“As we now understand these cancers much better than before, we are able to cure more and more of them.”
The examinations required to confirm and specify diagnosis depend on the type of cancer:
- For blood cancers (leukaemia, myelodysplasia):
- blood tests and bone marrow aspiration to enable a detailed genetic analysis;
- bone marrow biopsy;
- ultrasound of the liver and spleen.
- For lymphatic cancers (non-Hodgkin lymphoma, Hodgkin lymphoma, multiple myeloma, etc):
- full clinical examination focusing particularly on the lymph nodes (which is where lymphomas originate);
- blood tests;
- biopsy and bone marrow aspiration;
- PET scan;
- other examinations specific to the site of the condition: brain scan, digestive endoscopy, skin biopsy, etc.
Treatments depend on the type of cancer. They may be offered in isolation or in combination.
- Medication: conventional chemotherapy, targeted therapies and/or immunotherapy
- Surgical resection of the spleen in certain lymphomas
- Stem cell transplant, preceded by chemotherapy and sometimes by radiotherapy.
In a stem cell transplant (or bone marrow transplant) healthy haematopoietic stem cells are injected into the patient after all the bone marrow cells (healthy and cancerous) have been eliminated by intensive chemotherapy (and radiotherapy). The grafted cells may be the patient’s own cells (autograft) previously “cleaned” of cancer cells, or cells from a healthy HLA compatible donor (allograft). About 2 weeks later, the new transplanted bone marrow begins to produce healthy blood cells. During this period, the patient’s immune system is severely weakened. The slightest germ can lead to a serious infection and, unfortunately, prove fatal. The patient must therefore spend 2 to 4 weeks in sterile isolation. The Institut Jules Bordet currently has 12 sterile rooms. The “New Bordet” will have 40.
In Belgium, the Institut Jules Bordet is a pioneer in haematopoietic stem cell transplants. It has 3 graft “banks”: bone marrow and haematopoietic stem cells, umbilical cord blood and mesenchymal stem cells. It also has international connections to banks available in other countries.
The Institut Jules Bordet “Haemato” Multidisciplinary Oncology Team comprises haemato-oncologists, medical biologists, anatomopathologists, surgeons, radiologists, nuclear medicine specialists, radiotherapists, cancer care coordinator nurses and cancer psychologists. The team meets every week to discuss each patient and decide the most appropriate therapeutic strategy for their medical situation.
The Institut Jules Bordet's nurses, most of whom specialise in oncology, are committed to caring for patients with thought, humanity and professionalism.
Their role does not stop at care and treatment follow-up; they also meet families, and try to be as available as possible and by patients' sides while being attentive to everything confided in them.
The role of education, information and support is an integral part of their profession.
They must have relational, technical and scientific skills in line with the gravity and the complexity of the cancerous pathology.
The nurses are particularly attentive to the treatment of pain and other symptoms resulting from cancer treatment.
They also focus on their role as trainers to welcome and supervise students, and give them incentive to practice the profession in the best possible conditions.
With the medical teams, many other healthcare professionals support the patients. They are dedicated to help patients in managing their illness and treatments, and to promote their wellbeing.
The aims of post-cancer care are multiple:
- to keep an eye on the physical and psychological state of the patient
- to manage any medium or long-term secondary effects of certain treatments
- to detect any recurrence as soon as possible
- to identify any new cancer.
Recurrence means that cancer cells reappear after a period of remission that can vary from a few months to several years. It can also happen that the same patient develops different cancers several years apart. In all these cases, the earlier a recurrence or cancerous disease is detected, the faster a new therapeutic strategy can be offered.