Professor Jean-Pierre Lotz, head of the medical Oncology department at the Post Hospital in Paris, gives some tips on how to live his cancer on a daily basis. The entire interview is featured in the Health Bubble podcast below.
■ Do not hide anything from the surroundings or as little as possible, because if the situation does not evolve as desired, the lie reinforces the concern. Have a clear, honest, reasonable speech.
■ A patient must tell the surrounding person the truth about the disease. As far as the employer is concerned, it is better to act cautiously. It all depends on the workplace, the professional environment and the employee-patient’s confidence in the boss. It must be certain that everything that is said to the employer will not be broadcast, because only the patient can decide to break this professional secrecy.
■ Often people who turn away are people who are afraid, afraid to confront a patient who has cancer, afraid to confront a woman who has no hair… Patients should behave naturally, they do not have a shameful disease, they have been the victim of a disease. Everyone must understand that it is appropriate to help the sick. It can go through a small gesture of everyday life sometimes simple: a Hello, a smile, a benevolent look.
■ There is no pain, but dozens of different pains, related to disease, therapeutic gestures, medications or the effects of treatments. The English set up affirmative units to manage the pain from 1975, France attacked it thanks to the action of Bernard Kouchner in the early 2000. There are solutions to soothe the pain. For example, some patients have pain in the mouth due to toxicity on the oral mucous associated with chemotherapy, they can be offered mouthwashes, analgesics… If they are pains related to a surgical procedure, they can persist several weeks, several months, several years. For example during a mastectomy the scars hurt very long after. Do not hesitate to request a specialized consultation with the teams in charge of the pain (mobile teams or palliative care to provide support care).
■ This support care includes all: the prevention of nausea and vomiting, the prevention of white blood cells, the treatment of anemia, possible transfusion, the psychological support, the social worker, the nutritionist… These are not end-of-life care, but start-treatment treatments. Soft medicines are called “complementary alternative medicines” and are recognized.
■ It is extremely common and normal to be tired after treatments. First, there was the shock of the diagnosis, the course of the balance sheet (almost the “course of the combatant”), the administrative route, the surgery, the chemotherapy, the maintenance treatments, the rays, the back and forth to the hospital… Medications leave traces in the body, some very long. You have to do what you can do, as you feel. The patient knows himself well, and after a while the fatigue will eventually disappear.
■ Return to work reflects a return to healing. Half-time is a good solution. We find the colleagues, we go back to social life, we live again. It is necessary to persevere and over time fatigue will fade.
■ Sleep disorders have several causes. First there is the announcement of cancer and treatments, then some medications are potentially insomniacs, at least at first it’s a side effect. Some complementary alternative medicines prove to be effective: the use of psychology, hypnosis, homeopathy, sophrology, acupuncture…
■ You do not lose your hair as a result of radiation, unless you are irradiating your brain because you have metastases or a primitive tumor. Rays only act where they are directed.
■ In terms of nausea and vomiting from chemo, they are increasingly anticipated. Treatments are intended to avoid them.
■ Some patients relapse when the adjuvant treatments did not eradicate the dormant disease, i.e. the presence of residual cells, undetectable, imperceptible, even by modern means.
■ Two elements generate and redouble the risk of relapse: obesity for breast cancers and tobacco for all cancers.
■ In terms of sexuality, consultation with a urologist will obviously be useful to see if any disorders are related to a specific surgical procedure (e.g. pelvic lymph node cleaning). The psychologist’s help will also be very important in dealing with this libido problem. This is a common problem, much more than the patients want to tell us.
■ Social workers are aware of a number of resources outside the hospital, in town halls, associations… If there is no social worker in a service, you must contact the social worker of the town hall. Their vocation is to help to promote a social life, because it is not necessary to remain isolated after having faced the disease.
■ Physical activity is recommended after cancer because it reduces the
The risk of relapse. There is no restriction on the subject of a visit to the appropriate doctor. For the rest, patients know each other well and know how far they can go.