux du vécu de la radiothérapie : perspectives pour un meilleur accompagnement des malades

This paper reports the patient care experience during the trajectory of the radiotherapy. Plights are multiple. Patients are confronted with a complex and unknown distressing space, an irrelevant information, a banalisation of side effects, an isolation with a frequent inadequate support of their family or the caregivers team, with the fear of a definitive abandonment at the end of the treatment without conforting follow-up. It is imperative to state a real policy in order to improve the patient support. Sensibilisation and training of the caregivers, in spite of a frequent overbooking technical work, is required in a pluridisciplinary approach to provide a relevant reception with the collaboration of psychologists, social workers and self care groups and associations. The personal implication of the physicians and technologists is also essential. The simple smile is the intangible proof of the reliable emotional support.     

Qualité de vie des patients et soins de support en cancérologie des VADS

The quality of life of patients treated for head and neck cancers and their carers is part of the current concerns of health care teams. Assessment tools were created and helped to highlight the severe physical effects (pain, mucositis…) and chronic (mutilation, post-radiation complications…) related to the disease or to different treatments but also to consider the psychosocial impact of this disease. Improving the quality of life through a thoughtful and comprehensive support that must be associated with somatic care, mental health care, rehabilitation and inclusion of social difficulties and suffering relatives. Supportive care shall ensure a good quality of life for patients treated and their families but also reduce the physical effects associated with the disease and treatment. They rely on coordination of care including the cancer networks established in the cancer plan to ensure comprehensive and continuous care for these patients.     

Radiothérapie des carcinomes des sinus maxillaires : l’état de l’art

Maxillary sinus carcinomas are rare malignancies of the face, characterized by high local relapsing rate. Modalities of treatment are without consensus and respective roles of radiation therapy and surgery remain controversial. As those malignancies are often diagnosed at locally advanced stage, radiation therapy may frequently be used for patients having unresectable advanced disease. Nevertheless, surgery remains treatment of choice for more localized malignancies, in association with systematic postoperative radiotherapy. For those patients whose prognosis remains pejorative, it is necessary to precise the role of radiotherapy in first intention for inoperable tumors, to define necessity for nodal treatment performing and evaluate the place of neoadjuvant or concomitant chemotherapy in a multimodal strategy.     

<Emphasis Type=Bold>Les apports des Plans cancer dans l’amélioration des pratiques professionnelles en oncogériatrie : le point de vue des professionnels</Emphasis> (in partie I : Les apports des Plans cancer au service de l’amélioration des pratiques professionnelles)

Having successfully gone through the onset of pilot units in oncogeriatrics, which turned into regional coordination units, the oncogeriatric practice is nowadays a part of oncologists’ routine practice. In the light of our experience in this development, we present a global outlook on the advances and pitfalls of changing practices in oncogeriatrics as well as the stakes in the years to come.     

Les soins oncologiques de support et la formation continue: l’exemple de l’EFEC

Résumé: Enseigner un nouveau concept, «les soins oncologiques de support», ses déclinaisons dans la pratique professionnelle, individuelle et collective, des acteurs de santé impliqués dans la prise en charge de personnes atteintes de cancer, tel est le défi que sest fixé lEFEC voici un peu plus de trois ans. Deux points dentrée ont été expérimentés en matière de formation: limpact technique des «soins de support» dans la pratique professionnelle individuelle (du médecin ou de linfirmier) et son impact organisationnel dans la pratique collective de léquipe soignante, notamment sur le rôle que chacun doit jouer dans la coordination des soins de support. Seul objectif de ces formations: améliorer la qualité de la prise en charge dans une perspective de qualité de vie pour la personne malade.Très proches de la pratique professionnelle, sappuyant sur des cas cliniques, ces formations donnent du sens à ce nouveau concept.Elles sont pour linstant mieux accueillies par le public infirmier que par le public médical mais espèrent trouver un réel écho chez les médecins avec la mise en perspective des «Soins oncologiques de support» par le «Plan Cancer».Les soins de support en oncologie     

Cancer et vie quotidienne: propositions pour l’amélioration des aides

This article focuses on the impact of cancer on the lives of sick people. A multidisciplinary workgroup, including doctors, psychologists, social workers and pharmacists, conducted research works on possible answers (legal and statutory assistance) and discussion on the limits of these. In conclusion of this work, a proposal for the improvement of the existing solutions is proposed.     

Les thérapies ciblées de l’os métastatique: soins de support ou traitements de fond ?

Bone metastases in prostate cancer treatment stand as a clinical challenge in order to maintain quality of life and prevent pain and skeletal-related events. Bone metastases predominantly disrupts the dynamic equilibrium existing in healthy bone between osteogenesis and osteolysis. Therefore, bone microenvironment targeting agents under development are emerging as a specific component of care in the treatment of patients with metastatic prostate cancer.     

La place indispensable des associations de patients pour favoriser la parole et l’échange*

Sans résumé* Texte publié avec laccord de Claude Huriet, sénateur honoraire, Conseiller détat. Texte paru dans les actes du colloque (juin 2003): « Cancer : améliorer et humaniser la prise en charge des patients » (Rencontres parlementaires « Santé Société Entreprise »).     

Comprendre la non-adhésion à l’activité physique après un diagnostic de cancer pour mieux accompagner les patients — Partie II : Ajuster l’information et l’accompagnement

Despite the recognized benefits, the way to encourage cancer patients to integrate physical activity program remains complex, and the transmitted information may be inappropriate depending on the person’s profile. In this second part, we have shown that the analytical framework presented in the first part provides the practitioner with a substantial support enabling him to individualize his/her answers to the patients’ questions on physical activity according to their profile, which improves quality and relevance of the transmitted information.