Health Treatment in France – breast cancer
by Penelope Parkinson
When Frank and I moved to the P-O at the end of 2000, we had heard that the French health service was the “best in the world”, but I didn’t know that I’d be making so much use of it! It came as something of a shock to discover in April 2006 that I had breast cancer, but, nearly three years on, I can confirm that the health system here certainly does work and I hope, by relating my experience, to reassure any others unfortunate enough to find themselves in a similar position.
If you live in the P-O, you will know that over the age of 50 both men and women are offered free bowel cancer screening and, women, screening for breast cancer.
I went to Thuir, our nearest screening centre, on 12th April 2006, a Wednesday.
The technician was concerned about the mammogram and referred this to the doctor at the centre. She advised an ultrasound, which was carried out immediately.
As she was still unhappy with the results, she thought that I should have an MRI scan as soon as possible. She took the trouble to telephone my GP, explain to him her concerns and made an appointment for me to see him the next day. Within an hour I had left with the results of the mammogram and the ultrasound and a full report from the doctor on them both.
I saw our GP with my husband, he explained that the results were not good and we should prepare ourselves for the fact that I probably had breast cancer.
He telephoned the MRI unit at Clinique St Pierre in Perpignan and got the first appointment possible, the following Tuesday (it was the Easter weekend), and he made an appointment for us to return to see him a week later.
I collected the MRI scan results the following day. Thursday afternoon, back at the GP, he looked at the MRI report which confirmed the mammogram results. He advised me to go to Val d’Aurelle at Montpellier, a specialist cancer hospital which held clinics in Perpignan, and he had already, in anticipation of the results, made an appointment for me to see a doctor from there the following day in Perpignan.
On Friday 21st April I saw the doctor who became my surgeon.
Although a biopsy was needed for final confirmation, he explained that a mastectomy was likely and that I would probably need chemotherapy and radiotherapy. Great! But by the time we left his clinic, I had a date for the surgery (16th May) and appointments made by the nurse for a biopsy at Montpellier and visits to an anaesthetist, a heart specialist and for a lung x-ray! I had to do nothing except attend the appointments.
The operation went ahead as planned and I was home 5 days later.
The surgeon visited regularly and the nurses were attentive.
By the time I left hospital, I had received physiotherapy and had a leaflet with exercises to do, I had a prescription for nursing care at home, I had been visited by women who had experienced the same operation and who gave me phone numbers for support, I had a temporary prosthesis and a date for the follow up appointment.
Once at home, I was visited every two days by a nurse who came and changed the dressings and checked the wound.
Two weeks later, Frank and I were back at Montpellier for the results. Miraculously, despite extensive cancer in my breast, there had been no spread and my situation was referred to a case conference a few days later.
It was decided that chemotherapy, followed by radiotherapy, would be the safest option.
My surgeon rang me about 9pm immediately after the case conference to give me the news and asked me to choose between Perpignan and Montpellier for treatment. I opted for Montpellier, as recommended by our GP.
I saw the oncologist on June 7th to discuss the treatment.
The doctor was very frank and I was given a comprehensive booklet about side effects and steps that could be taken to help.
Before I left, the date of my first treatment (June 26th) was agreed and a nurse telephoned Perpignan general hospital to make appointments for me to have various tests before the chemotherapy could start.
The sessions were over in October. As before, the doctors, nurses and other staff were extremely helpful and very patient with my poor French.
The radiotherapy was to take place on a daily basis over a 5 week period so, for practical reasons, I opted to have this at Perpignan. I was referred to a doctor at Clinique St Pierre who works closely with the doctors at Val d’Aurelle.
As St Pierre was in the process of installing new radiotherapy equipment, I was advised to wait for this, and my treatment started on January 3rd 2007, being completed in February.
The appointments were almost always on time, the technicians were very good, explaining in detail the progress of the radiotherapy, its effects on my skin and giving me advice on skin care. Specialist cancer nurses were available for consultation both at St Pierre and at Val d’Aurelle at all stages of my treatment.
By April 2007, a year after that mammogram, life was virtually back to normal and I now have six monthly checks which will continue for the foreseeable future.
For me, the system here in the PO could not have been better. My French is passable, but it is far from fluent, yet I was never made to feel a nuisance. At all stages the doctors and staff were keen to ensure that I fully understood the treatment and procedures, although this meant that my appointments took longer as explanations had to be repeated and I was always encouraged to ask questions.
Wherever possible, appointments were made for me, results were provided promptly, a doctor was available to talk to at any time, nursing staff were there to discuss fears and worries – all this made a huge difference as it removed a burden at a time when decisions were difficult.
The kindness shown to me by all levels of staff at the hospitals and clinics could not have been better.
However, the experience left me with a feeling that some support in English could have been helpful, if not to me, then to those whose French was even more limited.
In November 2008 I became aware of a French registered charity called “Cancer Support France” which aims to provide telephone and other support to English speakers (although not only to English people). By chance, a new group was being established called “Cancer Support France – Sud de France” which covers the Aude, Ariège and Pyrénées-Orientales and I went to the inaugural meeting on December 2nd. This group is now fully functioning and I am co-ordinating volunteers from the P-O. So if anyone reading this would like to become involved, then please contact me either by e-mail at firstname.lastname@example.org or on 0468 388 128.
For anyone concerned about payment for treatment, perhaps I should clarify that, since we moved here, we have been in the French health system. We pay our tax in France (including the contribution to URSAAF) and we pay monthly contributions to a mutuelle. There was, therefore, never any issue about payment for treatment, I was covered in exactly the same way as any other French woman.
When my diagnosis was confirmed, our medecin traitant (GP) immediately completed the relevant paperwork to enable me to benefit from 100% state cover and, although the change to my carte vitale took about a month to come through, we were refunded promptly by our mutuelle which then reclaimed from the state. Our mutuelle paid for a single room for me at Val d’Aurelle, it also paid the daily charge (for food etc.), as well as newspapers and a television in the room. My only charge was for phone calls. In addition, when I left hospital I was given a prescription which entitled me to a prosthesis and a special bra and, before the chemo, one for a wig! The state contributes a basic amount to these items and it is true that I chose more expensive ones, all covered by our mutuelle.