Keane: ‘Vital that confidence is rebuilt’

RESTORING public confidence in the country’s cancer services is one of the “major jobs” of the new National Cancer Control Strategy, according to its director, Professor Tom Keane.

The newly appointed czar of the country’s services, admitted belief in the system had suffered following the series of misdiagnoses in Cork, Galway and Portlaoise.

Prof Keane told RTÉ Radio there was “an erosion of confidence that people can go into their hospital and get a diagnosis that they can believe in. I believe it is vital that confidence be rebuilt”.

However, he warned cancer diagnosis, even in the best centres worldwide, is “problematic”.

“There appears to be an expectation that with breast cancer diagnosis based on mammography; that you can walk out the door 100% certain that you don’t have cancer. That is not true... The best of confidence that you can have is 95% and that’s with the best-skilled staff and an in-depth environment... It isn’t and won’t ever be 100%,” he said.

Speaking on the planned centralisation of cancer services, he pointed out that “not all cancer services” are being withdrawn.

“We are talking about the critical original diagnosis and management of cancer. Even in good centres, we need critical mass and good multidisciplinary teams. If your initial treatment is not good, you are playing catch-up from then on in. The initial diagnosis and the initial management is crucial as is the surgery and the patient management decision. This policy decision is based on the recommendation of the cancer strategy. This is not an attack on the skill of the local surgeon. There is very clear evidence that low-volume surgery produces low volume outcomes, less than satisfactory outcomes,” he said.

Prof Keane said the situation in Portlaoise “is beyond that” margin of error, acknowledging that the amount of misdiagnosis “is higher than acceptable”.

“The aim of the cancer strategy is to get Ireland, at every level, up to an international standard that people can expect to get the same quality of care in relation to any cancer diagnosis as would be in any well-developed country be it Canada or Europe.”

As part of the strategy, the number of radiation oncologists is to be doubled. Prof Keane said he is confident the stalemate between the Department of Health and Irish consultants over their contract will not interfere with these appointments.

He said it was important the national cancer strategy set standards that must be attained by experts in the cancer field. Pathologists with a cancer speciality, were in short supply.