Consultant: Breast units no guarantee of improved cancer survival

CREATING centres of excellence to treat cancer is no guarantee breast cancer survival rates will improve, a consultant surgeon has warned.

Late diagnosis was the main reason for Ireland’s current poor survival rates for the disease, claimed Finbarr Lennon, a consultant at Our Lady of Lourdes Hospital in Drogheda.

There were also deficits in screening and inadequate and delayed access to treatments, such as radiotherapy and chemotherapy.

“This has been due to a failure to invest in diagnostic and treatment facilities and to a shortage in specialists in oncology and radiation medicine,” he said.

In a letter to a newspaper, the consultant emphasised it was only in the last decade that shortfalls were being addressed.

The organisation of cancer services and the application of evidence-based guidelines were also deficient, he said.

And while triple assessment and multidisciplinary care was now provided in most breast units, there was little evidence yet to confirm that such team-based care produced better survival rates.

Cancer services in Britain were better organised and more concentrated than they were in Ireland but their breast cancer survival rates were only marginally better.

Survival rates in Britain still lagged far behind rates achieved in north and central European countries.

Mr Lennon, who stressed that he was speaking in a personal capacity, said many senior medical professionals believed the site selection process was flawed and did not inspire confidence.

“The arbitrary new criteria used to choose these sites did not demand any prior quality assurance assessment. Nor was there consultation with many of the specialists providing the current service,” he said.

One of the new benchmarks of treating 150 new breast cancers a year had not been reached in some of the designated centres but Drogheda was treating as many new cancers as some of the centres.

Nevertheless, Drogheda’s development into a cohesive, functional, well-resourced regional unit, advocated by the O’Higgins Report of 2000 and assembled over the past five years, was now to be dismantled.

And while the Health Service Executive had indicated in recent days that breast cancer treatment was to be transferred from Drogheda to what was currently a less well-endowed and resourced unit in Dublin, nobody in the Drogheda unit had been formally notified.

“The agendas that drive this kind of implementation process can only seriously undermine the cancer strategy and healthcare reform in general and will erode the confidence of patients in the vocational commitment of doctors and nurses to their care,” added Mr Lennon.