The story behind Brian Lenihan, TV3 and me
The real scandal last week was that most patients get no treatment for an often fatal illness, writes John Crown
I wish to clarify the circumstances of my interview regarding pancreatic carcinoma, an interview which TV3 News broadcast after they had made the announcement that Finance Minister Brian Lenihan had been diagnosed with this condition.
In the first instance let me offer my best wishes to Mr Lenihan for a successful outcome to his treatment. If, as has been reported, he is being treated in the Mater Private Hospital for pancreatic cancer, then he will have access to the expertise of first-class, internationally reputed oncologists, nurses and surgeons.
TV3 contacted me on December 26 to tell me that they were going to report that a politician had been diagnosed with cancer and asked if I would be free to comment. I told them that I would not comment on the illness of any individual, but might consider doing an information piece about the type of cancer in question. The disclosure that a well-known figure has been diagnosed with cancer can increase public awareness, encourage people to avoid risk factors specific to the disease, and highlight the need for greater investment in research and in treatment.
TV3 then called me back and told me that Mr Lenihan had pancreatic cancer. I expressed my sadness that a young man with a young family had received this news, particularly at Christmas time. I told TV3 that I would consider doing a piece on pancreatic cancer without commenting on the minister's case.
I asked whether TV3 had sought the approval of the minister to broadcast the story. I was informed that they been in touch with his advisors before the holidays, and had, following consultation with these advisors, voluntarily agreed to delay their report until December 26. The TV3 staff told me that these advisors had acknowledged this, and would, moreover, be supplying a formal statement to TV3 for broadcast.
I would not have agreed to participate without the assurance that the minister had been informed.
I also stated that I would not allow myself to be interviewed at Government Buildings, but rather insisted that the crew come to the hospital.
While raising awareness of pancreas cancer, an important health issue in Ireland, could only be a good thing, I was also aware that the audience would likely include many pancreatic cancer patients and their families, including Mr Lenihan and his family.
For this reason, and unlike some newspapers which published explicit statistics, I spoke in generalities, describing patients having disease which could either be "cured" or "controlled". I never mentioned the words "prognosis" or "outlook". I stressed the need to give up smoking, the single most important avoidable risk factor.
Anyone who has the privilege of looking after cancer patients, and who has to break bad news to them, will feel for Mr Lenihan and his family.
Every year 400 Irish people hear the same news that he is reported to have received. Unfortunately, the great majority of Irish pancreatic cancer public patients appear to receive no treatment whatsoever for their condition. None. This was the real pancreas cancer scandal in Ireland last week.
The same scandal occurs every week of every year here. Health Minister Mary Harney's plan to centralise all pancreatic cancer surgery into one centre has already lost us the services of several highly qualified pancreatic cancer surgeons. It is hard to see it improving cure rates. Centralisations without resourcing are just cutbacks by another name.
In this regard, please note that during the time that one hospital was the sole centre for radiotherapy treatment for most of the country, it could not meet international guidelines for the timely institution of cancer treatments due to under-resourcing.
For an Irish public patient who does not have access to the Mater Private or any other private hospital, the waiting list for assessment of a problem which may be non-serious, or which may be cancer, is unconscionably long. A public patient with pancreas cancer who developed abdominal complaints and who tried to access the diagnostic services now would not have received the details of their diagnosis for some time.
Indeed, when one considers the wait to see a public consultant, followed by the second wait for admission and testing, then it is actually much more likely that the news would be delivered some months later. There is reason for this disparity in access between public and private services. It is not accidental, but results from the very deliberately crafted health policies of this government.
The reported anger of government press spokesmen at my interview must be seen not only in the light of these facts, but also in the context of the systematic government disinformation campaign on the issue of cancer and other health services in this country.
These include the extraordinary attempt to justify the denial of cervical cancer vaccination to our young women by alleging that it was too dangerous, the attempts to mislead the public about cancer service deficiencies, multiple episodes of whistleblower intimidation, and the attempts to prevent informed debate about cancer policy. It is entirely appropriate that cancer specialists involve themselves in increasing public awareness concerning pancreatic and other cancers. They should also highlight deficiencies in our cancer services.
If, as has been reported, Mr Lenihan has pancreatic cancer, I wish him well.
Professor John Crown is a consultant oncologist