TAKING A BREAK

One thing every Consultant, Doctor and Nurse says when you finish treatment is, “take a holiday”. But they don’t answer questions – Can I fly ? How far should I travel ? Will I get tired? etc. How do I get insurance ? etc. See answers to these and other questions at the end of the article. And here are some places to go and have fun, combining the European way of a holiday with a medical spa break. N.B I say ‘medical’; in Britain we tend to let pampering spas slide under the ‘Medi’ title – but they are not the same. Make sure if you want and need genuine spa treatments tailored for cancer patients, ask before you book – or you could end up with the British spa that, under the heading ‘Our medical team’ offers Tarot Card Expert!

FRANCE

Celebrities such as Kylie Minogue, Marianne Faithfull and others may live around the corner from the Royal Marsden Hospital, but where do they go for treatment ? To France. France has some of the best cancer treatment in the world. In Britain we are getting better at diagnosis, and generally we manage surgery, chemotherapy and radiotherapy well, but once this is finished – bye-bye. You get the impression you are no longer interesting, and your medical team has others to look after. Once every six months you get a hurried appointment, and no time to talk about worrying side effects. But in France, they realise that if you are on hormonal drugs, the side effects are going to be with you for a long time, and they are working constantly to improve patients’ lives. They monitor patients’, and provide help and back-up constantly to deal with side effects. So when you need treatment and help dealing with side effects – or a large dose of TLC- there is nothing to stop you tapping in to post cancer treatments in France, where their survival rates are some of best in the world – way above Britain. Best way to go is to get a letter of introduction from any of your doctors, listing what treatments you have had – send a copy to the Medical Director of your chosen spa, and you are in the system, If you can’t find the right person, the tourist office will be able to help. If you doctor considers this nonsense and won’t co-operate, then you make an appointment to see an English speaking doctor at the spa, and take it from there. You will have to pay a small amount for the appointment, but nothing like what a doctor’s visit costs in the UK.France has some of the best cancer treatment in the world. In Britain we are getting better at diagnosis, and generally we manage surgery, chemotherapy and radiotherapy well, but once this is finished – bye-bye. You get the impression you are no longer interesting, and your medical team has others to look after. Once every six months you get a hurried appointment, and no time to talk about worrying side effects. But in France, they realise that if you are on hormonal drugs, the side effects are going to be with you for a long time, and they are working constantly to improve patients’ lives. They monitor patients’, and provide help and back-up constantly to deal with side effects. So when you need treatment and help dealing with side effects – or a large dose of TLC- there is nothing to stop you tapping in to post cancer treatments in France, where their survival rates are some of best in the world – way above Britain. Best way to go is to get a letter of introduction from any of your doctors, listing what treatments you have had – send a copy to the Medical Director of your chosen spa, and you are in the system, If you can’t find the right person, the tourist office will be able to help. If you doctor considers this nonsense and won’t co-operate, then you make an appointment to see an English speaking doctor at the spa, and take it from there. You will have to pay a small amount for the appointment, but nothing like what a doctor’s visit costs in the UK. In France doctors understand side effects of hormonal drugs, and want to help you get through the five years’ treatment cycle as easily and painlessly as possible. You will find expert help, allied to proven therapies, and you can lie back and enjoy being pampered, knowing that the massage or treatment you are having is supervised by medical staff, who spend their working life helping get the best possible results for their patients. After cancer treatment in London, I tapped into the French system, and every few weeks off I go for a short break. Talking to doctors about any niggling worries or problems that have cropped up, I then indulge in treatments, and the only nasty side is knowing that many of the local patients are getting this on their health schemes and aren’t paying! There doesn’t seem to be a language problem. For your first appointment you can request an English-speaking doctor, and once they have assessed you, they will assign therapists and other staff to look after you. Many of these speak excellent English, and if not, medicine is international; they know their job, so just leave them to sort out your massage, skin problems, or whatever. Most of the medical spas that specialise in post cancer treatment have the word ‘Bain’ in their names; this is because treatments followed healing thermal waters. Some of my favourite places for post cancer treatment are:

Aix-les-Bains

The British have been coming here for years; it was where Stanley Baldwin, our Prime Minister during the Abdication would come for two months every summer, and many people in this flower-filled lakeside town speak English. At the marvellous spa, they are well-used to treating post cancer patients, and make a speciality of care for patients with mouth cancers. Their specially-developed little machines that look like dentists’ drills, directing streams of warm, healing water directly at the cancer site. You see patients having treatment with smiles on their faces. Massages are excellent, and give you back your bounce. This spa town has lots for the family, including an evening dinner cruise on the lake where you may see beavers (I saw two). If you drive there, DO use the town’s car park. The walls have the most wonderful collection of paintings: surreal but fun.

