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HSE cyber-attack had ‘particularly devastating effect on continuity of cancer services’, says HSE chief


Professor Risteárd Ó Laoide, the HSE’s director of cancer control. Photo: Marc O'Sullivan

Professor Risteárd Ó Laoide, the HSE’s director of cancer control. Photo: Marc O'Sullivan

Professor Risteárd Ó Laoide, the HSE’s director of cancer control. Photo: Marc O'Sullivan

The HSE cyber-attack had a particularly devastating effect on the continuity of cancer services and was a very difficult time for patients, their families and those providing their care, the Oireachtas health committee was told today.

Professor Risteárd Ó Laoide, head of cancer control in the HSE, said that through the continued efforts of cancer service teams, innovative approaches have kept services operating through these challenges.

They include extra evening and weekend clinics, extended working days, re-fitting of mobile screening units, pioneering changes to radiotherapy fractionation, virtual clinics, insourcing and outsourcing, and rapid development of clinical guidelines to support safe care.

He told the members that “the past 18 months have been a particularly difficult time for people living with cancer and it goes without saying that the Covid-19 pandemic had a significant impact on our ability to provide cancer services.

“It is important to note, however, that symptomatic breast cancer clinics continued throughout the Covid-19 pandemic. Furthermore, the symptomatic breast service was significantly bolstered during this time through resources from temporarily paused screening services being diverted into symptomatic services. This ensured that urgent, at-risk patients were seen, diagnosed and treated quickly.”

Approximately 3,500 new cases of breast cancer are diagnosed each year. The National Cancer Registry predict that this will rise to 4,650 by 2045. One in seven women in Ireland will be diagnosed with breast cancer in their lifetime. For each of these women, their diagnosis brings a worrying and uncertain time for them and their families.

The incidence rate of breast cancer has increased over time, by around 2pc per year between 1994 and 2008, partly due to improved levels of detection, and has levelled off since then.

“Crucially though, mortality rates from breast cancer have shown a consistent downward trend, decreasing by around 2pc each year from 1994 to 2016, supported by earlier diagnosis and improvements in treatment,” said Prof Ó Laoide.

He said that a pathway is being developed for the assessment and management of patients with a family risk of breast cancer, including recommendations for surveillance.

The majority of breast cancers are diagnosed through symptomatic breast disease clinics.

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Each year in Ireland, approximately 42,000 women are referred to symptomatic breast clinics by their GP. Roughly half of these are triaged as urgent referrals. Approximately 2,500-3,000 of the women referred to these clinics will receive a subsequent diagnosis of breast cancer. The rate of cancer diagnosis amongst women triaged as urgent is 10pc and less than 1pc for those triaged as non-urgent.

Most women with breast cancer will receive treatment with surgery, radiotherapy, systemic anti-cancer therapy or a combination of these.

Approximately 85pc of women diagnosed with breast cancer have surgery and over 70pc receive radiotherapy. The role of systemic anti-cancer therapy has grown rapidly over the last 10 years, and nine new systemic therapy treatments for breast cancer have been funded since 2012, with others under consideration.

Advances in genetic testing and molecular testing have driven more targeted treatment for patients. In addition, clinical trials translate research discoveries and knowledge into novel ways of treating patients.

People with a diagnosis of breast cancer account for almost a quarter of people living with and beyond cancer in Ireland. The Cancer Strategy’s particular focus on quality of life has led to targeted investment in psycho-oncology services and other supports.

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