Shortages force cancer patients to get treatment at night-time
Published 15/09/2015 | 02:30
Many cancer patients who need radiotherapy will have to attend evening clinics throughout the winter and early next year, it emerged yesterday.
St Luke's Hospital in Dublin, which treats 55pc of all cancer patients nationally, no longer has the capacity to provide care to everyone who needs it during the normal working day.
Dr Jerome Coffey, the interim head of cancer services, said evening clinics will be needed until new radiotherapy equipment is installed next year.
An independent evaluation of cancer services earlier this year said great progress had been made in providing more radiotherapy services since 2007 and new facilities opened in Dublin while expanded facilities are being built in Cork and Galway.
However, it criticised the policy of buying services for public patients from private radiotherapy centres as a top-up, saying a proper service relies on a complex multi- disciplinary team approach to patient care.
Around 55pc to 60pc of cancer patients need radiotherapy during their illness.
Patients should receive treatment within 15 days of a consultant deeming them ready.
Figures for the first quarter of last year indicated that 91.6pc of patients were treated within the target time.
Men with prostate cancer, who are deemed suitable, are now getting brachytherapy, which is a day care procedure in contrast to the traditional seven-and-a-half weeks of external beam radiotherapy.
Dr Coffey said men with prostate cancer could increasingly avoid treatment in favour of "watchful waiting" or "active surveillance" by their doctor.
It comes as new Irish research shows many men with prostate cancer have poor psychological well-being.
Most of the factors involved cannot be modified such as age and stage of disease.
However, identifying risk factors that can be modified could be very valuable, said the research from the National Cancer Registry and the Northern Ireland Cancer Registry.
Analysing data from 3,300 men, the findings showed that 17pc of survivors had depression, 16pc suffered anxiety and 11pc had distress.
"Several cancer-related symptoms were associated with psychological well-being. For example, the chance of having depression was higher in men with more urinary symptoms and more symptoms related to using androgen deprivation therapy, a type of treatment for prostate cancer that changes hormone levels," said the report.
"Men with worse cancer- related fatigue and insomnia also had higher risk of depression. Findings for anxiety and distress were similar to those for depression."
The authors said health services should put more emphasis on supporting survivors with higher levels of symptoms.
This, together with greater use of medicines and interventions to alleviate symptoms, "may help improve psychological well-being in men with prostate cancer".
A second study looked at whether follow-up care for men who had prostate cancer is more efficient if delivered by GPs rather than hospital clinics.
"Evidence suggests that follow-up by a GP instead of a specialist clinician doesn't change how long people survive, how many cancers are identified or quality of life for cancer survivors," it said.
"However, the costs of GP-led prostate cancer follow-up have not been investigated in Ireland."
If all the men diagnosed with prostate cancer in Ireland in 2013 were offered follow-up according to specific guidelines for the next 10 years, the health care system could save more than €760,000.