Brides-les-Bains

(easily reached via any Eurostar/Rail Europe service to the French Alps) is a lovely old Thermal spa that has been sympathetically modernised. Instead of visitors walking sedately around the gardens, today they go ski-ing in the winter, and indulge in the spa in summer. The Grand Hotel des Termes is one of the grand old hotels, where the incredibly rich Duke of Westminster used to deposit his wife for the summer, then hare across to the opposite corner of France to Biarritz and spend time there with his mistress, Coco Chanel. The hotel was totally renovated by the French for the Albertville Olympics to house their skating stars, who were expected to scoop the medals. Unfortunately they didn’t: I wonder if it was because they were enjoying themselves too much in the hotel? Slightly less expensive, but just as lovely is the Hotel Golf, which TripAdvisor rates as its favourite hotel. The breakfast buffet is enough to set you up for the day, and staff run round to help you. Bedrooms – especially on the first floor – are huge, and the bath goodies are sumptuous. The spa is dedicated to helping you lose weight along with meals. Handed a menu, what looks like incredibly high menu prices are actually calorie counts. And you eat dreamy food that does you good! Then go back for fantastic treatments that make you feel wonderful, but help the body get rid of toxins from drugs. If you want self-catering, the British chalet specialists, Lagrange. have a residence in the centre of Brides les Bains which has been recently completely refurbished to a high standard, yet remains very affordable. Residence Cybele was originally built to house Olympic athletes for the Albertville games and it boasts an indoor pool and sauna, as well as a handy on-site ski shop and is only 600m (or a free shuttle bus ride) from the Olympe gondola to Meribel. The residence is open all year round, meaning that during the summer months the area is suited to those who want to go walking, climbing etc. in between spa treatments. For skiers, Brides les Bains offers 3 Valley skiing at a fraction of the cost – a self-catering apartment for four for February half term (wk comm. 14/2) costs just £630 sterling, including a return Dover/Calais ferry crossing with SeaFrance, that’s a respectable £157.50 sterling pp based on 4 sharing.

La Roche Posay

Is one of the best medical spas I have ever visited. When my skin was rough, peeling and horrid to look at, their doctors just examined it – sent me off for lovely spa therapies, and put me in the hands of nurses who asked questions, examined my skin again, then gave me a goodies bag full of La Roche Posay products specially developed to help cancer skin. All this whilst I was sharing the experience with Frenchwomen who had been sent by their doctors to sort out side effects from their cancer drugs. The only difference being that the British have to pay – over 8,000 French people a year will probably get this treatment as part of their health service. The Spa lies in the Poitou-Charente (in the North West Corner), so is less expensive than spas on the fashionable East side, but has lots for the family to do. Legend has it that in the Middle Ages Bertrand du Guesclin stopped to drink the thermal waters when riding through. His horse, suffering from eczema, immersed itself in the water, and was cured. So if the waters are good enough for horses it must be good enough for us! In 1617 Pierre Million, doctor to Kings Henry IV and Louis XIII, analysed the water and was so impressed that the newly-founded Science Academy sent people to test the water -and the spa of La Roche Posay was founded. Napoleon built a thermal hospital there for his soldiers, and it has never looked back. In 1913 the Thermal Station was officially declared a Hydrothermal Station by the Academy of Medicine, and today it is the busiest dermatology cente in Europe. They treat all sorts of skin conditions, including running a marvellous clinic to teach people suffering from burns and birthmarks, how to cover these up with make-up. But I had come to try those treatments using the soothing Selenium-rich water (probably what cured the horse): fine-jet showers, which play over your body whilst you are massaged lying on a bed underneath, leaving your skin incredibly smooth. Dermatological wraps and massages are also designed to give us a soft skin, and as they say “improve our daily lives”. The town is the parent company of the excellent skincare products, La Roche Posay. Their products are only sold via chemists, and there are various ranges tailored to specific skin problems. If your skin is extra-sensitive, they even have a special range – Toleriane. You can now get all of these in Britain, and rumour has it that some patients in UK have been sent here on NHS for treatment for skin problems. Like all such rumours, the NHS doesn’t want this advertised – but it is worth while trying at least! There is a charming Art Deco hotel, and suites in the hotel are not expensive, but give a touch of Hollywood glamour to a family holiday. There are also more modern hotels in the town, all within a short walk of the thermal treatment centre. Here I had a ‘massage under water’ where you lie on a waterproof-covered table, with jets of water playing over your body whilst the therapist massages you. Afterwards my skin was incredibly soft (and I felt wonderful). Apparently the minerals in the water help the softening process and are excellent for cancer-stressed skin. The spa has also devised an incredible array of stunning cosmetics for disguise and glamour. So you don’t have to be a celebrity to go to France for some of the best post cancer treatment in the world for nasty side effects. You don’t have to be rich either, as treatments and hotel packages are designed for French people. They do not like spending too much !

