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Florent Pagny announced that he suffered from inoperable lung cancer on his Instagram account. The singer thus gives up his tour and must follow a 6-month treatment protocol consisting of chemotherapy and radiotherapy. How are these tumors treated? Why are some not operable? Update with Dr Liath Guetta, pulmonologist and member of the Doctissimo expert committee.
Dr. Liath Guetta: There are two possibilities: either the diagnosis of lung cancer occurs within the framework of a systematic assessment, carried out in a person followed by a pulmonologist. In this case, the patient is prescribed an assessment including a scanner and a nodule is detected, visible on the images. Or it is a patient who is already symptomatic, with a cough, shortness of breath, chest pain and who presents an alteration in his general condition (loss of weight, loss of appetite, fatigue, etc.). In this case, the patient is often at an advanced stage of the disease, the imaging will confirm the doubt and will make it possible to define the advancement and the stage of the cancer. Remember that lung cancer affects more than 40,000 people each year in France.
Florent Pagny evokes an inoperable tumor. Why can’t some cancers be operated on?
Dr. Liath Guetta: This is precisely related to the advance of the disease. Strictly speaking, there is no screening for lung cancer in France. These are often incidental findings. The patient passes a scanner for something else and we discover the tumor, located in a pulmonary lobe. In this case, it can be operated, the pulmonary lobe is removed and the patient is generally considered cured. When the disease develops, silently, it can affect the pleura, the envelope that envelops the lung, the contralateral lung, or even create metastases in the brain or in the bones… This is no longer operable.
Florent Pagny talks about a 6-month chemotherapy and radiotherapy protocol. Is this the usual treatment?
Dr. Liath Guetta: We speak of chemotherapy and radiotherapy treatment when immunotherapy is not an option. Immunotherapy is a targeted therapy but you have to have the “right cancer” and the “right receptors” to consider it. If this is not the case, immunotherapy cannot work, and doctors go on a protocol that combines chemotherapy and radiotherapy. In some cases, this can reduce the size of the tumor which can then become operable, it all depends on the stage of the disease, the response to these treatments…
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What is the prognosis for this type of cancer?
Dr. Liath Guetta: It all depends once again on the type of cancer, but it remains a disease with a fairly negative prognosis. We are talking about 30 to 40% survival for patients at an advanced stage, at 5 years. But research against this disease is progressing, even if it can feel like it takes time and never goes fast enough.
Prevention is still the best way to guard against it, by avoiding smoking, even if lung cancer can affect non-smokers. The problem is that the screenings are complicated to set up and when the symptoms appear, the disease is already advanced.