Thursday, August 18th
Few days have passed since I arrived in the South of France. I spent them mostly enjoying family time and, of course, some good food. I missed the wine, cheese, and dry salame (in France, it’s called saucissons but I feel in English, there is non perfect word to call it because Salame is a bit different !). Now, it’s time to go back to the important matter: get cured.
My mum and dad insist to come with me and meet the new hematologist-oncologist. (damn! it’s a long term)
They heard from him from 3 different doctor friends and he has more than 20 years of experience, so don’t worry for me! I’m in the best hands I could be in!
The Hospital is called Paoli-Calmettes Institute, in Marseille. It’s the big center for cancer treatment for the whole South-East region. Everything is really modern and design in it. It’s almost making you love the place.
By the way, Cancer in France is considered as a long-term disease (even though I hope it won’t be very long for me!). Therefore, all the necessary procedures and treatments are covered 100% by the social security. (Yeah, I realized how lucky we are in France when i start traveling and living abroad. It is sure pretty rare to have such an amazing health system!)
12PM. Time to meet the new doctor. HELLO !
He looks like a nice person and the kind that doesn’t tell you B*******T either! I like that.
Not like the previous one. Not like Mc Steamy (cf Dr Mark Sloan).
He was nice but between us it got a bit weird.. Ah yes now I remember why!
I was then with my boyfriend in the examination room for the first meeting when he tried to talk about fertility issues after chemo. But instead of giving me time to think about it and be ready to talk, he just went straight to the craziest option (for me).
“Best option is that we go directly with the Frozen Embryos technique.
– Excuse me ?
– (While looking at me and my boyfriend with the same stolid like it’s not a big deal) Well, first we would need to get your implant out. Then, stimulate your hormones so you can ovulate. Conceive a baby and once the egg is fertilized, extract and freeze it. It gives really good results! Your best option.”
OK but I’m like not ready at all. Neither is my boyfriend. I mean come on the doctor doesn’t even know which kind of couple we are. I could have found my boyfriend in a bar the day before… (which is what happen. No, i’m kidding with you but you got the sense)
So, let’s go back to what we were talking about! The NEW oncologist here in France.
“Sally, I have read your whole file but why won’t you start and tell me what happen from the beginning.”
I start to tell him what I know. The lump. Dad who insist to get it check. The fatigue. The MRI. The surgery and biopsy. Classes. The first oncologist opinion.
My mum cuts me and start talking. About little stuffs that seriously don’t matter. That she thinks I don’t sleep at night. BLA BLA BLA. But she doesn’t stop. And she keeps going and talking more and more. The doctor look at me and my dad..
“Stop. Now I want silence.
Sally is the patient so it is Sally who talks. Thank you”
Ha Ha! I like this doctor! I don’t mean it is fair to my Mum because I know she’s acting crazy because of the stress. She is just a little bit lost in all of this. But I mean, she deserved to be stopped at some point. And now she knows how the doctor will respond.
He explains us. You have Hodgkins’ lymphoma as you already know. Localized in more than two sites in the upper part of you body, what we call Stage II. You got no weight loss of more than 10% of your overall weight, no night sweats to the point you have to change your pyjama nor fever that last more than 8 consecutive days. Your sedimentation speed is good.
You are what we call a FA-VO-RA-BLE case. FAVORABLE.
“It means that with you, Sally, we go forward with the hope that this first chemo will be efficient and that you’ll enter remission. Understood?”
(Great! It is nice to hear it again even tough i knew it already! I guess it is very good for my parents to hear it from the doctor’s mouth, face-to-face. Especially for my mum ! I imagine that if he was saying UN-FA-VO-RABLE, the atmosphere at home would be much more pesant !)
Now, I have the report of my American colleague, who suggests a treatment by 6 Cycles of chemotherapy type ABVD (it means 6 months so 12 injections with one every two weeks).
But, I do the things a bit differently! Recent researches have shown that patient following a combination of chemo and radiotherapy showed a lesser risk of relapse with this disease than a longer chemo. But I’m gonna be very honest with you!
Thirty years ago, radiotherapy wasn’t as advanced as today and it wasn’t allowing us to target small regions of the body without risking to affect nearby organs. There has been an increased risk of secondary cancers for these nearby organs. However, today, we have the “in-node” technology, allowing us to target up to a group of cells, very precisely.
There is still a risk! And I won’t be lying to you saying it is 100% safe! But this risk is now very very small!
Since 20 years that I have been doing this job, I saw around 50 cases of Hodgkins per year. 40% were women. In total, I treated around 500 female patients. I only had 3 who came back for secondary cancers, especially breast cancers. Less than 1%.
“This risk exists! But it’s small. If you get another cancer because of that.. How can i put it in word gently .. It’s TOO BAD! But according to me, radiotherapy is a crucial tool in the treatment of localized Hodgkin lymphoma to consolidate and lower the relapse risk. I would advise this to my own daughter. It’s 3 months of chemo and 1 month of radiotherapy. I’m taking an appointment with the radiotherapeutic doctor so you can talk more in-depth with her. Anyway, till November, the course of the treatment stays the same. Radiotherapy only happens after chemo is over.”
Once the appointment is over, I go to the lab for another blood test. I should get used to it as I will do one every 2 weeks.
Do 3 months of chemo instead of 6 would be way nice, even if I’m a bit concerned of the risk of radiotherapy. We talked with ma parents and decided that we will take the time to get more info about it!