GERMANY

Clinic Bad Sulza, near Leipzig, is forging links with British cancer treatment centres, and even had lectures from a specialist British Therapist on differences treating British patients. Great hilarity during the training sessions, as therapists discovered the main difference is Germans are so used to massages that they take off clothes automatically; we have to be persuaded even to take our socks off. But therapists have seen it all before, and you soon relax under their skillful treatments. The Director, Dr. Toerpe, was in charge of an Olympic team, and a sports doctor, and what he doesn’t know about rehab. isn’t worth worrying about. The massive 500-bed complex is built around a huge Dome, housing five huge thermal swimming pools, and I couldn’t believe the size of the complex. It is filled with thermal waters at 36 degrees, and you could spend all day in them. In winter is it great fun to swim outdoors with snow falling, keeping blissfully warm in the water. If you go there for treatment your doctor will send your notes, which will have been read thoroughly by your English-speaking doctor, who then devises a schedule giving you two treatment sessions a day – which include different types of massage, special baths – the mud bath is incredibly soothing and fantastic for your skin – and other therapies which you can take if you wish. The basic cost is £99 pp a day, including single ensuite, three meals a day, doctor’s supervision and all recommended treatments. You could pay around £10 a day extra to stay in Haus 2, which is not so clinical and has larger rooms, and then walk in to the village for the evening meal, as the local food served in the Klinic is hearty – to say the least! In the village is a Castle (which belongs to the Clinic owners), with a good restaurant and fascinating little Carriage museum – including a carriage given to Napoleon whichis a right monster! There is also a Gastro-pub The Old Schoolhouse in the village, again with good food. The most expensive building in the complex is the Spa hotel, which includes the beauty spa run by Ute, and offering excellent treatments specially aimed at post cancer patients: manicures, facials (with fantastic results) and other treatments to induce moisture into dry skins. Air Berlin and Ryanair fly there (Air Berlin definitely wins hands over with their excellent treatment of anyone with the slightest disability), but you can take a train; overnighting in Cologne, or flying to Frankfurt and connecting up to the fantastic German Rail system from the Airport (2 ½ hrs to Weimar near Bad Sulza). And then I suggest hiring a car, as there is so much to see round about – the Castle where Luther wrote his thesis whilst imprissoned, the longest covered bridge north of Florence, Weimar, Jena, Dresden and Leipzig near by – or you can take out Klinic bicycles and explore the wooded countryside around. All treatments can be taken by others in the family, and kids can enjoy the special Kindergarten as well as take advantage of the massive thermal water pools. Just don’t ask German fellow guests how much they are paying: most are getting their stay free on the German health service. Makes you sick when you realise that they pay about the same overall as we do in taxes for the NHS, yet maybe because their hospitals aren’t burdened by massive administration costs, benefits go to the patient. As far as I could see there are only a small administration staff at the Klinik, but five full-time medically-qualified doctors and about 30 medical staff for up to 500 patients! If you have lymphoedema they are specialists in treating this, but you need to book a stay for at least 18 days.

ITALY

Sardinia has several well-managed Thalassotherapy treatment centres. These treatments are based on minerals found in sea-water, so have to take place near the sea (don’t believe mid-country spas that say they bring tankers of water in – it doesn’t work). Just Sardinia is one of the most efficient and caring tour operators I have come across; they know their Sardinia, and arrange everything beautifully if you want to book a stay. I stayed at the Hotel Capo d’Orso (you need a car if you stay here) where their Thalassotherapy centre became my haven from the world.

SWITZERLAND

If ever I win the lottery I will head straight for Clinique La Prairie, just outside Geneva. Haunt of stars, international politicians and anyone with several thousand pounds to spend on getting into tip top health mode, this is where they go for the most fantastic treatments. However, this is probably the most discreet place you will ever find. It is well documented that Sir Winston Churchill went here several times, but when I mentioned this to The Director, Dr. Walli, (who has a wonderful sense of humour), he looked me straight in the eye and said, “you know, I heard this too – but have never been able to find any confirmation of this”. That is why the world’s politicians go there when they need treatment. No-one ever finds out. And getting into their website gives you an idea of how secretive they are! The food is low calorie and delicious (they sell an inexpensive but excellent English cookbook), the treatments sooth away all aches and pains, and quietly they do a tremendous amount of good for underprivileged children, paid for by the film stars having plastic surgery. If anyone comes from Glasgow, the Clinic’s sense of humour was evident when I met their head plastic surgeon, who proudly said he had done his training at Glasgow general A & E hospital. He remembered Saturday night brawls with fondness, and the excellent training gained by stitching up torn noses and lacerated ears.

