Approximately one third of cancer deaths are due to the 5 main behavioral and dietary risk factors: high body mass index, low fruit and vegetable consumption, lack of physical exercise, smoking and alcohol consumption.
Anne Vincent-Salomon is an oncologist who works at the Curie Institute to help patients. Come and discover her job in this instructive interview!
Hello everyone, I am Anne Vincent-Salomon. My job is anatomo-pathologist or pathologist at the Curie Institute in Paris.
Specifically, I coordinate the Diagnostic and Theranostic Medicine Unit of the Institut Curie. I work mainly on the Paris site but this pole includes services located in Saint Cloud.
Pathology (or pathological anatomy and cytology) is a medical specialty in the same way as cardiology, gynecology, etc. Anatomical pathologists are "tissue" physicians, i.e. they analyze the biopsies (removal of a very small part of an organ or tissue for examination) given to them by radiologists or the surgical parts given to them by surgeons. The biopsies and parts are fixed in formalin and then sampled in the form of blocks and impregnated with kerosene and cut into sections a few microns thick. These sections are stained with three dyes: hematin, eosin and saffron to be observed and analyzed under the microscope. Tissue sections on slides are more and more often digitized using scanners. This allows pathologists to work on screens and no longer on microscopes. This digital transition is underway and allows pathologists to use artificial intelligence algorithms to help them work.
The missions of the anatomopathologist are :
Make diagnoses in particular cancer diagnoses. No cancer patient is treated without a diagnosis made by the pathologist
Define the prognosis of the disease for which he has just made the diagnosis. In oncology, the prognosis is mainly based on elements derived from the pathologist's analysis: size of the tumor, its degree of proliferation i.e. if the cells of the tumor divide quickly and a lot, if the tumor cells infiltrate the vessels surrounding the tumor, if there are a lot of necrosis in the tumor, if there are a lot of cells of the immune system around or in the tumor, if the tumor is well-differentiated or not i.e. if it resembles very much ( well-differentiated) to the normal tissue from which it comes, etc. ....
Define the presence of markers on tumor cells (e.g. HER2) or on stromal cells (tumor microenvironment) e.g. PDL1 that allow to prescribe targeted treatments against these molecules.
Ndlr: Diagnosis and prognosis are strongly correlated: diagnosis determines the set of components at fault explaining the observed dysfunctions, prognosis determines the future state of the components based on models of aging/degradation of the monitored system. (Extract from CNRS)
After a scientific baccalaureate, I entered the Faculty of Medicine (Pierre and Marie Curie University at the Pitié Salpétrière site) in 1981. During my studies and in particular with Pr Dautzemberg, a pneumologist during my externship, and then during my internship, I understood that I would practice medicine in a hospital because I liked teamwork and the possibility of taking the time necessary to understand the patient's situation without having to worry about budgetary aspects. That was more than 25 years ago.... I also realized very quickly that in the hospital the possibility of doing research to better understand the pathologies of our patients was possible. University hospital doctors such as Prof. Sraër and Prof. Rondeau at the TENON hospital were outstanding examples for me: the nephrology department included an INSERM research unit with real researchers and doctors who shared their time between the laboratory and their work at the hospital. My older brother, Prof. Denis Vincent, also showed me the way by doing, in addition to his specialty internship (Internal Medicine/Allergology), a thesis in Science at the Pasteur Institute. When I was 7 years old, he was the one who encouraged me to choose my first internship with Prof. Sraër at Tenon.
A determining factor for the choice of my specialty was to meet the father of my future children during my studies. He wanted to be a pediatrician, a specialty with many on-call hours. We wanted children and to have them young, so I chose a specialty without on-call duty and for which hospital positions were available. As I found all the specialties of my first internship exciting (nephrology; endocrinology; pneumology) and that during these internships I was in contact with pathologists, I understood their essential role in the care of patients. This medical specialty also allowed me to be interested in all the organs and there was no on-call duty!
I deprived myself of direct contact with patients, which I sometimes regret, I gave up prescribing, treating patients directly ... but I discovered a medical specialty that is constantly evolving in connection with the progress of research, a specialty of precision, observation and intellectual for which the reading of articles and books of medicine is essential throughout life. But it is also a manual specialty with the handling of surgical parts, with teamwork with technicians and engineers. And a specialty of interaction with the many clinical colleagues.
Today we need you in oncology. The discipline is in full evolution thanks to the integration of molecular biology as a complementary analysis technique to help pathologists make their diagnoses and also with the development of slide digitization and artificial intelligence tools.
The pathology departments function thanks to the pathologists but also to the teams of technicians. The technicians prepare the biopsy sections and surgical parts, and perform complementary analyses with bench-top manipulations for techniques to highlight diagnostic or theranostic markers. But they also help us in the macroscopic analysis of the surgical parts and the digitization of the tissue sections. The job of pathology technicians is a technical job that is diversified and will keep the manipulations at the bench for a long time.
Outside of my work, I chair the scientific committee of the association RUBAN ROSE, whose role is to inform about breast cancer screening and to raise funds for research. I also teach breast pathology in the International Academy of Pathology with my friends Dr ARNOULD (Dijon) and Dr MACGROGAN to help pathologist colleagues who know less about breast cancer than we do.
Being a doctor in a hospital means that you have to like to be totally committed to ensure the best possible care for patients. This means long days but never boredom and especially with the chance to work with young technicians, interns and young specialists. Working in a transgenerational team is the best experience ever! The hospital brings together people from different social backgrounds and cultures.
To be able to do research and learn throughout one's life is the best remedy to the loss of meaning! and keeps me curious and "young" at heart!
What I want to tell you is that it is an exciting job and the guarantee to feel useful all your life! Even if it is difficult to face cancer every day. Multiplying prevention and research efforts to better treat cancer patients is an inexhaustible motivation!
If I were 18 years old today, I would choose to study medicine again! I don't know boredom in my work and I work a lot but always with the chance to be mobilized by a curiosity for the others, for the sciences!
See you soon at the hospital!
Edited by Lise C. and Mazzarine D.
Anne VINCENT-SALOMON: oncologist, an exciting job and the guarantee to feel useful all your life
