Cancer diagnosis felt like being 'hit by a sledgehammer'

While working as Santa last December, a serious and persistent cough forced Declan Costello to quit. The following month, doctors diagnosed him with stage-four cancer. Now, immunotherapy is giving him a fighting chance
Cancer diagnosis felt like being 'hit by a sledgehammer'

Declan Costello from Rush who is undergoing immunotherapy for cancer says "The comback is stronger than the setback." Photograph Moya Nolan

DECLAN COSTELLO was in Galway in mid-December 2024, working as a Santa in the run-up to Christmas, when he developed a “bad cough”.

The cough got so bad that he had to stop working and return to his home in Rush, Co Dublin. As the cough worsened, he made an appointment with his GP.

“It was that time of year when a lot of people were going to their doctor with colds and flu,” he says.

“My doctor prescribed a cough medicine and said to try it for a few days to see if it would work. It didn’t, and shortly afterwards, I started losing my appetite.”

With Christmas approaching, Costello decided to get through the holiday period — even though, at this stage, the smell of food or cooking was turning his stomach. He returned to his GP in January 2025.

“He said to me, ‘I have a note in my file that if you came back to me in the same condition, I would send you for tests immediately’,” Costello recalls. “The thing was, I had my bag packed when I went to see him — we were both on the same wavelength.”

The 60-year-old went to Beaumont Hospital for a series of tests: Bloods, scans and biopsies. A tumour was found in his lung. “The cancer had spread to my liver — it was stage four lung cancer.”

On hearing the bleak diagnosis, the father-of-two says he felt like he’d been “hit by a sledgehammer”.

“One consultant we went to gave me six months to a year, and I thought, well, he must be right, because of how sick I was feeling at that point,” he says. “I wasn’t eating. I was still losing weight — I’d lost over three stone by then.”

However, his “survival instinct” soon kicked in: 

“I said, ‘I’m going to get better, and I’ll fight this’. If I lose the fight, I lose the fight, but I will fight.”

His oncology team, led by Jarushka Naidoo at Beaumont Hospital, came up with a plan to treat his cancer with immunotherapy.

“Immunotherapy is a new type of medication that activates a person’s immune system against their cancer. It is a rapidly evolving and complex area of practice that requires guidance from an expert lung cancer team,” explains Mr Gerard Fitzmaurice, consultant cardiothoracic surgeon at St James’s Hospital. 

“Deciding on a patient treatment plan is a complex process that involves completion of a number of investigations, called staging investigations, to determine the type of cancer and best approach to offer curative treatment.”

 Declan Costello from Rush who is undergoing immunotherapy for cancer says "The comback is stronger than the setback." Photograph Moya Nolan
Declan Costello from Rush who is undergoing immunotherapy for cancer says "The comback is stronger than the setback." Photograph Moya Nolan

Costello’s immunotherapy began in the first week of March 2025, and he receives treatment every three weeks. A scan in mid June revealed his tumours had shrunk by 2.5cm, and a subsequent scan last month showed the tumour in his liver had reduced again, with the mass in his lung remaining stable.

“That news was like winning the lottery for me,” Costello says.

“Just to hear the word ‘reduced’. It didn’t matter by how much, really. I just felt like what we were doing was working.”

He will continue with his immunotherapy every three weeks and is due to have another scan to determine his progress in January.

“I get my treatment on a Thursday, and it wipes me out for the day on Friday and a little bit of Saturday,” he explained. “But I’ve been keeping active. I walked 30 miles in September for the Irish Cancer Society — I walked one mile every day, and we raised over €3,000. I wanted to walk with a little bit of a twist, so a group of us used to meet up and I gave a little bit of a history of Rush as we were walking.”

He also regularly visits the palliative care unit in St Francis’ Hospice in Raheny.

“I’m a long-time member of the Rush Musical Society, and on Daffodil Day [March 28] this year, one of the members told me about the palliative care programme at the hospice,” he says.

“When I heard the word palliative, like many people, I just thought ‘end of life’. However, they have an absolutely outstanding day patient programme, and I visit once a month to receive a massage or reflexology treatment. Additionally, I can speak with a chaplain, occupational therapist, physiotherapist, or nurse.

“It’s absolutely fantastic.”

Before being diagnosed with lung cancer, Costello worked five days a week as a caretaker in his local community centre, and he also occasionally refereed football matches.

“I actually passed a fitness test for refereeing in August 2024. I’ve always been fairly active,” he says. “And now, I think I’m lucky as I’ve been able to stay a bit active with walking.

“I also go down to the sea every morning. I can’t swim, but I kneel down and I duck under the water three times and get out. When I told my nurse, and she suggested I could see the three times as healing my ‘mind, body and soul’, and I thought that was a lovely way of looking at it, so that’s what I say to everyone now.”

  • November is lung cancer awareness month
  • If you have any questions or concerns about cancer, contact the Irish Cancer Society’s freephone support line on 1800 200 700, or email SupportLine@irishcancer.ie. For more information, visit cancer.ie

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