Sunday 17 December 2017

How holes in our cancer services are putting lives at risk with late diagnoses

Prof John Kennedy, chairman of the Cancer Strategy Steering Group
Prof John Kennedy, chairman of the Cancer Strategy Steering Group
Eilish O'Regan

Eilish O'Regan

Serious deficiencies in cancer services are contributing to some patients suffering a late diagnosis while others are not receiving advanced tests to show the best treatment for their disease.

The extent to which Ireland is still lagging behind in cancer services is revealed in the National Cancer Strategy 2017-2026, which was launched yesterday.

It highlighted how "GPs' access to diagnostics in the public system is variable and there are long waits for some specialist services". This contributes to delayed diagnosis.

The strategy warns that "urgent attention must be paid to resolving these problems".

Prof John Kennedy, chair of the strategy's steering group, said that "once diagnosed" and patients are in the hospitals system they get "excellent treatment".

But "one of the problems can be getting to that stage", he added.

There needs to be faster access to ultrasound and endoscopy, he added.

He said the plan to centralise cancer surgeries in hospitals where doctors would have the greatest expertise and see the highest volume of patients has not been fully implemented.

The strategy suggests there needs to be one major cancer centre in the country.

This would not mean the closure of any of the eight existing cancer centres, but it would provide a world-class facility.

Investment of this kind is needed if Ireland is to attract the best cancer specialists to work here, said Prof Kennedy.

The report highlights the "poorly diagnosed and fragmented" molecular cancer diagnostic services for solid tumours.

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This kind of testing allows doctors to tailor a patient's treatment, but it has developed in an ad hoc manner.

The report confirms that cancer genetics services are under-developed and under- funded. There is an increasing demand for tests from people who may have inherited genes which predispose them to a particular cancer - but they face long waiting lists. It said that patients can face prolonged delays waiting for results.

Launching the strategy, Health Minister Simon Harris said it will require significant revenue and capital investment.

It is expected that at the end of its 10-year lifespan that an additional €100m a year will be spent on cancer services.

He said: "The burden of cancer on individuals and on society will grow, unless significant progress is made on improved prevention, early diagnosis and treatment. The number of cases of cancer in Ireland is expected to increase by 50pc in men and 40pc in women by 2025, and to nearly double by 2040."

An annual report will measure the progress of the recommendations of the strategy.

Some 30-40pc of cancers are avoidable through improved diet, exercise, reduced alcohol intake, limited exposure to ultraviolet radiation and not smoking.

Significant investment is needed if the plan to expand BowelScreen to all aged 55-74 by end-2021 is met.

"Patient involvement will continue with the establishment of a Cancer Patient Advisory Committee, involving patient representatives in policy making and planning," the minister added.

There is a need to provide more specialist cancer nurses and improve infrastructure which is struggling to cope with the rising demands placed on it. The report refers to the new therapies and diagnostics which continue to come on stream and will present major financial challenges.

Irish Independent

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