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.
Colorectal cancer screening
Colorectal cancer (CRC) is a common tumor in our population. Indeed, each year in Belgium, more than 9500 new cases are diagnosed! It is the 2nd most common cancer in women and the 3rd in men. Its incidence increases especially after the age of 50. Currently, more than 75% of CRCs are diagnosed at an advanced stage, often justifying a heavy treatment (surgery, chemotherapy), important costs for the patient and society as well as a high mortality (50% of the patients affected).
This cancer, asymptomatic in its early stages, is easily detected because it is predictable. Indeed, almost all cancers develop from benign polyps ("adenoma"). The average time for a polyp to develop into cancer is about 10 years. The goal of screening is to identify and remove these polyps early so that they do not develop into cancer.
Screening is therefore a winning strategy since it reduces the incidence of CRC and/or diagnoses it in its early stages, thereby reducing mortality.
As this is a real public health problem, a screening program has been initiated since 2009 in the French community with unfortunately a low participation of the population (<15%). It targets people aged 50 to 74 years, at average risk, i.e. without personal or family history of CRC (70% of people), by proposing a search for occult blood in the stool. If the result of the test is positive, it should lead to a colonoscopy to exclude polyps or cancer that may be bleeding at low tones. The performance of this test remains average and there can be false positives as well as false negatives! However, this test becomes useful if it is started early (≥50 years of age), repeated every 2 years and followed by a colonoscopy if it proves positive. This "large-scale" population screening has demonstrated its benefit since it reduces specific colorectal cancer mortality by 20%.
For people at higher risk, i.e. with a personal and/or family history (in the first degree) of polyp or CRC, or for those who are aware of the problem and want the best means of screening, colonoscopy is certainly the examination of choice!
Indeed, in addition to the identification of polyps, it also allows in most cases to treat them (resection) in the same operation time. The examination is therefore both diagnostic and therapeutic!
On average, colonoscopy is performed every 5 years for most patients!
Detected at an early stage, colorectal cancer can be cured in 9 cases out of 10 !