[LUM#11] Questioning humans to fight cancer
A physical activity program, a tailored diet, psychological support, meditation... A simple recipe that nevertheless heralds a revolution in cancer care. In twenty years of research into what are known as non-drug interventions,the Montpellier Cancer Research Institute (IRCM) has become a leader in the field.
" We are entering an incredible era, " comments Gregory Ninot, professor at the University of Montpellier and researcher at the Epsylon laboratory. "It's a real revolution in cancer treatment." Enthusiasm is high following the announcement by the Minister of Health that supportive care for people who have been treated for cancer will now be reimbursed.
Supportive care refers to a set of physical, dietary, educational, and psychological methods that provide a framework for personalized, science-based support for cancer patients undergoing chemotherapy, radiation therapy, or surgery.
Complementary therapy
These non-drug interventions (NDIs) are not alternative medicines or occupational activities. They treat specific symptoms associated with the disease and the side effects of treatments such as fatigue, stress, or nausea. Based on precise specifications tailored to each patient, these treatments constitute "a truly targeted and personalized complementary therapy that supports and improves the effectiveness of cancer treatments," the researcher emphasizes.
The research conducted by Gregory Ninot and his team has really taken off since they were awarded the prestigious SIRIC (Integrated Cancer Research Center) label. Research funding has been secured to conduct the first clinical trials on INMs. "This synergy between the hospital and the university has made us pioneers and enabled us to move beyond the purely mechanistic prism of cancer research," notes the researcher. Today, we understand that our mission is to study humans and put human methods back at the center of cancer care, such as INMs."
Comprehensive oncology care?
Clinical trials have clearly demonstrated the effectiveness of non-drug interventions in limiting resistance to cancer treatments, for example. They have also validated the positive psychological impact of an approach that empowers patients to take an active role in their own recovery. Better still, appropriately tailored physical activity programs may have an effect on the risk of recurrence of certain cancers. A study conducted on a cohort of patients after colon cancer treatment revealed that prescribing such programs reduced the risk of recurrence by 38%. "If clinical trials confirm the results of these observational studies, then NMPs will become oncological treatments in their own right, to be systematically prescribed for certain patients," explains Gregory Ninot.
Non-invasive treatments that are less costly for patients and therefore well worth reimbursing by Social Security. This should be achieved in 2020. Today, research continues in order to "structure all these INMs so that tomorrow, every patient will have access to tailored solutions and appropriate support, " concludes the researcher.
Physical activity: instructions for use
Long considered incidental, physical activity is now recognized as a therapeutic solution in its own right during and after cancer treatment. And it has proven its worth. A study published in 2016, which compiled cohorts of 35,622 patients, concluded that sufficiently intense and regular physical activity (3 hours per week) is associated with a 38% reduction in the risk of cancer mortality in breast cancer, colorectal cancer, and prostate cancer.
And while it's never too late to do the right thing, an appropriate physical activity program should be offered to patients as early as possible. "Not after treatment, as was the case 10 years ago, but as soon as the diagnosis is announced!" recommends Grégory Ninot. "The spontaneous reflex when you are ill is to rest, which is appropriate when you have the flu. But with cancer, this becomes counterproductive. The more you rest, the weaker you become and the more tired you feel. Specialists refer to this asthe vicious circle of deconditioning." An inactive patient will lose muscle mass, making them less able to tolerate treatment. "It's counterintuitive, but exercise will help combat fatigue."
"The more you rest, the more tired you get."
The question remains: how much effort, and at what intensity? "We recommend a minimum of two hours of endurance training and one hour of strength training per week," replies Grégory Ninot.
Adapted physical activity programs could even help slow the progression of certain cancers and prevent recurrence. "The basic idea is to slow tumor progression and help prevent recurrence by targeting the patient's immune, metabolic, inflammatory, and neuropsychological functions through personalized physical activity, " says the specialist.
While studies are currently being conducted to validate these hopes, it has already been proven that sufficient and well-balanced physical activity improves patients' quality of life and general condition, reduces the side effects of treatment, and enhances certain beneficial effects. "This is already a significant achievement, and it is encouraging oncology centers to include adapted physical activity professionals in their care teams."
Eating better for fewer cancers
How can you eat better to reduce your risk of cancer? "You should follow the scientifically validated recommendations of the World Cancer Research Fund (WCRF)," replies Grégory Ninot. In practice:
- Limit consumption of red meat and processed meats. "Red meat less than four times a week, and ham one slice per week."
- Eat a diet rich in fruits, vegetables, whole grains, and legumes. "You should eat more than five servings of fruits and vegetables per day, whether raw, cooked, or in compote, " says Grégory Ninot.
- Limit consumption of fast food, industrial cuisine, and processed foods high in fat, starch, or sugar to "once a week at most."
- Consume less than 7 alcoholic drinks for women and 14 drinks for men, no added salt, less sugar, "sugary drinks in particular should be banned."
"These recommendations should also be followed after cancer treatment," says Grégory Ninot. Patients who are too thin or have too much abdominal fat may respond less well to treatment, " says the researcher, who advises adapting one's diet to maintain a body mass index (BMI = weight/height squared) between 18.5 and 25.
Are there any dietary supplements that can be taken in the event of cancer? Are there any specific diets to follow? Should intermittent fasting be tried? "At present, the WCRF has not identified any solid scientific evidence proving their effectiveness, " replies Grégory Ninot. " Dietary supplements may even interact with certain chemotherapy drugs and reduce their effectiveness, so it is best to avoid them."
Taking charge of your recovery
"The diagnosis of cancer is a shock that can lead to difficult family, professional, or social situations. Social isolation, job loss, the departure of a partner—in all cases, the consequences hinder the healing and resilienceprocess ," reports Gregory Ninot. Many symptoms such as stress, chronic fatigue, sleep disorders, lack of motivation, and smoking are psychological in origin and can be resolved through targeted NIMs.
To help patients, supportive care departments such as the ICM's are staffed by psychologists, hypnotherapists, therapeutic education specialists, serious game specialists, social workers, and socio-aestheticians. Psychologists, for example, offer meditation practice. "We have seen convincing results with MSBR (Mindfulness Based Stress Reduction) mindfulness meditation. People focus their attention on solving the problem, and there is greater adherence to treatment." This psychotherapeutic intervention allows participants to look at their illness differently, by listening to themselves more and better.
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