National News March

DONEGAL PATIENTS BECOME FIRST TO BENEFIT FROM THE NEW COMMUNITY CANCER CARE PROGRAMME

March 15, 2011

The Director of the National Cancer Control Programme has congratulated the Donegal Public Health Nurses who have become the first nursing group to graduate from the new Community Oncology Education Programme.

The nurses will become the first nurses nationally to deliver a specific range of cancer services to patients in their own homes.Acknowledging the important role of nurses in the delivery of cancer services, Dr Susan O’Reilly said she was impressed by the depth of knowledge and experience of oncology nurses in Ireland – drawing comparisons with international experience and noting that Irish nurses were on a par with the best in the world.Expressing her delight in making her first formal visit to the NCCP satellite cancer unit in Letterkenny, Dr O’Reilly stressed the important link between the designated cancer centres and the communities they serve.

For the NCCP, this new community oncology education programme is a key component in the development of cancer services in the community.According to Dr Marie Laffoy, Community Oncology Advisor with the NCCP – “We know that most patients, where possible, prefer to receive treatment at home. Where it is safe and appropriate for this to occur we are working to make that happen.“A major objective of the HSE is to integrate health care between the community and hospital services. HSE structures have been reconfigured in an effort to achieve this priority. This way of working will enable the best possible coordination of patient care, whereby all health personnel who treat a patient, work together to ensure the best possible patent outcome.“It is a priority for the HSE to maximise its available resources to the advantage of patient care and outcomes. This includes the conversion of inpatient work to day case work; a focus on reducing patient length of stay in acute hospitals; the implementation of hospital avoidance strategies and the provision of more services in community settings thus reducing the dependency on inpatient beds.”The NCCP is working in partnership with the HSE Office for Nursing and Midwifery Services, acute hospitals, primary care and community care settings to deliver a safe and seamless medical oncology service to adult oncology patients. Some oncology patient care can be safely provided in the community setting.

Dr Laffoy added: “The Community Oncology Nursing Programme is an excellent example of how patient care can be integrated between hospital specialist services and community health services. It aims to promote best practice in caring for cancer patients in the community.”

It further aims to ensure that service delivery is seamless, that legislative and regulatory requirements are met and that employees and line managers understand their roles and responsibilities.It intends to facilitate effective nurse education and training to ensure competency, act as educational tool and further act as a basis for audit and evaluation. The service can be delivered by community nurses who have successfully completed the NCCP Community Oncology Education Programme.Dr Laffoy concluded: “In choosing Letterkenny as the pilot site we knew we had the skills and experience of individuals like Janice Richmond (Advanced Nurse Practitioner, LGH) Dr Karen Duffy (Consultant Medical Oncologist) Dr Anne Flood (Director of Nursing LGH) Eileen Quinn (Director of Public Health Nursing, Donegal) who along with the support of management including Sean Murphy (General Manager LGH) and John Hayes (Local Health Manager) successfully collaborated to develop this pilot programme that has now expanded the skills of the nurses which in turn benefits their patients.”Many Donegal patients undergoing active oncology treatments travel to their treating cancer unit – Letterkenny – several times for blood sampling, medication management and care, and management of central venous access devices (these are devices that are fitted to patients through which chemotherapy drugs are administered). Once fitted these lines have to be maintained and managed, with patients routinely returning to the hospital and in some cases this involves patients travelling long distances.This new programme has been devised to provide nurses with the appropriate skills to safely assess and manage a patient at home, reducing the number of hospital visits for interventions. Patients are identified as suitable for community nursing intervention by the Consultant Medical Oncologist (in Letterkenny General Hospital this is Dr Karen Duffy) and are referred by the specialist cancer team. If a patient is symptomatic or requires a medical assessment while undergoing active cancer treatments and being cared for in the community, they are referred either immediately or urgently back to their local treating cancer centre. Developed on a pilot basis in Letterkenny, the programme was initiated last September with nine Donegal Public Health Nurse participants. The six month programme included classroom based theory, the development of clinical skills under supervision and the subsequent application in the community.

DACC invite you to read full article by clicking on this link pleasewww.donegaldaily.com/2011/03/15/donegal-patients-become-first-to-benefit-from-the-new-community-cancer-care-programme/

Keep the big 'C' at bay with exercise

  • Monday March 14 2011 Courtesy of the Irish Independent

People who lead an active lifestyle are up to a third less likely to develop polyps which can develop into bowel cancer.

