Prevention and screening
Prevention is the first weapon in the fight against cancer. It is within everyone's reach and must be integrated into our daily lives. By simple gestures and attentions, we can reduce the risks of being affected by this disease.
Let's avoid smoking, adopt a healthy and balanced diet, including fruits, vegetables and whole grains, and avoid excessive consumption of alcohol and fats. Let's practice regular physical exercise and reduce prolonged exposure to the sun and sunbeds. That is to say: avoid the sun between 12:00 and 16:00, use a sun cream with a sufficiently high UVB coefficient and strong UVA protection and reapply the cream regularly.
Early detection of a tumor increases the patient's chances of recovery.
The various medical services involved in the management of cancer in our center offer patients the possibility of performing the appropriate screening examinations thanks to specialized equipment.
The World Health Organization, through the International Agency for Research on Cancer, has published a European Code against Cancer. This European Code against Cancer proposes simple measures that every citizen can implement to promote cancer prevention. Read about it here
It also suggests 12 ways to reduce the risk of cancer. read more
Breast Cancer Screening
Breast cancer remains the leading cause of death in women between the ages of 50 and 69. One in 9 women can develop breast cancer and its early detection can greatly increase the chances of cure and survival. Early breast cancer does not give any symptoms. Screening is therefore very important.
The screening program set up in Belgium is aimed at women aged 50 to 69 and is based on a breast X-ray, or mammogram, every two years. This is the "Mammotest", a basic examination, intended for women with no particular risk factors. If such factors are present, screening can be done by personalized screening: this is a senological assessment requested by the gynecologist or general practitioner. It includes an interview, a clinical examination, a mammogram and most often an ultrasound, performed during a single specialized consultation.
In our center, we perform personalized breast examinations at the request of gynecologists and general practitioners. This check-up is recommended for women from the age of 40, every year until the age of 50, and then every 2 years without age limit.
Patients are referred either for screening, or for surveillance after treatment of breast cancer, or for clarification of an abnormality, or for a complementary check-up performed outside the clinic and a second opinion.
The results, most often benign, are sent to the referring physician after comparison with previous check-ups. In the event of an abnormality, additional tests are performed. Most often, a simple fine needle puncture is sufficient. It is performed under ultrasound control, is not very painful and is quick. It allows cysts to be emptied or cells to be removed from a nodule. The results are reliable in 90% of cases and are obtained within a short time.
In case of doubtful lesion, micro- or macrobiopsies are performed either under ultrasound control in case of a lesion visible on ultrasound, or under stereotaxis (mammographic guidance) on a dedicated table.
The combination of the Mammotome and the dedicated stereotaxis table allows an improvement in patient care, both in terms of diagnosis and comfort.
The third breast imaging technique after mammography and ultrasound is magnetic resonance or breast MRI. Its indications are precise and limited.
The breast examination allows for the screening, diagnosis and monitoring of breast pathologies. It is a complete examination performed by a specialized team with high-performance equipment.
Organized screening programs have not kept their promises in terms of mortality reduction. It therefore seems urgent to change the concept of organized screening. Based on the data in the literature, organized screening based exclusively on age should evolve in the coming years towards a more personalized, more dynamic screening that is a function of the combination of several risk factors, clinical, familial, genetic and radiological.
Our country is participating in a large-scale European project that was launched in January 2018 and will last 8 years. The name of this project is "My Personalized Breast Cancer Screening" (My PEBS). This project intends to compare standard breast cancer screening in 5 countries (Belgium, France, Italy, the United Kingdom and Israel) with a screening strategy that takes into account the woman's risk of breast cancer and the contribution of new genetic techniques. This trial intends to enroll 85,000 women in the five countries mentioned.
Screening for skin cancer or melanoma
Melanoma is a skin cancer that develops from pigmented cells called melanocytes. These cells allow the skin to tan. When these cells come together, they form a tumor that can be benign, called a nevus (or mole), or malignant, called a melanoma. Melanoma can develop from a nevus, but most often it develops from single melanocytes.
Most melanomas develop on the surface of the skin and then later infiltrate the deeper layers of the skin. The aggressiveness of the melanoma depends on its extension in depth. This extension is defined by the Clark index (I to V) and the Breslow index (thickness measured in millimeters under a microscope).
Melanoma is the most aggressive skin cancer. If diagnosed early, the chances of a complete cure are high. When metastases appear in lymph nodes, the probability of cure decreases. These metastases are rare in early melanoma and their frequency increases proportionally with the thickness of the melanoma.
Prevention and screening for melanoma is essential! Learn self-monitoring.
Dépistage du cancer colo-rectal
Le cancer colorectal (CCR) est une tumeur fréquente dans notre population. En effet, chaque année, en Belgique, plus de 9500 nouveaux cas sont diagnostiqués ! Il est le 2ème cancer chez la femme et le 3ème chez l’homme. Son incidence augmente surtout après l’âge de 50 ans. Actuellement, plus de 75% des CCR sont diagnostiqués à un stade avancé justifiant souvent un traitement lourd (chirurgie, chimiothérapie), des coûts importants pour le patient et la société ainsi qu’une mortalité élevée (50% des patients atteints).
Ce cancer, asymptomatique dans sa forme débutante, se dépiste pourtant très facilement car il est prévisible. En effet, presque tous les cancers se développent au départ de polypes bénins (« adénome »). Le temps moyen pour qu’un polype se transforme en cancer est d’environ 10 ans. L’objectif du dépistage est l’identification et la résection précoce de ces polypes pour qu’ils ne se développent pas en cancer.
Le dépistage est donc une stratégie gagnante puisqu’il permet de réduire l’incidence du CCR et/ou de le diagnostiquer dans une forme débutante ce qui en diminue la mortalité.
S’agissant d’un réel problème de santé publique, un programme de dépistage a été initié depuis 2009 en communauté française avec malheureusement à ce jour une participation faible de la population (<15%). Il cible les personnes, de 50 à 74 ans, à risque moyen c’est à dire sans histoire personnelle ou familiale de CCR (70% des personnes), en leur proposant une recherche de sang occulte dans les selles. Si le résultat du test est positif, il doit mener à la réalisation d’une coloscopie pour exclure des polypes ou un cancer qui saigneraient à bas bruit. La performance de ce test reste moyenne et il peut y avoir des faux positifs comme des faux négatifs ! Cependant ce test devient utile s'il est débuté tôt (≥50 ans), répété tous les 2 ans et suivi d’une coloscopie s'il se révèle positif. Ce dépistage « à grande échelle » de la population a démontré son bénéfice puisqu’il réduit de 20% la mortalité spécifique du cancer colo-rectal.
Pour les personnes à risque plus élevé c’est à dire avec une histoire personnelle et/ou familiale (au 1er degré) de polype ou de CCR ou celles sensibilisées à la problématique et désirant le meilleur moyen de dépistage, la coloscopie reste certainement l’examen de choix !
En effet, outre l’identification des polypes, elle permet également dans la majorité des cas de les traiter (résection) dans le même temps opératoire. L’examen est donc à la fois diagnostique et thérapeutique !
En moyenne, la coloscopie est réalisée tous les 5 ans chez la majorité des patients !
Détecté à un stade précoce le cancer colorectal peut être guéri dans 9 cas sur 10 !