Mouth cancer survivor Rita is left with a lifetime of bills
Rita Kierce, who discovered she had mouth cancer when she was three months pregnant with her daughter, is still paying the financial price of her disease 25 years after getting her diagnosis.
Rita, who lives near the Burren in Co Clare, developed a blister on her tongue while pregnant with her second daughter Emer.
"I neither smoke nor drank and was on the Irish cross-country team," she said.
Her baby was induced at eight months so that Rita could begin intensive treatment, which included removing three-quarters of her tongue and later having a skin graft to build it up again.
"I was just given months to live at one stage but it was thanks to the surgery of Tadhg O'Dwyer in the Mater Hospital in Dublin that I was saved," she said.
Rita is grateful to have beaten the disease and recently won more gold medals running. But she was left with a lifetime of medical bills which can be typical for a patient with mouth cancer.
"I would be frightened to add up the whole cost," she said. They include expensive dental treatment, special lotions and dry mouth treatments.
Dr Eleanor O'Sullivan of the Cork University Dental School and Hospital, said patients with mouth cancer face particular financial burdens.
"They can need a range of oral products that are quite expensive, such as lubricant and special toothbrushes.
"They can suffer dry mouth, risk of infection and may need prosthesis which can cost over €1,000 to allow them to have some quality of life. If you have a hole in your palate, your speech can sound like marbles and food can come down your nose.
"People are suffering considerable hardship because of their expensive dental costs.
"If you have a medical card, you are entitled to just two fillings a year. People have to choose what cavities to fill."
Cancer patients in rural areas have the highest travel costs, according to the report.
People living in Munster have the longest journeys for treatment - averaging 70km.
The highest travel expenses were felt by patients in Leinster, outside Dublin, who spend €194 a month, followed by people in the Connacht and Ulster regions at €177 a month.
Travel costs in Munster clock up to €168 a month, while for people in Dublin the monthly bill is around €117.
Overall, people in rural regions travelled just under 60km, compared to 28km on average in urban areas.
When it comes to parking costs, they are highest in Dublin at €78 a month, followed by €64 in the rest of Leinster. Parking costs for patients in other areas of the country varied from €40 to €50 a month.
Reductions in salary are highest among patients living in Dublin and along the east coast.