The conclusion is based on analysis of 20 previous studies looking at the link between exercise and large polyps.

More than 2,200 people in Ireland are diagnosed with bowel cancer every year and the incidence of the disease increases as people get older. Rates are highest among the 55-74 year age group although younger people are also affected.

20% Rise Seen in Number of Survivors of Cancer

By PAM BELLUCK Published: March 10, 2011  Courtesy of THe New York Times

  • About one in every 20 adults in the United States has survived cancer, including nearly one-fifth of all people over 65, according to new federal data.

The numbers, released Thursday by the Centers for Disease Control and Prevention and the National Cancer Institute, indicated that the number of cancer survivors increased by about 20 percent in just six years, to 11.7 million in 2007, the latest year for which figures were analyzed, from 9.8 million in 2001. In 1971, the number of cancer survivors was three million. “There’s still a concept that cancer is a death sentence,” said Dr. Thomas R. Frieden, director of the Centers for Disease Control. But, he said, “for many people with cancer there’s a need for them and their families and caregivers to recognize that this is a stage. They can live a long and healthy life.” About 65 percent of cancer survivors have lived at least five years since receiving their diagnosis, 40 percent have lived 10 years or more, and nearly 10 percent have lived 25 years or longer. The implications, Dr. Frieden said, are that many cancers are treatable and that it is just as important for people who have had cancer not to assume that they will necessarily die early. “You might think, ‘I’ve had cancer — I don’t have to worry about eating right, quitting smoking, exercising,’ ” Dr. Frieden said. But people with cancer “need to be just as concerned about heart disease and other risks as they would otherwise,” he said. The study defined a survivor as anyone who ever received a diagnosis of cancer who was alive on Jan. 1, 2007, and it did not indicate if the person was cured, undergoing treatment, afflicted with a chronic cancer-related illness, or in the process of dying at that time.

DACC invite you to read full article by clicking on this link please www.nytimes.com/2011/03/11/health/11cancer.html?_r=1&ref=health

Survival rate for women with ovarian cancer has doubled

  • By John von Radowitz in London Wednesday March 09 2011 Courtesy of The Irish Independent

Five-year survival rates for women with ovarian cancer have almost doubled in the last 30 years, new figures show.In the early 1970s, only 21pc of women diagnosed with the disease in England and Wales were still alive after five years. Today, the numbers have expanded to 41pc. More than 1,000 women per year are surviving ovarian cancer for at least five years, according to Cancer Research UK.But the charity said more work was needed to see improvements in women diagnosed with advanced ovarian cancer, who account for the majority of patients.Women diagnosed with stage III cancer, who make up the 45pc of the total, still only have a 20pc chance of living for five years. For women diagnosed with stage IV disease the figure falls to less than 6pc.James Brenton, from Cancer Research UK's Cambridge Research Institute, said: "These latest figures show improvements but we face a real challenge in translating these improvements in survival to women whose ovarian cancer has already spread."

7 March 2011 Last updated at 00:48 GMT

Women's lung cancers has doubled since 1970s in over-60s

Most lung cancers are linked to smoking  Lung cancer rates have more than doubled for women over 60 since the mid-1970s, figures show.Cancer Research UK figures say the rate rose from 88 per 100,000 in 1975 to 190 per 100,000 in 2008, the latest year for which statistics are available.

Lung cancers in men fell, and CRUK say this is linked to smoking rates.

The proportion of male smokers peaked before 1960. But women had rising rates in the 1960s and 1970s, which would have an effect on those now over 60.Overall, the number of women diagnosed with lung cancer has risen from around 7,800 cases in 1975 to more than 17,500 in 2008. Figures for men went from 23,400 over-60s diagnosed in 1975, falling to 19,400 in 2008, with rates showing a similar large drop. The charity said 5,700 women over 60 were diagnosed with lung cancer in 1975, compared with 15,100 in 2008.

Exposure

In the late 1980s, lung cancers in women in their 60s plateaued, and even started to fall.But they began to rise again in 2002.However cancer rates among women in their 40s did fall between 1975 and 2008.Smoking causes around 90% of lung cancers, and CRUK wants more efforts to be put into anti-smoking measures.Jean King, Cancer Research UK's director of tobacco control, said: "Around nine in 10 cases of lung cancer are caused by smoking and one in five people still smoke, so it's vital that work continues to support smokers to quit and protect young people from being recruited into an addiction that kills half of all long term smokers.

