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Cancer Treatment in France


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Thanks for your list Norman, I have printed it off and will study it in depth, definitely remember hearing je pique on Tuesday and Wednesday.

Ah The Bridge Inn what a strange little place that is, never did manage to get into the 'inner sanctum', always had to drink in the room with the rest of the peasants. So that is you and Rose I obviously know personally now, it feels like one big happy family.[:D]

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I think that British people have a reticence to ask help from an "Aide Sociale" as they have a feeling it is for the poor and needy who can't manage, or for the sort of situation where children are removed from a family.

I can assure you that in France they are used by ordinary people with  problems 'of society' (Look at the thread about  someone who has a problem with an ageing father and read what Hereford has to say about being helped by one at the Hospital)

I have used the service to help me find a convalescent home, and they are there  exactly to deal with a situation such as you and you wife may face.

If you are worried about the French I am sure CSF can help..

Don't be afraid to ask for help. You have enough problems to deserve it [:D]

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Thanks for all that info Norman, although after today's visit for my echo endoscopy I think an operation is on hold for the time being. The doctor who carried out the procedure spoke French for the procedure itself, but told me his findings in English, which was very nice of him. He said the tumour is not very 'sick', I assume he meant not too advanced, but there is a 1 cm lesion either side. He proposed a course of radiotherapy to try and shrink the lesions and the tumour before an operation. He said there would be a better chance of saving the sphinter is the tumour was shrunk beforehand, which to my mind makes sense. Not quite as good as I was told by the doctor who viewed my MRI last week, but the doctor who viewed my CT scan did flag this extra problem up. The doctor today said that it is normal to find the lesions, not sure that it makes it any better, but we have to wait and see. I have still not been officially diagnosed as yet, but I have an appointment with the specialist who has been treating me on Friday, hope he doesn't tell me it is too bad a stage.

On top of all the stress of the endoscopy the taxi booked for this morning did not show up, we had to make a frantic call to their office, and  they said they had no record of us booking one, my wife somewhat flipped, and a taxi eventually showed 30 minutes late. We phoned the hospital to advise them of the problem and they told us not to worry. Luckily the procedure still took place, but they were running an hour late, my fault I guess although really it was the fault of the taxi company.

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That makes sense. Of the various treatments available chemo and radiotherapy are often used before and after surgery, exactly as you describe to shrink the tumour and afterwards to mop up any thing left over.

This is why it makes sense to have all the treatments given in one centre by a co-ordinated team.

All my tests and scans etc are held in the central IT records of the clinic that I go to (although I am given copies) and bit by bit things get easier and easier administratively.

The taxi problem is not uncommon, but once the firm gets to know you (or you decide to use another one that you then get to know) they will treat you like a friend.

I always snd an SMS the day before to confirm all the same even after 7 years...

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I guess you would say good news to a degree, and not so good news as to how the good news will be achieved, hope you are following. After seeing the specialist today he said the tumour is in an early stage, although did not give me a specific stage level, and is treatable. Unfortunately as I already knew it is very low in the rectum, and the tumour will need to be shrunk back, to enable an operation. He is proposing a 6-week course of radiotherapy, 3 times a week. Something I must say I am not looking forward to, after reading up of all the possible side-effects, but I guess I would have taken the scenario I have been given today, some 4 weeks ago when first informed of the cancer. So I must just grit my teeth and take it as it comes.

He said the proposed radiotherapy will be at Poitiers, which is about 50 miles away, so a 100 mile round trip for each session, not sure how I will cope with that if I have a lot of the possible side-effects. I have an appointment to see the surgeon in Bressuire on Tuesday, with the proposed operation to be carried out there, although the specialist said it is my choice, and also said the surgeon is very good. I guess I can take some comfort from the fact the operation need not necessarily be carried out at the specialized unit at Angers, it would certainly be easier for my wife. The specialist also thought it possible for a the operation to be successful without the need for a permanent stoma, only one for 3 months and then have it reversed.

So overall after the initial shock of being told 4 weeks ago of the situation, then having no idea as to how the whole system works in France, to having all the scans, and now the diagnosis I guess things could have been a whole lot worse. First stage of the experience  completed, next stage coping with the radiotherapy, I was a little low yesterday when I read of all the possible side-effects it can cause, but after today's news I have a good chance, it is something I will have to endure.

I would like to thank all you good people for getting me this far, I really appreciate all the support you have given me. Being in a foreign country and to be given the news I was, I found really, really scary but with all the advice given on this thread you have got me to where I am at the moment, a lot, lot better place than I was 4 weeks ago, thank you all very much indeed.

The experience continues but at least at the moment I am past the initial shock, have a reasonable diagnosis and a treatment plan, so I can now concentrate on the next phase.

