Cancer. It is a word that has caused pain and fear in households across Ireland for generations now. There are very few families in our country that have been untouched by it and sadly we are all too well aware of the hardship and loss it can bring. As a country thankfully we’ve moved on from the time when cancer was spoken about in whispers and we have made significant progress in diagnosing, treating and living beyond it.
Great strides were made under the current national cancer strategy, in centralising surgical, radiation and medical oncology services, putting in place rapid access clinics and cancer screening. This progress has resulted in improved outcomes for patients and better survival rates. Now we must take the next steps and that includes new and different challenges.
In Ireland there are currently over 150,000 cancer survivors and this number will grow as cancer incidence grows and treatments improve. I have a particular memory of a lady speaking in ARC Cancer Support Centre in relation to her treatment journey and her goal to reach the day when she completed her hospital care. However, when that day came she had no feeling of euphoria, instead she had a mild sense of panic, missing the structure, routine and engagement of treatment and feeling somewhat isolated facing the future. She talked of the hospital, and the associated routine, as being like a comfort blanket and of having a feeling of dropping off a cliff as she left the hospital.
Normal lives
This is a feeling that I think many of our cancer patients have felt over the years, and it is a feeling that we hope to banish through the implementation of the new National Cancer Strategy 2017-2026, which the Government has approved.
We aim to ensure that supports are available to help patients to return to their normal lives, backed up by primary care services and with access to acute services when required. The patient voice had been an integral part of the development of the new strategy, with the Cancer Patient Forum providing strong, informed patient input. This has proved to be invaluable in producing a strategy that is responsive to the needs of patients. Patient involvement will continue with the establishment of a Cancer Patient Advisory Committee, involving patient representatives in policymaking and planning.
Overall, the strategy sets out four goals: reduce the cancer burden; provide optimal care; maximise patient involvement and quality of life; and enable and assure change. These are goals we must all work together to achieve and, as Minister for Health, I’m determined to take a lead in this national effort. This strategy sets an ambitious target, but one which I genuinely believe must be our goal. The aim is to be in the top quartile of European countries for cancer survival by the end of the strategy period.
Lifestyle changes
The stark reality is that the burden of cancer on Irish individuals and on Irish 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 50 per cent in men and 40 per cent in women by 2025, and to nearly double by 2040. But we cannot accept this as a fait accompli. Every individual cancer case avoided counts, and cancer prevention offers the most cost-effective, long-term approach for cancer control. Many cancers can be prevented if we make lifestyle changes.
We have to get the message across that 30-40 per cent of cancers are avoidable through improved diet, more exercise, reduced alcohol intake, limited exposure to ultraviolet radiation and of course not smoking. The strategy commits us to communicating this more strongly.
If we are to reach the ambitious survival targets we have set ourselves as a country through this strategy, then early diagnosis of cancer is vital and cancer screening is key. The new strategy recommends the continued expansion of BreastCheck, which currently covers women aged 50-64, to include women of 65-69 inclusive, and the expansion of BowelScreen over time to all aged 55-74.
The new strategy also aims to ensure that patients receive the required care, in a timely fashion, from an expert clinical team in the optimal location. It recommends the expansion of radiation and medical oncology, as well as the concentration of surgical services in the designated centres.
Across the country, there is great work being done by our consultants, nurses and many other health and social care professionals in providing services for cancer patients. One of our key challenges now is retaining these people and attracting those newly qualified and those working abroad into our services. I believe this strategy will play its part in motivating people to remain or come to work in Ireland.
Fighting cancer in the years ahead will take a huge national effort – but it is a challenge, not a choice. Now we have the plan, let’s get on and do it.
Simon Harris is Minister for Health