"In particular we want displays in shops covered up so that young people are no longer being exposed to this form of tobacco marketing."

5 March 2011 Last updated at 02:52 GMT By Dominic Hughes Health correspondent, BBC News

Hope for early bowel cancer DNA test

A test to detect the early stages of bowel cancer could be one step closer  Scientists have discovered what could be the first step towards a DNA test to detect the early signs of bowel cancer.Tests on two distinct genes were highly accurate in distinguishing between tumours and benign polyps - growths in the bowel that can become cancerous.While not all polyps in the bowel become cancerous it is thought almost all bowel cancers develop from polyps.The Cambridge study, in the BMJ journal Gut, analysed 261 samples from patients with benign polyps or bowel cancer. In particular it looked at what are called DNA methylation patterns - a key process in cell development.

'Protective genes'

The researchers at Cancer UK's Cambridge Research Institute at Cambridge University say that DNA methylation is essential for life. This first step in detecting molecular 'flags' for bowel cancer, could, one day, lead to a simple test to search DNA for the early signs of the disease”

Dr Ashraf Ibrahim Cambridge Research Institute

In healthy cells a compound called a methyl group is tagged to DNA where it acts as a "red light", preventing certain genes from producing proteins. But this process can go wrong in cancer cells and DNA methylation can also contribute to the cause and development of cancer by blocking important "protective genes"Dr Ashraf Ibrahim, the lead author of the study, says studying molecular changes could make diagnosing bowel cancer much simpler in the future."The molecular signals, which tell genes whether to make proteins or not, can become jumbled in cancer cells. We've identified several places where this signal becomes damaged and shown this is linked to bowel cancer development. "The majority of bowel cancers develop from benign polyps that turn cancerous - and this crucial research deepens our understanding of the molecular changes behind this development. "This first step in detecting molecular 'flags' for bowel cancer, could, one day, lead to a simple test to search DNA for the early signs of the disease."

'Improve survival'

Dr Lesley Walker, Cancer Research UK's director of cancer information, says the research opens up the possibility of much earlier diagnosis of bowel cancer, when it is easier to treat."We've come a long way in improving screening and developing better treatments - our scientists have been involved in testing many drugs that are used to treat bowel cancer and they've had a key role in pinning down the genetic causes of the disease. "But there is still more to be done. Research like this is vital in our goal to develop the best methods to detect, monitor and treat cancer and improve survival."More than 38,000 people in the UK are diagnosed with the disease each year.

Deal says new health system by 2016

[Posted: Sun 06/03/2011 - www.irishhealth.com]

Universal health insurance is to be introduced by 2016, according to the Fine Gael-Labour programme for Government agreed by the party leaderships last night.

In the health area, the agreement states that universal health insurance will be brought in by 2016, with access according to need and payment according to ability to pay, and the introduction of universal primary care will remove the need to pay fees for GP care.Under universal health care, everyone regardless of income will have equal access to the same standard of GP and hospital care.Those on middle and higher incomes would contribute to the universal insurance system while those on lower incomes would be subsidised or fully covered by the State.

The deadline of 2016 mentioned in the new programme for government indicates a slightly speeded up version of Fine Gael's manifesto plans for the new system.

Fine Gael has previously said set a timeframe of well over five years for free GP care to arrive, after the introduction of universal hospital cover. Labour has promised free GP care after four years of Government, followed by universal hospital cover around 2016.Fine Gael has proposed a system run by private insurers and overseen by the State, while Labour has proposed an amalgam of a public insurer, to include parts of a reconstituted HSE, with private insurers. Fine Gael had promised to abolish the HSE by 2016.

The funding of the new insurance scheme appears to be dependent to a large degree on employment numbers increasing within the next five to six years in order to maximise the number of people contributing to the insurance fund.

Fianna Fail had cast doubts on the funding of both Fine Gael and Labour's health plans during the election campaign, claiming that many people would end up paying more for healthcare cover than they do now under the new system.

Fine Gael's Dr James Reilly is expected to be appointed Health Minister when the new Government is formed on Wednesday.

The new joint programme has been provisionally agreed by the party leadership. The Fine Gael Parliamentary Party is expected to formally ratify the deal this afternoon, as is a special delegate conference of the Labour Party today.

 

Partners of cancer patients face illness

[Posted: Sun 06/03/2011 by Deborah Condon - www.irishhealth.com]

People who are married to or cohabiting with a cancer patient suffer increased illness in the year following their partner's diagnosis, the results of a new study indicate.