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Hi Grecian,

I wondered how you'd been getting on today. Like you said, some good news, some not so welcome, but you sound as if you're coping with it all very well. It's quite a distance for your radiotherapy , but at least you'll be transported there and back, so you'll be able to relax and not have to think about that part of it. Tiredness is one of the efffects of the treatment, but usually not at first, and of the other side effects, not everyone gets them all, so it's a case of the luck of the draw really. Remember to get plenty of rest and drink lots of fluids when the treatment gets under way. Be kind to yourself. Wishing you all the very best, and remember to keep in touch.

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There are different doses of radiotherapy as there are of chemotherapy. Obviously it tends to be greater when it is the single and only treatment but as yours is just the first stage to shrink the tumour you may well find that the side effects are minimised.

I had 40 sessions  for 4 days a week 7 years ago for my prostate cancer, and I must say that I had no ill-effects, and I also had a trip of 65 km each way, and it was the only treatment so a higher dose.

Don't worry in advance. The Doctors are doing this all the time and will be aware of the possibilities.

Cancer treatment is rapidly evolving not only in how efficient it is but also in finding out how to avoid the worst side effects.

 I had the temporary stoma and it has worked out fine, although it takes some time to adjust.

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gardengirl/Norman thanks for your replies.

I know it can be pot luck if the side-effects will affect me or not, so no point in worrying until/unless they happen, as I have no real choice but to have the radiotherapy I must just get on with it. I am telling myself now that if all goes to plan sometime around my birthday in May things may start to be on the mend, so I am just focusing on that at the moment.

I am guessing your advice to drink lots of fluids does not stretch to include alcohol gardengirl, tant pis.

Gosh Norman you really have been through it haven't you, I would have thought facing 40 doses over 10 weeks must have seemed very daunting at the time, but you come across as a guy who just gets on with the case in hand, must say I admire you attitude,

Going back to the Bridge Inn in Topsham I really do not think people on this board appreciate Norman that in reality you are just short of being royalty, having been invited into the inner sanctum by Phyllis/Norman, well it just humbles me. Bow, bow.

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Grecian, I am just sooo delighted that you now seem to have adopted exactly the right attitude towards this very worrying episode in your life.

You have lightened up and your mood is very.  Bravo!!!

Hey, I know the Bridge Inn as well[:D]

Though not a local, OH spent many childhood holidays in Exeter and we lived in Taunton for a bit so we did have days in Topsham, just because it's such a delightful spot.

I've got some items from that antique place (a few stories and lots of goodies) by the pier that are now languishing somewhere around our present house.

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Going back to the Bridge Inn in Topsham I really do not think people on

this board appreciate Norman that in reality you are just short of being

, having been invited into the inner sanctum by Phyllis/Norman,

well it just humbles me. Bow, bow.

The nearest I got to Royalty was sharing a local with James Hewitt. [:D]

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Hi Grecian.

As mint says you seem to have got your head around the situation.

After a few disappointments I, in agreement with the consultant, will be having external beam radiotherapy. There is a three month course of tablets to be taken first and when I mentioned that we would normally be in Spain at this time he sais just go and he'll make the appointment with the oncologist for the middle of February.

The radiotherapy will commence shortly afterwards and will be Monday to Friday and spread over six weeks. Unlike Norman my round trip will only be about 20 miles. Needless to say we're leaving for Spain on Tuesday!

Best of luck.

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I can only echo all the other comments Benjamin, have a good holiday. When we lived in Exeter we went on the ferry from Plymouth to Santander for a couple of weekends, we both really like Northern Spain, we thought about maybe moving there, but the house prices were too expensive at the time, I guess they are a lot cheaper now! Speak fluent Spanish; dos cervezas por favor, that's about the whole language cracked isn't it?

After Norman stated he had 40 radiotherapy sessions, and you are to have 30 sessions, I feel quite ashamed at whinging about my 18 sessions to come, good luck with yours when the time comes. You seem pretty relaxed about the situation yourself, I guess we all deal with the situation in different ways, and hopefully end up as relaxed as we can be, until the next phase of treatment.

Mint I think you need to move house, you will soon clear any items 'languishing somewhere around the house', having moved 3 times in 7 years you become quite ruthless in throwing things away, and that is hard for a male! Agree Topsham is a nice place, but damn expensive, we certainly could not have afforded to live there, even with the thought of seeing Norman staggering from pub to pub. [:)]

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Don't forget that mine and Benjamin's I think was radiotherapy as the only treatment, so there needed to be enough sessions.

Yours is a preparation.

One great advance at the time (probably available everywhere now) was that the machine moved around me sending little bursts of radiation from several positions (but each focused on the tumour) to make sure that nowhere else got much of a dose.

That helps to avoid some of the effects that old-fashioned radiotherapy could have.