TAKING A BREAK

When you first venture out into the ‘real’ world, after treatment, you need answers to questions before you feel confident to go off on holiday. Can I fly? Can I go out in the sun? What about diet? Where can I find reasonably-priced travel insurance for post cancer? And biggest fear of all ‘what happens if I get ill whilst I am away?’ This probably won’t happen, but you are emotionally low and afraid of the slightest sneeze.

Can I fly ?

The short answer is probably yes – but best to keep to short haul. Your doctor should explain the problems and risks associated with flying, from standing in long queues before you board your plane, sitting cramped in a seat without enough leg room, and what most forget – dehydration from the air in the plane’s cabin. Long haul flights are probably a no-no for the time being. Not only because of the perceived risks, such as possible DVT complications, but also because your body is going to be in a fragile state. Doctors specialising in aviation medicine say a rule-of-thumb for jet lag is that the body needs one day to recover for each hour spent crossing a time zone in an aircraft. There is even more data coming out about this, often supressed by the tourism industry as they don’t want you to be put off. So travel by all means, but try and go somewhere near by – either in Britain or in Europe. Trains have just got better and better, they can be surprisingly comfortable, especially if you are at all unsteady on your feet, and really to be recommended instead of a car journey.

Can I go out in the sun ?

The answer is yes – warmth and heat are good for you, but be very, very cautious in sunlight – and this means watching that the sun’s rays don’t reflect off a shiny surface such as concrete, as well as the sea. You can be sitting under an umbrella and still be burnt. Whenever you go out, wear a high factor suncream (see Watch that Sun!) and renew it frequently.

What about diet ?

Nutritionists will probably tell you the Mediterranean diet is the best you can eat. We tend to eat more fruit and vegetables when on holiday, so as long as you are careful, peel fruit, don’t have ice cubes in your drinks, and watch you don’t go mad – diet will be fine.

Where can I find reasonably-priced travel insurance for post cancer patients ?

See under Insurance in right hand column.

What happens if I get ill again whilst away ?

This probably won’t happen, but after treatment you are emotionally low, and the slightest sneeze has you worrying about your health. This is normal; your body is at a low and your immune system is shot to pieces. If you go on holiday you are more likely to be relaxed, and when you have something to look forward to you tend to think “I’ll sort out that sniffle later on” and of course you soon forget ! However, if you are going on holiday, do as the Continentals do and go to a properly-approved medical spa. We think of spas as places where OAPs sit with bottles of pills on the table, with a nasty smell of mineral waters wafting around. But Europeans aren’t so stupid. Remember it was the Romans who believed in baths – sadly when they left Britain we forgot about this sensible habit, and it took nearly two thousands years to return. But on the Continent they have been taking the waters all this time, and their sophisticated patients take it as a natural thing to ask their doctor to recommend a suitable spa (sometimes they can even get help with costs from their health service (NHS – are you listening ?). France, Germany, Italy, etc. have spas that specialise in post-cancer treatment – even down to different spas that treat different cancers, such as Aix-les-Bains for throat and mouth cancers, La Roche Posay who can help with skin side effects from hormonal drugs, Klinic Bad Sulza, etc. The only thing that will spoil your holiday is waiting for your therapist to give you a wonderful, targeted massage – to find sitting next to you is a local who is getting it for free on their health service ! And every spa has marvellous sport and recreation facilities, so you won’t see your family as they take off paragliding, canoeing, swimming in fantastic pools, or just enjoy the sun sitting in a café. You are doing your long-term health a favour by tapping in to the Continental health system. Just about every European country has a better post-cancer survival rate than us – France is usually top of list, we are way down between 17th and 25th – not good, is it? And one reason is they have specific treatments for their type of cancer.

