Treatment is determined only after a clinical and paraclinical full analysis has been carried out (biological tests and screening). To select a treatment, the general condition of the patient is evaluated. An expanded check will help determine the stage:
A biopsy will help determine an accurate diagnosis indicating the histological and biomolecular report. Protein expression or a tumor mutation will help to select an immune therapy or targeted therapy.
Supportive therapy is also offered to eliminate side effects and pain to improve the patient's quality of life. Supportive therapy helps alleviate nausea, pain, etc.
To select a treatment protocol, after all the tests have been completed, a medical panel is convened to discuss various possible types of treatment. When choosing a protocol, specialists are required to follow the recommendations of the European and French authorities. This board consists of specialists in various fields, oncologists, radiotherapists, specialists in organs (pulmonologist, gastroenterologist), surgeons, radiologists, and nuclear medicine specialists. Thus, a group of specialists selects an individual and optimal treatment approach for a particular patient. The treating physician of the patient and paramedical personnel are also present in the treatment chain. For foreign patients, an oncologist or radiotherapist who leads the patient is prescribed by the attending physician.
Surgery and systematic treatments such as radiotherapy are essential in oncology. If chemotherapy or radiotherapy are carried out before surgery, then this is called neoadjuvant therapy, if afterward, then adjuvant. In the presence of a metastatic process, up to three types of treatment are offered: treatment of the first, second and third lines.
Radiotherapy helps locally affect a specific area, in contrast to chemotherapy, which affects the whole body. The radiotherapy procedure lasts from 15 to 30 minutes, they are carried out 5 times a week daily.
Oncology treatment is a long process. Prices for treatment are set by the state. After treatment, the patient is actively monitored over the next five years. To monitor the situation, regular screening tests and blood tests are usually done. A clinical analysis and examination is also done during regular consultations.
What specialists are there in the medical board that decides on the choice of treatment for the patient?
These specialists make a decision based on the following factors:
Anatomopathology and molecular analysis, which are carried out during a biopsy of tumor tissue, molecular and gene analysis. During the analysis, the following indicators are revealed - kRAS, EGFR, alk, Ros1, expression HER2, expression PDL1 - necessary to understand the feasibility of conducting immune therapy.
Advanced tests, such as a chest scanner or PET with 18 FDG (Fluorodeoxyglucose) or 18F choline PSMA (for prostate cancer), brain MRI.
TNM stages (T - tumor, N - nodes, ganglia, M - metastases). As mentioned above, the classification of the disease occurs according to the system from I to IV. The stage of the disease is evaluated by the size of the tumor, the presence of affected lymph nodes and the presence of metastases.
Age and general state of the patient.
Tumor marker assays: PSA for prostate cancer, ACE for adenocarcinoma, CA19-9 for digestive tumors, CA 125 for ovarian tumors.