Breast Cancer Care in France

As is the case worldwide, your breast cancer care in France will depend on the type, grade and stage of the cancer you have. Your age, family history and general health will also be taken into account. Treatment may include one or a combination of the following.

• surgery,
• radiotherapy,
• chemotherapy
• Targeted treatments.
• Genetic testing and counselling.

Take a deep breath. You will be heavily supported by your medical team. At the head of this will be your infirmière au sein (breast care nurse) who will be assigned to you upon diagnosis. The role of these nurses is to organise your appointments, answer your questions and concerns, and guide you through the process. They will know all of your information and you will be given a phone number to call them on any time you need them. They are an invaluable resource. Don’t be afraid to lean on them if you are unsure or worried about anything.

Following your diagnosis of breast cancer in France

So you are living in France, have just been diagnosed with breast cancer and are wondering what to do next.

If you are not in the French healthcare system:

The first thing to do if you are seeking treatment for breast cancer in France but are not already on the French healthcare system, is to get on it immediately. Cancer treatment can be very expensive, and if you are not on the system you will be required to pay out of pocket.

When you are on the system you will be given a social security number and can then apply for a Carte Vitale. Whilst you are waiting for your Carte Vitale you will be given a temporary social security number to use in its place. If you are required to pay anything in the meantime, you will be given a feuille de soin (essentially a medical receipt) which can be used to claim reimbursement of the costs at a later date.

What are your rights as a cancer patient in France?

Once you are in the French health care system 100% of the cost of your breast cancer care will be covered. This is called prise en charge.

What is included?

• All consultations and appointments.
• All medications and treatment.
• All tests and scans, including follow ups after treatment..
• Supportive care such as home nurses and physiotherapists.
• Private transport to and from appointments (chemotherapy, radiotherapy, surgeries and scans).
• Wigs for those having chemotherapy.

To initiate your rights, you will need to see your médecin traitant généraliste (your general practitioner) with the proof of your diagnosis and they will update your Carte Vitale. It will then be apparent on the system whenever you use it at appointments and pharmacies.

Private transport

For some treatments such as chemotherapy and surgery, you will not be able to drive afterwards. You will be offered a private taxi to pick you up from your home, take you to the hospital, then bring you back afterwards. If you have higher medical needs or transport between hospitals you will be taken in a fully equipped ambulance.

To claim full payment of transport fees you will need to request a prescription médicale de transport from your oncologist. You then simply hand the prescription over to your taxi driver and they will take it from there. In the case of ongoing treatments such as chemotherapy and radiotherapy, your oncologist will give you one transport prescription that is valid for the duration of your treatment.

To find a reliable taxi service ask your breast cancer nurse for a recommendation. They will have a relationship with the ones that patients use regularly.

Other financial benefits

During treatment for cancer it can be difficult, or even impossible, to maintain normal professional activity. If you are working in France, and your work capacity is reduced by at least ⅔ you are entitled to financial help for loss of income.

The amount you are entitled to will be based on your gross income and resources. This is usually a capped amount of around 50% of your wage for a duration of up to 3 years.

You may also be entitled to domestic assistance (for example a cleaner) if you need it.

The first step is to get an arret de travail (a stoppage of work form) from your oncologist. You will then need to send a copy to your caisse primaire d’assurance maladie (health insurance body) and another to your employer within 48 hours. This will be extended every 2 weeks as required.

It is important to keep in touch with your employer throughout your treatment to keep them updated. And maintain the relationship.

If you are not working and have limited resources in France

If you have insufficient resources and are not yet at the age of retirement you are entitled to l’Allocation supplémentaire d’invalidité (ASI). Contact Ameli.fr for more details.

At diagnosis you will be assigned an oncologue (oncologist) and chirurgien(ne) (surgeon) in a hospital that is local to you. If you are not happy with the one you are given for any reason, or just seek a second opinion, you can find others by searching on doctolib. You will be seeing your oncologist a lot, so it is important that you are comfortable and confident with them. Proximity is also important to consider as you will be having regular rendezvous (appointments) for treatment and checkups.

If you don’t speak fluent French

The language barrier can seem especially overwhelming when dealing with something like breast cancer. It is important that you understand all of the information you are given, so take someone to your appointments who can translate for you.

It is also advisable to record the appointment on your phone (with the permission of your oncologist/surgeon) so that you can go back and listen to it in your own time.

As part of your breast cancer care in France you will be offered a referral to a psychologist who specializes in patients with cancer. In some cancer-specific hospitals a psychological counsellor will come and talk to you during your treatment if you need some support.

Your breast cancer nurse will be able to refer you to one who speaks English if there is one available. There are also many available online that offer teleconsultations.

For more support and information on breast cancer go to ‘Breast Cancer Now’.