Dr. Desbiens

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Dr. Desbiens is a surgeon-oncologist at the CHU de Québec-Laval University, a clinical researcher at the Research Center of the CHU de Québec-Université Laval, and a clinical professor at the Faculty of Medicine of Laval University.

Dr. Desbiens is the leader of the Canadian Clinical Trial Group at Saint-Sacrement Hospital of the CHU de Québec. She is also the medical director for the Centre des Maladies du Sein du CHU de Québec.

Finding Purpose in Medicine
When I completed my surgical studies, I went to work in a rural area for 7 years. With the team, I developed a small centre for women with breast problems. At that time, I was the only woman on the team, and I felt drawn to breast pathologies, for which I had developed a particular interest.
Today, and since 1999, I have been practising as a surgical oncologist at the Centre des Maladies du Sein which I am Director of. At the Centre, we work as a team to monitor female patients with breast cancer, including metastatic breast cancer.

About mBC
When we talk about metastatic, or stage 4 breast cancer, we do not realize just how many differences there are. Some progress slowly, while others develop very aggressive metastases. Metastatic disease is not immediately fatal. Some women will go back to work and be metastatic for 20 years! This is because disease progression is so different from one patient to another that care needs to be personalized.

In the past, when a patient had stage 4 cancer, it was sometimes decided not to operate, in the belief that it was not worth it. Today however, we know a lot more about the disease. Now we operate on patients with brain metastases, which we did not do before. Their survival has therefore improved greatly, going from 3–6 months to several years.

The future of mBC and patient care
Due to research and studies, treatments have evolved, medication is much more successful than in the past, patient survival has improved, side effects are better controlled…in short, quality of life is much better. Not only can we offer our patients better quality of life, but we think about it. We try to understand what upheavals the diagnosis causes in their lives, and we adapt the choice of treatments and protocols we are going to apply as a result.

Although there have been many advancements in recent years, we still have progress to make. This is true for patients who can still work, but not at 100%. Some would not be able to work full-time hours but could do 3 days a week. Unfortunately, this is difficult for employers to accept. Society needs to be educated about these women’s reality and solutions which suit them need to be found. We also need to continue researching to develop treatments with the fewest possible side effects to maintain maximum quality of life for patients.

My patients are fighting, and they fight hard. For them, every small victory counts and they see the positive in their misfortune. That is what helps them keep going. I try to tell them to live in the present, not based on the next treatment. That is why our approach with metastatic patients is not just medical. Our nurses, psychologists, physiotherapists, nutritionists, really, the whole team contributes to support them as well as their families.
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