USEFUL THINGS TO TAKE

Luggage

When you go on holiday, you aren’t going to be as fit as you think you are – and this is where a brilliant company called Live Luggage comes in. They have developed powered luggage; a suitcase with built-in battery that takes 85% of the load off your arms. Included in the design is a clever handle in the shape of a Y (when you see it you wonder why no other luggage manufacturer has thought of this ergonomically-sensible design). Lift up the handle, a little motor kicks in, and however heavy the case, all you do is guide it along. Like a kid with a toy, I road-tested a large suitcase (the sort you cram clothes in to for a two-week holiday). I took it down stairs; out into the garden; across a lawn; and back up again. It didn’t stop once, and neither did I. Later on, using it tocarry more heavy thing inside, it was a doddle – where normally I would have had to stop every few yards as it was so heavy. There are problems: the suitcase is suitable for trains and for main holidays, but too big for a short weekend where you want to carry-on luggage on an aircraft. And the price puts this suitcase into the Rolls Royce class. But, remember how expensive flat screen TVs were a short while ago? I am sure that prices will come down. For the technically-minded, the tilt switch/sensors only power the wheels at certain angles – between slopes of 15% and 35%. If you accidentally drop the case or let go, it won’t run away from you. In these instances, the case will go beyond its ‘active’ angles, so no power will be delivered to the motors. For the non-technical like me, there is a wonderful little umbrella hidden under the handle. When you arrive and the rain is bucketing down, you just tilt the handle and pull out your brolly. Genius. The handle can be adjusted to three height levels making it as comfortable for people of all heights. The lock has been approved by the US’s TSA (likened to the KGB), and also our CAA. If you lose it, you go on the web with your ‘credit card’ that comes with the case, and the built-in tracker tells you if it has been handed in. The power comes from a battery, which you charge like your mobile phone, and if you forget to do this the case can be pulled like an ordinary wheeled case – but without the power. So, why would anyone want to use a power assisted suitcase? (Apart from those like me who had surgery on a breast). With a heavy case the problem pulling it along is not on flat marble floors – the problem is getting to and from departure lounges, the long and steep gradients, steps, kerbs, taxi and train steps, to name but a few. And all these obstacles the case takes in its stride. Empty, the case weighs 10.6kg, just 3kg more than the standard hard luggage of similar capacity/ volume. However, the important thing to remember is when it has a 30kg payload it actually ONLY feels like 3kg weight – even when going up a gradient – which means a 6 year old or an 86 year old can go almost anywhere with a fully loaded case. I treated my case gently, but it is strong enough to withstand baggage handlers in most terminals (even T5). The handles are injection moulded in a PC ABS material and glass filled nylon, similar to modern day car bumpers. Fully charged, it will travel around 2 kms with a 32kg, approximately 2.5 hours charge.

WHY GO ABROAD

Generally, European medical spas are very used to treating patients, and looking after their families. Up until the First World War everyone, from Queen Victoria and King Edward VII would go abroad each summer ‘to take the waters’, and doctors would recommend this to their patients. But recently, we have got out of the habit of doing this, even though European spas have gone roaring ahead with superb treatments for medical problems, especially those which we get after cancer. Germany provides massages as part of their health service, as does France, and at medical spas you see queues of patients clutching their medical forms, all having fantastic free sessions which would cost us a fortune in Britain. You can take advantage of their system; you will have to pay, but visiting a properly approved medical spa will still be far cheaper than going to a glitzy resort. At a medical spa there will be genuine doctors in charge, rather than therapists who waft around in white coats (the local tourist board will tell you which are approved). Treatments will be tailored to your type of cancer, you will be under the care of a doctor who actually spends time with you, and often speaks excellent English, and the family can take advantage of the swimming pool, treatments and kid’s facilities. You may not see them from morning till night. At Aix-les-Bains, whilst watching coach loads of OAPs arriving for their monthly treatments, I realised that I could take advantage of their system. So here is my mini-guide to having fun at Spas. This is very much tailored towards what I experienced, and what worked for me (I had breast cancer) but generally the medical spa websites will tell you which cancers they specialise in. TRAVEL If you are worried about flying, or told that you can’t fly, train travel is getting back to the days of glamour – or almost! Thanks to Eurostar, in conjunction with Rail Europe, there are often seamless changes at Lille Europe station for onward trains to Switzerland, Germany, France, etc. Now that St. Pancras Station is opened it will be even easier to take a train from the Midlands and North to catch Eurostar, and times are very fast. Through trains run from London to many destinations across France and Belgium, but if you have to change, try and get Rail Europe (Eurostar’s European rail partner) to organize the change at Lille. Here you will only have to change platforms, rather than go across Paris to another station. If you have to change in Paris, don’t even think of taking the Metro (no lifts or escalators) but taxis are cheaper than you might expect. Going to Germany, Netherlands, Luxembourg and many towns in Belgium, you only have to take the lift down to the main concourse, and then take another lift up to the platform.