"Having a close relative with cancer entails worry and anxiety and an increased workload that places a strain on one's health," explained researcher, Katarina Sjövall, of Lund University in Sweden.

According to her findings, the number of diagnosed diseases among the partners of cancer patients increased by 25% after the cancer diagnosis. The most significant increase was in diagnoses of mental illnesses, such as depression. However, there was also a significant increase in cardiovascular disease, musculoskeletal diseases and abdominal diseases.

The highest increase was in cardiovascular disease among the spouses and partners of people with lung cancer - this rose by 50%.

This increase in diagnosed diseases among partners led to increased use of the health service, primarily inpatient care.

Meanwhile, among the partners who worked, the number of days of sick leave also increased. The worst affected were the partners of lung cancer patients, who had over 70% more days off sick than the general population in the year following the cancer diagnosis.

Ms Sjövall found that care at the end of life was good at helping relatives and making them feel involved in what was happening. At earlier stages of the illness, however, there appeared to be wide variations in approach and opportunities to offer support to relatives.

Meanwhile another part of the study looked at the cancer patients' sick leave in the year prior to the cancer diagnosis. Individuals with colon cancer and lung cancer had twice as many days off sick as the control group even in the year before their diagnosis.

"One reason could be that both forms of cancer have a lot to do with lifestyle. Therefore, individuals with colon cancer often also have diabetes, and individuals with lung cancer often have cardiovascular disease. The sick leave may have been due to these other diseases, but it could also have been due to early symptoms of the cancer. This makes one wish there were better ways to make a diagnosis based on very early cancer symptoms," Ms Sjövall added.

Thousands of jobs at risk in ‘broke’ health service

By Lisa Smyth Saturday, 5 March 2011 Courtesy of The Belfast Telegraph

· Michael McGimpsey said the health service in Northern Ireland will not have the money to pay its bills from next month

Thousands of jobs and life-|saving treatments could be axed after the Health Minister warned the NHS is broke. While Michael McGimpsey accepted additional cash given to his department is a “step in the right direction” he said he still does not have enough money to pay the bills next year. Indeed, Minister McGimpsey claimed he needs to find more than £150m of savings in a matter of weeks. The Department of Health, |Social Services and Public Safety has been given an additional £189m to spend over the next four years but Mr McGimpsey said the new package did not go far enough.

“I am asking people whether they would prefer the Omagh bypass or would they like a new local hospital in Omagh,” he said.

“Do they want a new radiotherapy centre at Altnagelvin or a |new road between Strabane and Donegal?

“Should Casement Park be refurbished or should we build a new maternity unit at the Royal?

“All of these capital projects are still at risk. They can’t be delivered under the current circumstances. “I am pleased some of the arguments I have made have got through but we still need £200m next year to balance the books and we’re getting £45m, so we’re still £150m short.

“Quite simply, the health |service is broke.  We’re three weeks from the new financial year starting, which doesn’t leave me any time to plan or do this properly. I am in an impossible position.  “I can’t find this amount of money and I won’t be able to pay the bills. I warned that 4,000 jobs may have to go, and that still stands given the budget we have at the moment.”  The new financial year starts in April so redundancies are not an option — money will have to be saved elsewhere — and quickly.  It is likely access to new drugs will be stopped, independent sector and agency work will be dramatically reduced — meaning clinics and departments will close at short notice and waiting lists will increase further — and domiciliary care packages will be further restricted, meaning bed blocking will soar.

In the Assembly yesterday Mr McGimpsey came under fire for his refusal to implement efficiency measures in a review of spending by the NHS. The McKinsey Report made a series of recommendations, including the introduction of charges for services and the closure of some of Northern Ireland’s hospitals, and said that any delay in acting will cost the taxpayer millions of pounds.

Of course, both are highly |emotive suggestions but may go some way to helping address the current financial situation.

Certainly, there are some tough decisions ahead — but not for Mr McGimpsey as he will step down from his post in a matter of weeks ahead of the Assembly elections |in May.

The minister has steadfastly argued that the NHS has already been stretched to the limit and many of those working in the health service would agree.

No-one has said efficiencies cannot be found but these must be patient driven and not — as it currently stands — implemented by the need to cut costs, otherwise it will be some of the most vulnerable members of society who will suffer.

It will be up to the new Health Minister — whoever that may be — to make the budget work.

