Each month, a personality from the medical world sheds light on a particular spa treatment: what are its health benefits and the care provided? In December, Professor Patrick Carpentier, professor emeritus and specialist in thermal treatment for lymphedema, answers our questions.
Patrick Carpentier, academic and professor emeritus in vascular medicine at the University of Grenoblebegan his career in hydrotherapy through a combination of circumstances. As phlebology was relatively late at the end of the 1980s in hospitals, he set up, with his mentor, Professor Alain Franco, a small university research center relocated to the thermal baths of La Léchère-les-Bains. The idea was tostudy spa guests suffering from vascular pathologies to advance medical knowledge.
Gradually, by listening to the enthusiastic testimonies of spa guests about the benefits of spa treatmentthe two doctors, in cooperation with the director of the thermal baths, decided to build a protocol to scientifically evaluate the effectiveness of a thermal treatment in the management of severe chronic venous insufficiency, the results of which were very positive . Reiterated on a larger scale, theThermes&Veines study will appear in 2009 in a prestigious American journal (Journal of Vascular Surgery). This year will mark Professor Carpentier’s immersion in thermal medicine. Encounter.
What are your medical activities related to hydrotherapy?
I am director of the La Léchère University Research Center (CRULL) and we develop studies, often in partnership with AFRETh (French Association for Thermal Research), to advance thermal research applied to venous and lymphatic diseases. At the La Léchère thermal baths, I meet the patients participating in the research program and every three weeks I carry out a conference on venous pathologies for the attention of curists. During the two months of welcoming spa guests suffering from lymphedema, I also carry out conferences on lymphatic pathologies.
At the same time, I am coordinator for therapeutic education programs and regularly brought together the spa center’s healthcare teams to take stock. Also, I have been part of the AFRETh scientific committee and more recently, I chair two scientific committees: that of the Interuniversity Institute of Thermal Medicine of the Auvergne-Rhône-Alpes region (Innovatherm) and the medical commission of ESPA (European Spas Association).
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What you need to know here is that the lymphatic circulation is an auxiliary circulation to the venous circulation. It promotes the return of fluids present in the tissues, particularly from the extremities (such as the arm and leg) to the blood vascular system. Lymphedema is a buildup of fluid in the connective tissues found preferentially in one or more lower and upper limbs, due to a deficit in lymphatic circulation. The causes are multiple and lymphedema can be primary, malformative (congenital or more or less long latent) or secondary following an alteration or even destruction of the lymphatic system of the limb, especially after radio-surgical treatment of cancer and particularly in the breast cancer.
For the moment, we do not have the possibility of curing lymphedema, but compressive treatment, associated with a specific lifestyle, makes it possible to avoid worsening and complications. The thermal treatment allows the edema to partially regress, improving the function of the limb and the quality of life. and to help the patient take control of their compression treatment and adopt appropriate health behaviors (nutrition, physical activity and skin maintenance). The basis of thermal treatments is that of phlebology treatment with massages performed by a physiotherapist (depending on the stage of lymphedema, lymphatic drainage or tissue mobilization massage) and where possible a therapeutic education program (Thermoedema program).
This therapeutic education program allows you to learn how to live better with lymphedema. It integrates individual interviews and practical workshops (self-bandaging, skin care, self-drainage massage, etc.) as well as group workshops on knowledge of the pathology and its treatment (definition and understanding, care and daily life).
Four stations offer the Thermoedème program: Argelès-Gazost, Luz-Saint Sauveur, Barbotan-les-Thermes and La Léchère. Note also a valuable partnership with the AVML association (Association for living better lymphedema) which greatly helps patients and the carrying out of thermal studies.
What are the health benefits of such a spa treatment?
In the Thermoedema program, the combination of high-tech treatments helps activate circulation in the lymphatic collectors that remain functional. The series of 186 patients who followed the Thermoedème program at La Léchère showed a significant reduction in the volume of the affected limb achievement of health behavior objectives in 70% of cases at 3 months and improvement of quality of lifelinked to health. A national comparative therapeutic trial including 140 volunteer patients, including a control group, is underway under the aegis of AFRETh to scientifically evaluate the effectiveness of the Thermoedema program. The study is expected to conclude in 2025 with results published in 2026.
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What are your expectations and hopes regarding these results?
Lymphedema is a difficult pathology for doctors to treat. By scientifically demonstrating the benefits of thermal treatment for these patients, I think that a significant number of doctors, and more particularly vascular doctors, will change their outlook on thermal therapy and will offer this treatment to their patients. I hope that this evidence of effectiveness will allow the ARS (Regional Health Agencies) to further finance therapeutic education programs in thermal environments. Today, it is the patients or the stations who cover these costs linked to therapeutic education. I sincerely hope that these results will move the lines !
Sources :
Exclusive interview with Patrick Carpentier, December 10, 2024
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