Frequently Asked Questions

What is Cancer? 

Cancer is not one disease but many, all with some similar features but all with a distinctive character which varies according to the cancer’s type and location. 

There are over 200 types of cancer, but all start in the same way. Put simply, cancer is a disease of the cells. The control signals in a normal cell in the body go wrong, resulting in an abnormal cell. Cells normally divide and replicate themselves as a process of renewal, in a controlled way, but abnormal cells keep on dividing and this forms a lump.

The cluster of abnormal cells is called a tumour. Some tumours are benign, or harmless, and often don’t need treatment. But malignant tumours - the cancers - can spread. They may be dangerous because they can invade nearby parts of the body and stop them working properly. Cells from malignant tumours can break away and travel to other parts of the body, where they can form new groups of abnormal cells, called secondary growths. It is therefore possible to have a secondary breast cancer in the lung, for example.

What causes cancer and how quickly the cells grow and spread, is different from person to person. A large number of people with cancer overcome the disease, or live fulfilled lives for many years. A poor diet, lack of exercise, being over weight, smoking, heavy drinking, over exposure to the sun and hereditary factors can all contribute to causing cancer.

Cancer Terms Explained
Below are explanations of some of the most common medical terms relating to cancer:

Adjuvant Therapy - Treatment, usually chemotherapy or radiotherapy given following surgery. It is given even if there are no symptoms of cancer at the time of treatment but where the risk of a secondary cancer is thought to be high.

Alopecia - Hair loss
Benign - Non-cancerous, used to refer to tumours which grow slowly in one place and which, once removed by surgery, tend not to recur.
Biopsy - Microscopic examination of a sample of tissue that has been removed from an area of the body where cancer is suspected. Sometimes a small sample is taken with a special needle and sometimes a complete growth is removed for examination.

Bone Marrow - The spongy inner part of large bones where blood cells are made. Bone marrow aspiration is the removal by fine needle of a small amount of bone marrow for examination.

Bronchoscopy - A test used to examine the inside of the lung.

Cancer - The name given to a group of diseases that occur in any organ of the body, and which all involve abnormal or uncontrolled growth of cells.

Carcinogen - A substance that can cause, or help to cause, cancer

Carcinoma - A cancer that arises from the lining of an organ or system. They are the commonest cancers.

Chemotherapy - The treatment of disease with chemicals, such as cytotoxic (cancer destroying) drugs. The drugs can be given as tablets or more usually by injection or by a drip inserted into the arm by a needle.

Cytology - Microscopic study of individual body cells.

CT (Computed Tomography) scan - Produces a cross-section image of the head and body which is then analysed by computer.

Diagnosis - Identification of a disease in a person’s body.

Endoscopy - Looking inside the body through a small fibre-optic tube passed into the lungs or the digestive system

Haematologist - A doctor who specialises in the treatment of blood disorders.

Histology - The Study of tissues, used in diagnosis.

Hormone Therapy - Treatment with hormones to control cancer growth, usually for cancer of the breast, prostate, thyroid and uterus (womb).

Isotope Scan - A scan involving the injection of a very weak radioactive substance which collects in the organ being investigated so that it can be viewed more easily with a special camera.

Lesion - Damage or change to the tissue which may or may not be cancer.

Lumpectomy - The surgical removal of a lump

Lymphangiogram - A special x-ray procedure carried out to display the lymphatic system.

Lymphatic system - The system of lymph nodes and the vessels or small tubes which connect them. Lymph nodes are located throughout the body, filtering out dangerous substances and producing infection-fighting cells called lymphocytes.

Lymphoedema - Swelling, usually in the arms or legs, which occurs became the lymph vessels are damaged or blocked. This can occur following some treatments for cancer, or due to the cancer itself.
Malignant - Cancerous. Malignant tumours can invade and destroy surrounding tissue and have the capacity to spread to other parts of the body.

Mammogram - A specialised x-ray which shows up the breast tissue and can detect breast cancer at a very early stage.

Mastectomy - The removal by surgery of all or part of the breast.

Metastasis - The spread of cancer from one part of the body to another, by way of the lymphatic system or bloodstream.

Neoplasm - Another name for a tumour.

Oncologist – A specialist dealing with the study of tumours that may or may not be malignant.

Oncology - A type of medicine dealing with the study of tumours that may or may not be malignant.

Orchidectomy - Surgical removal of a testicle.

Palliative Care - Palliative care concentrates on your quality of life and that of your family. It focuses on the provision of pain relief and symptom control during illness. It is especially important for those whose illness cannot be cured, but should be available to all cancer patients.

Primary cancer - The place where cancer originally developed.

Prognosis - The predicted future course of an illness.

Prosthesis - A specially made replacement for a part of the body which has been removed, such as a breast or a limb.

Radiographer - The person in the health care team who takes x-rays and scans or gives radiotherapy (therapeutic radiographer)

Radiology - The use of x-rays in the diagnosis and treatment of disease.

Radiotherapy - The treatment of cancer by x-rays or gamma rays to destroy cancer. A dose of radiation is directed at a particular area of the body. It can also be carried out internally, under general anesthetic.

Secondaries - A site to which a cancer has spread through the blood stream.

Staging - Determining the extent of cancer in a person, using strict measures. It helps doctors to decide on best treatment.