Raising awareness of oesophageal cancer

[Posted: Fri 04/03/2011 - www.irishhealth.com]

Almost 1,000 patients with Barrett’s Oesophagus have been included on a national register since its establishment last year, according to the Oesophageal Cancer Fund (OCF).

The announcement was made to coincide with the OCF’s annual fundraiser, Lollipop Day, which takes place this weekend.

Now in its tenth year, Lollipop Day is designed to raise awareness of oesophageal cancer. Thousands of volunteers sell lollipops to raise funds, while fact sheets and posters for display in surgery waiting rooms have been circulated to General Practitioners across the country. Early diagnosis remains the key to prevention.

The Barrett’s Oesophagus register aims to improve cure rates in oesophageal cancer through diagnosing cancer at an earlier stage in this at-risk population. Barrett's Oesophagus is a condition where long-term acid regurgitation from the stomach to the oesophagus causes irritation of the tissue. Over time cells in the irritated part of the oesophagus may change and resemble the cells that line the stomach. Barrett's oesophagus increases the risk of oesophageal cancer.Last year, the OCF pledged €500,000 over a three year period to the establishment of the register. The project involves collaborative research into oesophageal cancer and Barrett’s Oesophagus, which underlies the vast majority of cases of oesophageal cancer.

“In the ten years since the OCF has been operating, we have seen an increased awareness among Irish people of oesophageal cancer,” says Prof John Reynolds of St. James’s Hospital, who is head of the Barrett’s Oesophagus register project.“This is a difficult cancer but the earlier it’s caught, the easier it is to cure. At our centre at St. James’ Hospital, we have seen between a 50% improvement in the cure rate recently compared with a decade ago, this is very promising."The establishment of the register may improve these figures further by allowing for the close monitoring of patients and hopefully identifying cancer at an earlier stage, while also reassuring many patients, Prof Reynolds said.

“Ireland has one of the highest rates of oesophageal cancer in the world among men and women. More and more people know that if they’re experiencing symptoms such as long-term heartburn or reflux they should go to their doctor,” said Noelle Ryan, Chairperson of the Oesophageal Cancer Fund (OCF).

Patients wait three months for cancer test

[Posted: Fri 04/03/2011 by Niall Hunter, Editor - www.irishhealth.com]

Nearly 60% of public patients referred for urgent colonoscopies at Dublin's Tallaght Hospital are waiting between one month and three months to get this vital test, according to to latest figures from the HSE.

Urgent colonoscopies are usually be ordered to check for possible signs of bowel cancer, in which early detection is regarded as vital.According to the HSE statistics for the end of December, while nearly all hospitals in the country are complying with the target waiting time of 28 days maximum for a patient to get a colonoscopy, Tallaght Hospital was well outside this target.The statistics show that the Dublin hospital had 24 patients waiting between one month and three months for an urgent colonoscopy, which accounted for nearly 60% of the total numbers waiting for this test.The HSE's HealthStat performance rating system gave Tallaght's colonoscopy performance a 'red light' unsatisfactory rating, requiring urgent attention.According to the latest statistics from the HSE, nationally, just under 98% of people waiting for an urgent colonoscopy are kept waiting less than 28 days.A spokesperson for the Irish Cancer Society told irishhealth.com that despite recent improvements, it was still concerned about the situation and continued to monitor waiting times for colonoscopies.The spokeswoman said the Society wanted the waiting times issue dealt with, with all hospitals achieving a less than 28 days waiting time target, before the national bowel cancer screening programme is introduced next year.The latest HSE statistics also show that some hospitals continue to have very long waiting times for routine public outpatient appointments.The average waiting time for a surgical appointment at an outpatient clinic in Galway University Hospital is well over a year, while patients requiring an ear, nose and throat appointment at the same hospital must wait nearly three years.

At Our Lady of Lourdes Hospital in Drogheda, the average wait for a similar appointment is over two-and-a half years.

The HSE's official average maximum waiting time target for outpatient appointments is three months.However, the figures indicate that just under half of hospitals are complying with this target in surgery and less than one-third of hospitals are compliant with the three-month target for outpatient appointments in medicine.Only four hospitals in the in the country - Sligo, Wexford, St James's and St Vincent's - have an average waiting time of under three months for ear, nose and throat appointments

Obesity ups risk of breast cancer

[Posted: Thu 03/03/2011 by Deborah Condon - www.irishhealth.com]

Women who are obese with a sedentary lifestyle are at an increased risk of developing a specific type of breast cancer, the results of a new study indicate.