Virtual simulation, 3-dimensional conformal radiation therapy, and intensity-modulated radiation therapy

The planning of radiation therapy treatment has been revolutionized

by the ability to delineate tumors and adjacent normal structures in

three dimensions using specialized CT and/or MRI scanners and planning


Virtual simulation, the most basic form of planning, allows more

accurate placement of radiation beams than is possible using

conventional X-rays, where soft-tissue structures are often difficult to

assess and normal tissues difficult to protect.

An enhancement of virtual simulation is 3-dimensional conformal radiation therapy (3DCRT), in which the profile of each radiation beam is shaped to fit the profile of the target from a beam's eye view (BEV) using a multileaf collimator

(MLC) and a variable number of beams. When the treatment volume

conforms to the shape of the tumor, the relative toxicity of radiation

to the surrounding normal tissues is reduced, allowing a higher dose of

radiation to be delivered to the tumor than conventional techniques

would allow.[4]

Intensity-modulated radiation therapy (IMRT)

Intensity-modulated radiation therapy (IMRT) is an advanced type of

high-precision radiation that is the next generation of 3DCRT.[35] IMRT also improves the ability to conform the treatment volume to concave tumor shapes,[4] for example when the tumor is wrapped around a vulnerable structure such as the spinal cord or a major organ or blood vessel.[36]

Computer-controlled x-ray accelerators distribute precise radiation

doses to malignant tumors or specific areas within the tumor. The

pattern of radiation delivery is determined using highly tailored

computing applications to perform optimization and treatment simulation (Treatment Planning).

The radiation dose is consistent with the 3-D shape of the tumor by

controlling, or modulating, the radiation beam’s intensity. The

radiation dose intensity is elevated near the gross tumor volume while

radiation among the neighboring normal tissue is decreased or avoided

completely. This results in better tumor targeting, lessened side

effects, and improved tre
atment outcomes than even 3DCRT.

When I knew Topsham there was still active salmon fishing (I went out with George Leech from the Passage a few times) and there were no pubs where you could eat. The first food place was called Le Bistro  then Denley's opened.

The place has been destroyed by the sort of 'Guildford High Street' crowd that infest France and call themselves 'Expats' [6]

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  • 2 weeks later...
Have been taking a bit of a breather from this thread for a while, basically it has just been a case of waiting. Finally saw the surgeon on 18th November, not a particularly nice man, although I guess you have to be a little strange to do the job that he does. Came across lacking much compassion, most of the appointment was conducted in French, with the odd sentence in English. I think basically he was saying we will have to wait and see by how much the tumour shrinks before any decision is made on a temporary or permanent stoma, which to be fair is all he could have said I think.

Received a telephone call this lunchtime for an appointment at Poitiers hospital for what I guess will be the 'marking-up' of the site to be radiated and I assume discuss all the implications of the treatment. Whilst I have wanted the radiotherapy to start as soon as possible, I am a little daunted at the prospect of somebody zapping me with radiation and what the possible side-effects will be, but this is the situation I find myself in, so I guess I should just say 'bring it on'.

Many thanks for the above post regarding how the radiotherapy treatment works in this day and age Norman, much appreciated. Hope you are off your gruel diet and back on solids, if not I am sure that you will have told them what you think, including all expletives!

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Am back home and f*rting for Europe..

Surgeons are notoriously cold. I think it is a necessary distance from someone you are going to cut open. In the theatre the nurses refer to me by my room number...

Did you understand what he said? You can ask  someone from CSF who speaks good Frencg to be with you for consultations I think

As for the radiotherapy, I was put under the scanner so they could see exactly where the tumour was, then little points like tattoos  were marked on my skin so the radiotherapy machine has its target delineated..

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Glad to hear you are back home Norman, and that Europe has a potential champion in the making in the wind department. [+o(]

Totally agree about the surgeons being notoriously cold, I was not expecting any different, very similar to the surgeon who operated on my wife's back, many years ago back in the UK. I think I understood most of what he was saying, or my wife was able to translate, it would have been handy to have had someone from CSF with us. The person who has been assisting me at CSF was going to come along with me when I had my CT scan, but at the last minute pulled out, saying she did not think it would be worth her coming, so I did not bother to ask her to attend when I met the surgeon. I will ask for somebody when the decision has to be made regarding my operation, but that is quite a while away for the moment.

Will find out Tuesday I guess, all about my radiotherapy treatment, not sure if the doctor I am seeing will overrule the specialist and change the number and frequency of what he proposed, or stick with the original plan. Certainly will be glad to finally start my treatment.

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Well after nearly 7 weeks of many ups and downs, not to mention a very stressful journey of trying to ascertain how the whole scenario plays out in France as regards to treatment, I finally have a start date for my treatment, 15th December. After two journeys to Poitiers this week, and after being marked up today, the long journey to recovery is upon me.

