Repatriation? Support for ongoing chemotherapy.

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Good morning MacMillan.

I'm Dan, and my father was diagnosed Malignant Mesothelioma 2 years ago, this April. He currently resides in North Cyprus, and has received surgery of the right lung to remove lesions, plus Pemetrexed and Carboplatin. After the first round of treatment he was told he was in remission, however it returned late last year.

He has spent most of the past two years in debilitating pain due to the surgeon's decision to use vicryl mesh at the operation site. To top it all, my dad has been previously diagnosed with depression, for which he was prescribed relevant anti-depressants.

The past few months have been increasingly hard on his partner, and as such they are returning to the UK for further treatment, having been told by the oncologist that he will need a maintenance dose of chemotherapy every 21 days. We're concerned that his mental health has taken a turn for the worse, as you can imagine, due to hoping for remission again, and being told he will never be in remission. The oncologist was very... forthright in his approach. It did not go down well.

I guess my questions are; can he receive these treatments on the NHS, and how do we go about setting up support for his condition? He has lost so much weight through this, due to appetite and change in tastebuds. I've tried to help with nutrition, as thats where my degree background is, but he needs more comprehensive help, such as physiotherapy... counselling... I don't know where to start.

Please send halp.

Kind regards,

Dan.

  • Dear Dan,

    My name is Liz and I’m a Cancer Information Nurse Specialist on the Macmillan Support Line

    Thank you for reaching out for information and support as your dad plans to return to the UK for ongoing treatment for his mesothelioma.

    I can’t begin to imagine how hard it must be for you and his partner seeing him unwell both physical and emotionally, however making plans for his return is an excellent step to getting the help he needs.

    To receive NHS treatment within the UK you must be “ordinarily resident” Being ‘ordinarily resident’ means you are in the UK legally and living in the UK is part of your normal life for the time being. This can be for the short or the long term. People can be ordinarily resident in more than one country at the same time. UK citizens who return to the UK on a settled basis will be classed as ordinarily resident. This means he will be eligible for free NHS care immediately. This includes cancer care.

    He might be asked for proof that he is returning to settle in the UK.

     

    The first thing to do, is for dad to be registered with a GP near his home, this will allow for a referral to an oncologist who can take over his care from his doctors in Cyprus. He should bring with him as much information about his mesothelioma and treatment as he can, ideally translated into English including histology results and scans.  

    His new oncologist will review all the information from Cyprus and possibly discuss him in the local lung multidisciplinary team meeting and then recommend a treatment plan based on NICE guidelines, this may or may not match the treatment plan of his doctor abroad.

    His new GP can refer him to a community dietician about his weight loss and possibly prescribe nutritional supplements, we also have resources about diet and cancer which might be useful.

    Support for his mental health will be available through his GP also Macmillan works in partnership with BUPA to provide free one to one telephone counselling for people living with cancer. If dad is interested in this, there is more information on our website.

    If dad will be living with his cancer for the rest of his life, then a referral from his GP to the local palliative care team would be useful. They can support dad not just with any symptoms but also provide emotional support to him and the rest of the family.

    We have a good booklet, which you might find helpful about looking after someone with cancer, if you would like a hard copy you can order it on be. Macmillan or by phoning us on the support line

    Caring and supporting a loved one with cancer is exhausting so please make sure that you are looking after yourself as well, Dan.

    I hope this information has been useful, please contact us whenever we can help. 

    Take care.  

     

    Liz 

     

    Cancer Information Nurse Specialist  

     

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. Ref LZD/ KHa