Doctors have long noted a link between obesity and breast cancer in postmenopausal women. Until now, studies suggested that most of this increased risk was in the subtype of the disease known as oestrogen receptor positive breast cancer. However these new findings suggest a risk beyond oestrogen.

US researchers found a specific relationship between obesity, physical activity and triple negative breast cancer, a subtype of breast cancer that is characterised by a lack of, among other things, oestrogen.Triple negative breast cancers account for 10-20% of all breast cancers and generally have a very poor prognosis, due to a lack of targeted drug therapies."Breast cancer is not just one disease. It is a complex combination of many diseases. The fact that we found an association with triple negative breast cancer is unique because, biologically, this subtype is very different from other breast cancers," said Dr Amanda Phipps, of the Fred Hutchinson Cancer Research Center.

The researchers analysed data from over 155,000 women. They found that women with the highest BMI (body mass index) had a 35% increased risk of developing triple negative breast cancer and a 39% increased risk of developing oestrogen receptor positive breast cancer.Those who reported high rates of physical activity meanwhile had a 23% decreased risk of triple negative breast cancer and a 15% decreased risk of oestrogen receptor positive breast cancer.Details of these findings are published in the journal, Cancer Epidemiology, Biomarkers & Prevention.

HSE stops publishing bed closure figures

[Posted: Wed 02/03/2011 by Niall Hunter, Editor - www.irishhealth.com]

The HSE has stopped publishing monthly updates on the total number of beds closed in hospitals around the country while it tries to work out what constitutes a closed bed.The health executive confirmed to irishhealth.com that it had not been publishing monthly bed closure updates on it website since December.A HSE spokesperson said it had been decided to suspend the publication of bed closure figures pending an audit of all hospitals which was being carried out to give a more accurate picture of the number of beds closed.

The HSE says different hospitals had been using different criteria for defining what constituted a closed bed, and it wanted to introduce standardised criteria for calculating bed closure figures.The spokesperson said as an example of this, some hospitals may have been including in bed closure figures beds that had been closed as far back as 2005-2006, when there had been widespread closures. Others had not been counting those closed beds.

The health executive says it wants to standardise the criteria used for designating a bed as closed and on the reasons for its closure.Asked if a closed bed was not always a closed bed, whenever it had closed, the HSE spokesperson said a certain cut-off point had to be arrived at in order to reflect current bed closure numbers.Asked why, in terms of accountability, it did not continue to publish bed closure numbers to give some idea of the national picture pending the audit, the HSE said it would be preferable to publish more reliable figures.The spokesperson said it could not yet be predicted whether the new figures, when published, would show substantially higher or lower bed closure numbers than under the old system. He said there would not be a long delay before new bed closure figures were published.

The HSE said a 'cut-off period' would be decided upon after which beds would be counted as closed for the purposes providing a more accurate picture of current bed closures in its reports.Until December last, bed closure totals had been published on a monthly basis in performance reports on the HSE website.The last published figure, based on calculations made in October last, showed that there were 1,045 acute hospital bed closures around the country, not counting hundreds of additional acute beds that were not available due to delayed discharges.However, the Irish Nurses and Midwives Organisation (INMO) had said the HSE's figures understated the true number of bed closures nationally.

The INMO's own most recent bed closure count claimed that just under 1,700 hospital beds were closed. This figure, however, included some long-stay as well as acute beds.While the HSE just counts acute bed closures, even taking long-stay beds out of the IMNO's estimate leaves a figure of just over 1,300 acute bed closures, well ahead of the HSE's most recent estimate of 1,045.

A small number of beds were re-opened back in January to cope with unprecedented pressure in emergency departments.

The HSE has not published outpatient waiting lists figures for a number of years. It says it is also carrying out an audit on these figures to verify numbers

Cancer risk for postmenopausal smokers

[Posted: Wed 02/03/2011 by Deborah Condon - www.irishhealth.com]

Postmenopausal women who smoke or used to smoke are at an increased risk of developing breast cancer, the results of a new study indicate.

Some 2,000 women are newly diagnosed with breast cancer in Ireland every year.

According to the findings, female smokers - current or past - may have up to a 16% higher risk of developing the disease. Furthermore, the findings suggest that women who have had extensive exposure to passive smoking, either as children or in adulthood, may also have an increased risk of developing breast cancer.

