In 2005, Doctor Etienne Brain received a 79-year-old patient, operated for breast cancer in Saint-Cloud (Hauts-de-Seine). This oncologist from the Institut Curie then realizes “the cruel lack of data, among women of this age, to guide [sa] therapeutic decision. This will be the beginning of his fight in favor of a care more adapted to the elderly. It was still necessary, for this, to carry out specific studies within these elderly populations; however, these are too often excluded from therapeutic trials.
“We have a very distorted image of populations affected by cancer, explains the oncologist. We often imagine a young person, struck in the prime of life. In reality, those over 70 represent more than 40% of women with breast cancer, for example. In about ten years, they will be more than 60%. »
Rare fact for a French oncologist, Etienne Brain was honored, Sunday, June 5, by the powerful American Association of Clinical Oncology (ASCO), during the opening ceremony of its congress, in Chicago (United States). He received the Byrl James Kennedy Award for Scientific Excellence in Geriatric Oncology. “Etienne Brain is a world leader in this fieldgreets Martine Extermann, professor of oncology at the University of South Florida (United States). On a scientific level, he is very involved in French and European studies on breast cancer in elderly women. »
The main pitfall, in the elderly, is “overtreatment, more frequent than undertreatment”, estimates Etienne Brain
His course: avoid two pitfalls, “two extreme and simplistic positions”, he explains, between which oncologists often oscillate for their elderly patients. On the one hand, “deny them access to care” ; the other, “getting enthusiastic about useless treatments, applied blindly”. These two positions “are no longer acceptable”, insists this 56-year-old doctor, in a colorful bow tie, during the presentation of his prize. With old people, “the challenges are many”, recalls Etienne Brain. Their symptoms are often atypical, communicating with them can be difficult, if they have hearing or cognitive disorders; they often suffer from other illnesses and receive other treatments… But the biggest challenge is “linked to ageism”, insists the oncologist, this discrimination against seniors which can lead to judging a treatment useless for them. The main pitfall in these elderly subjects, however, is “over-treatment, more frequent than under-treatment”he believes.
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