It’s the biggest cancer killer, and yet 27% of Irish people can’t name one symptom of lung cancer. This Lung Cancer Awareness Month, Ellie O’Byrne talks to a couple all too familiar with the disease, and with a researcher dedicated to improving patients’ outcomes.
It was April Fool’s Day, but the phone call was no joke.
Rory Mooney’s GP was on the phone telling him that a chest X-ray Rory had undergone at Beaumont Hospital the day before had uncovered suspected lung cancer.
“Let’s say I’m glad I was in bed at the time, or the shock would have knocked me over,” says Rory,
chuckling. Nearly a decade later, having survived not one but two bouts of Ireland’s biggest cancer killer, as well as a stroke, Rory says it’s his “black humour” that has often seen him through.
Like many lung cancer sufferers, Rory experienced almost no symptoms prior to his first lung cancer diagnosis; it was a cramp when breathing that alerted Rory and his wife, Marion, that something was up.
“We brought my daughter to New York for her 18th birthday and I started getting pain in my right lung on the way back,” says Rory.
“Marion said, ‘right, you’re going to the doctor’, and I said, ‘I’m not, you know’, and she said, ‘it’s either that, or you end up in hospital’. I ended up in hospital.”
The first lung tumours, in his left lung, were treated with chemotherapy and the removal of part of his lung; that was in 2008. Rory, a fireman with Dublin City Fire Department, made a good recovery and, five years on, he was given the all-clear.
However, that wasn’t to be the end of his encounter with lung cancer.
In March 2016, he suffered a stroke. Ironically, it was a life-threatening twist of fate that may, ultimately, have saved his life. During the explorations and scans he had, while he was in the hospital for the stroke, tumours were found in Rory’s other lung.
“I really think that if he hadn’t had the stroke we wouldn’t have found it,” says Marion. “Who knows how advanced it would have been by the time he had symptoms? It could have been too late.”
Facing into a second lung cancer diagnosis was tough on Rory.
“You don’t admit it, but it scares the shit out of you,” he says.
“When you’re feeling a bit low, it’s easy to get very low. And the surgery takes a lot out of you and leaves you pretty weak, but you get on with it. What else can you do?”
Rory and Marion are speaking from their Dublin home, where Marion, 53, now cares full-time for her husband, who has complications from his stroke, as well as his cancers; he’s recovering from a recent bout of pneumonia, to which he’s prone, due to the scarring on his lungs, and he has mobility issues, using a stairlift to get upstairs.
He gets short of breath after minor exertions and uses a nebuliser three times a day. “Having two halves of a lung will do that to you,” he quips.
Despite the humour, it’s frustrating for Rory, who was used to a life of action as a fireman and who was looking forward to an active retirement. He’s 65 this year, but the pace of his life has had to slow down significantly.
“It’s annoying to the nth degree. I watch TV a lot, and I get told what to do, when to do it, and how to do it. She’s a bully,” he says of his wife, but there’s warmth in his voice; it’s clear that joking with each other is a coping mechanism for the couple.
“Well, I bug him into doing things, but you have to,” Marion interjects.
“I used to go to the hospital from eight in the morning until eight at night, giving him physio; the nurses told me I was giving him too much, but they also said he’d never walk again; he can walk about half a mile now before he gets knackered. We go out every single day, for a walk and then a coffee, just to get out of the house.”
The Mooneys know Rory is lucky to be alive. Lung cancer is the most fatal cancer in Ireland. Of the 2,500 people diagnosed with the disease in Ireland each year, more will die of it than of any other form of cancer.
The link between lung cancer and smoking, uncovered against a backdrop of denial from the tobacco industry, only began to be understood with research in the 1950s. Now, smoking is known to be the single biggest risk factor in developing lung cancer, as well as being the most easily avoidable.
Rory was a heavy smoker for 40 years, and urges everyone to kick the habit.
However, occupational exposure to chemicals, such as asbestos, genetic predispositions, ultra-fine airborne particles found in areas around industrial smoke-stacks, radon gas exposure, as well as the so-called “urban factor”— where air pollution is high — are all known to be risk factors for lung cancer, too.
In fact, in 2016, the US Centre for Disease Control (CDC) released a study that indicated that fire-fighters are a high-risk group for many cancers, being more prone to respiratory cancers than the general population.
“I never attended a fire in a building with asbestos, to the best of my knowledge and we always worked with breathing sets,” says Rory.
The couple also spent 12 years travelling to Chernobyl twice a year to deliver food and medical aid to orphanages, a clearly high-risk activity, as they regularly visited a site 80km from the scene of the nuclear disaster.
“On one trip we went on, eight of the other people ended up developing cancer,” says Marion. “I’ve never smoked and I had cervical cancer twice. You just never know, do you?”
Rory says his experience has taught him that cancer “is a word, not a sentence”. His advice, after quitting smoking, is to “enjoy your life to the full, but listen to your body all the time. Don’t go along with macho bullshit: be sensible, and look after yourself”.
Professor Karen Redmond (below) , a specialist cardiothoracic surgeon in The Mater Hospital, and the first female lung transplant surgeon to be appointed both in the UK and Ireland, heads up a team that operates on up to 600 Irish patients a year.
She says that lung cancer’s reputation as a silent killer comes from the fact that so many patients won’t have any symptoms until the disease is quite advanced, but also that symptoms may be confused with minor ailments.
“People don’t attend their GP when they think they have the common cold, but they may attend after a nine or 12-month symptom history of persistent coughing, or when they start coughing up a bit of blood,” she says.
“Then, when they do present, they’re often inoperable, because lung cancers tend to spread quite quickly.”
However, she says surgical advances and emerging chemotherapy treatments are slowly improving patients’ outcomes.
“Maybe it’s because now we have specialist thoracic surgeons in Ireland who will take on these cases that weren’t offered surgery in the past, who will now have what seem to be quite difficult operations and survive,” she says.
“I’m trying to be optimistic for the people who are out there who are in the early stages of fighting this; a doctor has to go through all these stages with someone, and bring them on that journey. It’s context; you do your best on an individual basis.”
January is the Irish Cancer Society’s Lung Cancer Awareness Month. Fittingly, it also marks the beginning of a new research project for Ms Redmond: She’s teaming up with a Pulmonary Rehab group in DCU led by former Dublin footballer Dr Noel McCaffrey for research, funded by the Irish Cancer Society, into the effects of physical fitness on lung cancer patients before, during and after treatment. It’s hoped that improving physical fitness prior to surgery will mean reduced morbidity, mortality, and length of hospital stay.
“I think we’ll show it has a massive impact on both mental and physical health,” says Ms Redmond. “You see a difference in tailored, achievable targets.”
This Lung Cancer Awareness Month, visit www.cancer.ie for information on lung cancer, including symptoms and tips on quitting smoking.
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