Unfortunately I will not be getting off as lightly as I first thought, going by what the specialist said to me back in November, he said no chemo and 6 weeks radio, 3 times a week. Well as it pans out I am to have 27 sessions of radio, combined with 1500 mg Capecitbine tablets twice a day, I have been told that the dose of the tablets are a lower dose to enhance the affects of the radiotherapy, the doctor told me today very few people suffer any side effects with these tablets (I wish!), not convinced about that, but will just take it as it comes, no point worrying about what may not happen. Then a 6 to 8 week gap, supposedly the radiotherapy carries on working after the course is finished before an operation to remove the problem. The doctor today said they will try to get a result regarding reversing the stoma, nobody will know until all the treatment is completed. Whilst I am a little apprehensive, I am relieved that finally something is happening, so just have to grit my teeth and get through the next 6 or 7 weeks, and take matters from there. To date the fastest a taxi driver has completed the journey is an hour flat, today we only managed about 1 hour 5 minutes going up, and a rather poor hour and 15 minutes coming back.

Once again thank you all very much for your support and kind words, still a long way to go but feeling a little more positive at the moment.

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Good man, Grecian, you are thinking like a winner!

Look after yourself, eat nutritious meals, take some exercise (maybe some walking daily) and rest when you feel tired.

You are going to have to be in good nick when you go in for this stuff, good physically and good mentally.

Bon courage [:)]

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 [:)]As I've told you, it is always the not knowing that is the worst bit. Once you know and know what they can do, things sort of slot into place and you just get on with it. As a good friend put it, 'it's the not knowing that's doing my head in'........ and she is quite right.

So how is your wife? I know how hard it is for spouses when there are health problems.

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Good morning Grecian, I'm so pleased to hear you've got your treatment plan. Waiting really is the most awful part of it all, with the mind taking you to places you don't want to go to, as you've found. During my latest bout it was the waiting that hurt most of all.

As the dark days of December give way to spring you'll be steadily moving along on your journey with the promise of summer ahead. It can help to plan treats ahead, however small. Many of us on here are sending lots of positive thoughts to you both. Take care of one another.
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  • 2 weeks later...
Just an update and to thank you all for your kind words yet again.

My treatment plan started on Monday with my first radiotherapy session at Poitiers, it was pretty scary Monday morning looking down at the chemotherapy tablets and thinking I must put that poison into my body, but as it is the only option on offer I duly swallowed the tablets. I must say that the support I have received from the staff at Poitiers has been non-existent, totally appalling, nobody has explained anything to me regarding the treatment. I have not been given any prescriptions to alleviate any potential side-effects. As it was my first treatment on Monday I would have thought that the two nurses who carried out the radiotherapy would have taken some trouble to explain how the process will work. I could imagine some people totally freaking out when left in the room on their own, once the machine starts whizzing around you, red lights coming on, and a loud noise when blasting is in operation. All they said to me is 'do not move' and left the room.

I saw my own doctor this morning and told him of my experience and he seemed really shocked, he asked me if I had been given a booklet explaining the whole procedure, which I had not, and looked very surprised that I had not been given a prescription for potential side effects. On the first consultation at the hospital a particularly nasty nurse reduced my wife to tears, when my wife remarked that the appointment was rather early in the morning for somebody who lives 50 miles away, the nurse snapped at her basically saying tough luck. I will be really glad when I am finished with Poitiers hospital, and can only hope when I have my operation that the staff will be nicer at Bressuire.

To date my wife has come with me to all my appointment, but unfortunately it has taken a toll on her physically, without elaborating as my wife is a private lady when it comes to her ailments, I have taken the decision to attend all further treatments at Poitiers on my own, it will be a little scary as my French isn't brilliant, but if it is now just a routine for the radiotherapy then hopefully I will be able to cope. It could be a strain in the taxi trying to speak to the driver for two and a half hours, but I guess it will improve my French.

I have taken onboard what you have said gardengirl looking forward to spring and leaving the dark days of December in more ways than one behind me. I am finding the thought of another five weeks of radiotherapy/chemotherapy a little daunting at the moment, but if I can get this behind me for the time being it will be the hardest part out of the way. I will worry about any further chemo if it is required after my operation.

I guess it will be no more red wine for the foreseeable future[:(] maybe that is the hardest part of the treatment afterall. Must stay positive, at least now things are happening.

Thanks again for all your support.

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You are doing well, Grecian.

To have started..............wonderful!  And now you can begin to mark each session off and keep the end in sight.

You have indeed been unlucky with the medical staff.  However, don't worry about talking to the taxi driver:  he is being paid and will be used to nervous patients who don't wish to talk.

Take a book or a crossword or a sudoku or something for the taxi ride and the waiting around.

Good luck![:D]

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