According to US researchers, while some previous studies have indicated that smoking increases the risk of breast cancer, the theory that passive smoking is also a risk factor remains controversial.They decided to carry out a large scale study following participants over a long period of time to investigate this issue further. Almost 80,000 women aged between 50 and 79 were included. In total, 3,250 cases of invasive breast cancer were identified during 10 years of follow-up.The participants were asked a range of questions about their smoking status, for example whether they had ever smoked or were former or current smokers. Current or former smokers were asked the age at which they started smoking and the number of cigarettes smoked a day. Former smokers were asked the age at which they quit.Questions on passive smoking related to whether the participants lived in smoking households as children and/or as adults, and whether they had worked in smoking environments.The study found that smokers have a 16% increased risk of developing breast cancer after the menopause, while the increased risk for former smokers is 9%.

The highest breast cancer risk was found among women who had smoked for over 50 years or more compared with lifetime non-smokers. Women who started smoking as teenagers were also at particularly high risk.

Furthermore, an increased risk of breast cancer continued for up to 20 years after an individual stopped smoking.

The study also found that among non-smoking women, those who had been exposed to extensive passive smoking - for example, over 10 years' exposure in childhood, over 20 years' exposure as an adult at home and over 10 years' exposure as an adult at work - had a 32% excess risk of breast cancer.The researchers emphasised, however, that their analysis of the link between breast cancer and second-hand smoke was restricted to the most extensive passive smoking category and therefore more research is needed to confirm these findings."Our findings highlight the need for interventions to prevent initiation of smoking, especially at an early age, and to encourage smoking cessation at all ages," commented Dr Karen Margolis of the HealthPartners Research Foundation in Minneapolis.

Details of these findings are published in the British Medical Journal.

Exercise cuts risk of developing bowel cancer polyps

By Dominic Hughes Health correspondent, BBC News 2 March 2011

Regular exercise reduces the risk of developing polyps which can lead to bowel cancer People who lead an active lifestyle are up to three times less likely to develop polyps which can develop into bowel cancer, according to a study.The report pulls together 20 previous studies looking at the link between exercise and the development of large polyps.

Bowel cancer is the third most common cancer in the UK.

More than 38,000 people are diagnosed with the disease each year.

The work was done by scientists from the Washington University School of Medicine in St Louis in the US.Publishing their findings in the British Journal of Cancer, they say they have produced the most accurate figures yet that show low exercise levels are linked to bowel polyps.

They found that people who take regular exercise were 16% less likely to develop bowel polyps and 30% less likely to develop large or advanced polyps.

  • The reality is that exercise is acting through more than one mechanism. The upside is there are so many benefits all over the body, it is hard to pinpoint” Professor Kathleen Wolin Washington University School of Medicine

Polyps - also known as adenomas - are growths in the bowel and while they are not cancerous in themselves they can develop into cancer over a long period of time. Cancer Research UK says most bowel cancers develop from a polyp and about 1 in 4 of us have one or more by the age of 50, while about half of us have them by the time we are 70. But only a small fraction of polyps develop into cancer and it takes years for that to happen.

Exercise link

Professor Kathleen Wolin, one of the lead authors of the research, says the evidence now shows a clear link between exercise and a reduced risk of bowel cancer but it is not yet clear exactly why that link exists."There are a number of likely pathways but we don't know exactly. So for example exercise reduces inflammation in the bowel, which has been linked to bowel cancer. "But exercise also reduces insulin levels and improves the body's response to hyperinsulinaemia (excess levels of insulin circulating in the blood), which again increases polyp risk. "It also enhances the immune system and because people who exercise often do so outside, they get vitamin D, which is also important for bowel cancer."The reality is that exercise is acting through more than one mechanism. The upside is there are so many benefits all over the body, it is hard to pinpoint."

Keeping active

Sara Hiom, director of health information at Cancer Research UK, says the evidence shows that keeping active could help prevent thousands of cases of cancer every year."We'd recommend doing at least half an hour's moderate exercise a day - such as brisk walking or anything that leaves you slightly out of breath. Getting enough physical activity will also help you keep a healthy weight, which is one of the most important ways of reducing the risk of cancer." Mark Flannagan, Chief Executive of Beating Bowel Cancer, backed the study and said it was clear that lifestyle was an important factor in protecting yourself from cancer."Although the majority of polyps are not cancerous, it is thought that almost all bowel cancers develop from polyps. Therefore we recommend taking 30 minutes of physical activity each day, along with a healthy diet and lifestyle, to reduce your risk of developing bowel cancer."