Syringe drivers - A means to administering pain-killers or chemotherapy drugs under the skin which relieves patients of the need for frequent injections.

Systemic therapy - Use of treatments, like chemotherapy, which affect the whole body.

Terminal care - Care of a person in the last days or weeks before they die. The emphasis is on making the person free of pain and as comfortable as possible.

Terminal illness - Active and progressive illness which cannot be cured. The Patient receives palliative care.

Tumour - A growth, formed out of a mass of cells, which can be either benign or malignant. Also known as a neoplasm.

Tumour markers - Substances produced by some tumours that can be traced in the blood.

Ulcer - A sore that doesn’t heal. An ulcer can be cancerous or non-cancerous.

What are E106, E111 & E121 forms and why do I need them?

What do I need to receive health care in Spain? 

In this article, we will endeavour to unravel the mysteries of the
forms and procedures required for both holidaymakers and residents of
Spain to receive state health care. As the UK is in the EU, there is a reciprocal agreement with Spain to provide medical cover for UK nationals, depending on the individual circumstance. However, an anomaly currently exists, as apparently the DWP (formerly the DSS) say if you are out of the country for more than three months of the year you are no longer considered resident in the UK, while Spain go by the more logical timescale of over six months of the year. In truth, so many individuals are travelling to and from Europe for varying periods of time, it is very difficult for both the Spanish or the British offices to keep track, and many individuals who have a Residencia card in Spain remain on the DWP records in the UK because they have never officially 'de-registered' by notifying their health centre or the DWP. 
Before we get too lost in this particular bureaucratic maze, suffice to say there are four main categories for a UK national to use the Spanish national health services:

A) holidaymakers and people spending occasional periods of time in Spain;

B) pensioners;

C) people of non-retirement age living in Spain who are unable to work; and

D) people intending to live and work legally in Spain, or who have taken early retirement.

A) If you are a visitor to the area (and this applies to anyone who has not applied for a Residencia card, nor has a work contract, nor is self
employed), you should contact the Overseas Department of the
DWP in Newcastle prior to leaving the UK, and request a form El11, which entitles you to routine medical treatment. The E111 is usually issued for a one year period, and you can normally renew it for a further 12 months. Thereafter, a second renewal will usually be refused as it is apparent you are spending the majority of your time out of the UK, and you will be expected to make provision for medical cover in the country where you are living. If you do need to visit a doctor or hospital, you should present the El11 to them as soon as possible

B) If you are of pensionable age, and intend to live in Spain, you can contact the DWP and request a form E121. This is applicable for British men over 65 years old and women over 60 years old. However, the Costa Calida will only accept this form if you apply for, or hold, a Residencia card. The E121 should be handed to the Seguridad Social (Social Security) office in Murcia. It provides permanent health cover and does not need to be renewed. You will be issued with a temporary health card, and in due course, will receive a permanent card and letter confirming the details of your designated doctor and clinic. This will always be in your area.

C) If you are unable to work, and claim incapacity benefit, you may
also apply for a form E121, regardless of your age. If you do not claim incapacity benefit, you will not be eligible to use this form. Again, you must apply for a Residencia card in order for the Spanish social security office to accept your request for state medical care.

D) If you decide to take early retirement, or wish to receive medical cover while you are finding work in Spain, you may apply for a form E106. Please note you are only eligible to this form if you have been working and/or paying in to the UK system for the last three years. The E106 provides temporary cover, usually for two years: thereafter you will not be able to request an extension. If after expiration of the E106 you have reached retirement age, you can then apply for the E121 as described above. In all other cases, you will be expected to provide your own medical cover, either through private health insurance or by working within the system. With an E106, you do not receive a medical card; you take your El06 form to your local state health centre/doctor in the same manner as an E111. Please note that private doctors, clinics and hospitals do not accept any of the European (E) health care forms. It is also important to note that the E121 and El06 forms are regarded as permanent: in other words, you will be transferring your health provision from the UK to Spain. This means that you will still be eligible for cover in the UK, but as a visitor. Should you decide to return to live in the UK, you should contact the DWP and ask them to re-register you on the British health system.

Turning now to work related cover: at a later date we will look in closer detail at all the paperwork required for self employed individuals. However, in respect of health provision, cover is provided both for the worker and their family members by way of a social security monthly payment. For employees, the employer should provide for their social security cover by paying the requisite monthly "stamp" at source.

Again, this includes cover for dependants. There is a new system for
registering a dependant of the holder of an E121/E106 form or a self
employed/employed individual. An Asistencia Sanitaria form must be
completed in duplicate, showing the details of both the person with the
health provision and their dependant/s. If the dependant is a wife/husband, the original Marriage Certificate + copy must accompany
the form. If the dependant is a child, the Birth Certificate + copy must be produced. If the dependant is a partner, a Certificate of Convivencia must be obtained from the local Town Hall/Guardia Civil. 
As always, when discussing matters that relate to European regulations,
these are evolving as the rules within the EU are refined, and it is quite possible that the above could be in future be modified. Should anything significant change in the coming months, WE will endeavour to advise you accordingly.

ALTHOUGH THIS INFORMATION HAS BEEN ELABORATED WITH THE GREATEST POSSIBLE CARE, AND ITS CONTENTS ARE CORRECT IN ACCORDANCE WITH THE INFORMATION CURRENTLY AT OUR DISPOSAL

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