Deborah Alsina, Chief Executive of Bowel Cancer UK, said the report was good news. "Evidence also shows that the combination of taking more exercise and having a healthy diet may protect against bowel cancer, as well as weight gain and obesity, so we encourage people to do both. "It is also important that people take part in the screening programme, if eligible, as screening is an effective means of detecting polyps at an early stage. These polyps can easily be removed, reducing the risk of bowel cancer developing."

Most men 'unaware of prostate cancer test'

By Stephen Adams Tuesday March 01 2011 cOURTESY OF thE iRISH iNDEPENDENT

Two-thirds of men at a raised risk of prostate cancer do not know about a blood test described as the "first line of defence" against the disease, says a charity.

The Prostate Cancer Charity is worried that men are effectively being denied access to the prostate specific antigen (PSA) test. A raised PSA level can indicate prostate cancer, although experts dispute its effectiveness. Experts are divided about the test, which gives many false positive and false negative results.

One of the problems is that levels naturally vary widely between men. A raised level can also indicate an enlarged prostate, rather than cancer, or cancer that is growing so slowly that it is unlikely to cause any problems. Men can subsequently opt for invasive tests and treatment, suffering side effects including impotence and loss of sex drive, only to find out there is no serious underlying problem

Despite its drawbacks, the chairty says it is currently the "first line of defence" for picking up potential problems John Neate, chief executive of The Prostate Cancer Charity, said: "The lack of knowledge by so many men about the PSA test, reinforced by our latest research, is a completely unacceptable inequality in our society and can no longer be tolerated. "GPs must begin to engage men much more pro-actively in discussions about prostate cancer, their risk of the disease and the role of the PSA test. They must never stand in the way of a man's right to make a personal, informed choice about having the test."

Scientists discover cause of rare skin cancer that heals itself

  • By Richard Alleyne Tuesday March 01 2011 Courtesy of The Irish Independent

Discovering how a rare cancer heals itself could lead to new treatments for other types of the disease, claim scientists.

Researchers believe they have found a key gene involved in Ferguson-Smith disease, otherwise known as multiple self-healing squamous epithelioma (MSSE), a skin cancer that grows rapidly but then a few weeks later, inexplicably, heals itself. They believe that by finding out how the faults in the gene TGFBR1 cause the cancer and then subsequently heal it could give valuable insights into beating other types of tumour. The TGFBR1 gene is involved in the making of a protein through which cells receive messages from their neighbours, instructing them to carry out jobs essential to growth and development. But malignant cells interpret the "instructions" transmitted by TGFBR1 in two completely different ways, depending on the maturity of the tumour.

TGFBR1 initially acts as a "brake" preventing the growth of early tumours of various types but when cancers become more advanced and aggressive, their cells undergo a "signalling switch". In more advanced cancers, TGFBR1 promotes tumour growth and spread instead. The reverse happens with MSSE which is caused by an inherited fault in the TGFBR1 gene. Patients with faulty TGFBR1 develop lots of small tumours – but at some point there is a "switch" in behaviour and the tumours lacking TGFBR1 heal themselves.

Scientists do not yet understand how this happens.

The scientists, based at the University of Dundee, made the discovery after examining the DNA of more than 60 people with MSSE and 110 of their unaffected relatives. Dr David Goudie, Cancer Research UK scientist at the university, said: "We hope that by shedding light on how one rare cancer manages to heal itself we’ll understand more about what goes wrong in other types of tumours. Dr Lesley Walker, director of cancer information, Cancer Research UK, said: “This intriguing research provides an important insight into the various ways that cellular machinery can get messed up – which can then cause different types of cancer. “This finding adds to thousands of discoveries being made by our world-class scientists every year. "The pace of progress in cancer research is accelerating every year – enabling us to develop better ways to detect, monitor and treat the disease. "This piece of research is another step – moving ever closer to our vision of beating cancer.” The research is published in the journal Nature Genetics.

MSSE is very rare. Only a handful of new cases are diagnosed in the UK each year.

[Donegal Action for Cancer Care] [About  DACC] [Next County Meeting] ["Cancer-You Are Not Alone"] [Financial support for cancer patients] [Cancer Related Sites] [Letterkenny General Hospital] [Annual Report 09] [Local Radio 2010] [Local News 2011] [National News March] [National News Feb 2011] [Recent events 2010] [Upcoming Events] [Just for you!]