{"id":186609,"date":"2025-11-18T06:19:09","date_gmt":"2025-11-18T06:19:09","guid":{"rendered":"https:\/\/www.europesays.com\/ie\/186609\/"},"modified":"2025-11-18T06:19:09","modified_gmt":"2025-11-18T06:19:09","slug":"fighting-against-the-system-here-is-extraordinarily-tough-the-irish-times","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/ie\/186609\/","title":{"rendered":"\u2018Fighting against the system here is extraordinarily tough\u2019 \u2013 The Irish Times"},"content":{"rendered":"

Pancreatic cancer<\/a> is one of the fastest-killing forms of the disease for several reasons, not least that it is typically well advanced before it is identified.<\/p>\n

Only about 10 per cent of patients in Ireland are still alive five years after diagnosis, says consultant medical oncologist Prof Gr\u00e1inne O\u2019Kane, who specialises in pancreatic cancer at St Vincent\u2019s University Hospital in Dublin. (This compares with five-year survival rates of about 88 per cent for breast cancer and 93 per cent for prostate cancer.)<\/p>\n

Yet, for the 600 people who develop this so-called silent cancer every year, there is still no rapid diagnostic clinic that would give them a better chance of survival.<\/p>\n

We rightly have rapid diagnostic clinics for breast, prostate and lung cancer, she points out, but not for the aggressive pancreatic form. Despite being relatively rare, pancreatic cancer is projected to be the second leading cause of cancer-related deaths by 2030.<\/p>\n

\u201cIf there is one that is going to need rapid access it should be that type of cancer, because if someone\u2019s at home, losing ground, not knowing what\u2019s going on, then you can miss a window of opportunity to treat that patient.\u201d<\/p>\n

Some tests may be carried out in the community but often not in the way she and her multidisciplinary team would like them to be done. Every week lost is going to make a difference.<\/p>\n

\u201cThat\u2019s where I guess a lot of us struggle. We see people that you just wish you had seen earlier, then things might not have progressed as much. As a pancreatic cancer grows and grows it gets harder to treat and patients are often sicker.\u201d<\/p>\n

Although the cancer is more likely to occur in patients in their 70s, \u201cwhat is really frightening is that it is increasing in younger patients\u201d. For unknown reasons, in common with other cancers such as colorectal cancer, more people under the age of 50 are being diagnosed.<\/p>\n

\u201cI would have many young people in their 40s. My youngest patient was 23 with pancreatic cancer.\u201d<\/p>\n

[\u00a0Pancreatic cancer: \u2018I just can\u2019t explain what it felt like hearing those words\u2019Opens in new window<\/a>\u00a0]<\/p>\n

In seven to 10 per cent of cases, there is a family history of pancreatic cancer, a specific gene that predisposes them to pancreas cancer has been inherited. Anybody with this gene should undergo screening but that has not been available in Ireland. However, enabled by a large grant, a screening programme will begin in 2026.<\/p>\n

There is some association with the typical cancer risks of smoking, alcohol and obesity, \u201cbut we see many patients that don\u2019t have any of those\u201d.<\/p>\n

The first symptoms that people go to their GP about may be nonspecific, such as tummy or back pain; other indicators include weight loss, fatigue and jaundice. More awareness among both the public and GPs is needed to recognise where these signs might be leading.<\/p>\n

Referral of patients to a specialised clinic would lead to a much quicker diagnosis and decision on whether or not surgery is an option. To its credit, our health system has two designated, specialised centres that perform surgery for pancreatic cancer: St Vincent\u2019s University Hospital and the Mercy University Hospital in Cork. <\/p>\n

However, at least 80 per cent of patients will never get to surgery. O\u2019Kane expresses frustration at systemic failings in other aspects of care for these \u201cmost vulnerable\u201d of people, who she must look in the eye at the most difficult time of their lives. <\/p>\n

\n

You have to want to make sure you\u2019re not a patient who has the potential to access different therapies and could live for a long time<\/p>\n

\u2014 \u00a0Prof Gr\u00e1inne O’Kane<\/p><\/blockquote>\n

Sitting in her second-floor office, which was vacated by the campaigning oncologist and former senator Prof John Crown on his retirement from the public health service, O\u2019Kane, who is 43, is not afraid to speak out either. Talking rapidly, yet choosing words carefully, she radiates a sense of somebody for whom there is never enough time in the day \u2013 for her patients, for research, for her husband, a radiologist, and their three children aged 12, 10 and six, for herself. We meet, she has just spent a weekend teaching on an advanced pancreatic cancer course for European oncologists. She favours cycling and running as downtime pursuits.<\/p>\n

She is \u201cvery driven\u201d and loves her job in this particularly challenging field of oncology, treating liver as well as pancreatic cancer. Her native Derry accent is coloured by North American tones acquired from seven years living in Canada, where she did her oncology specialist training and was then a consultant in Toronto\u2019s Princess Margaret Cancer Centre. She returned to Ireland and worked for two years in St James\u2019s Hospital before taking up her post in St Vincent\u2019s a year ago.<\/p>\n

Rarely the deliverer of good news, she believes in being very honest with patients and in the importance of providing them with support and guidance. She is often \u201cin awe\u201d of how they and their families handle themselves in the face of utmost adversity. <\/p>\n

\"\"<\/p>\n

The value of giving options and hope is rarely talked about, she says. Yes, it is an aggressive and highly fatal disease but \u201csome patients I\u2019ve come across have been told not to bother doing anything. This is crazy because every patient is different and every patient\u2019s tumour is different. I have some patients who will live for years.<\/p>\n

\u201cThat is not commonplace, but you have to want to make sure you\u2019re not a patient who has the potential to access different therapies and live for a long time.\u201d<\/p>\n

For her, the \u201cpsychological trauma\u201d of the job comes when she thinks she has not been able to offer the patient every possible option. \u201cIf I feel that there\u2019s something that they could benefit from, but I can\u2019t get it in Ireland, or I feel like the system has let them down, that\u2019s what I struggle with most.\u201d<\/p>\n

She says she and her healthcare colleagues could do better for patients \u201cif we just had organisation and resources in order to deliver a service\u201d. A rapid diagnostic clinic would be part of that, which would also help to attract more clinical trials \u2013 another front on which she advocates.<\/p>\n

[\u00a0\u2018The reason pancreatic cancer isn\u2019t talked about so much is because there are very few survivors to advocate for it\u2019Opens in new window<\/a>\u00a0]<\/p>\n

Specialists in pancreatic cancer believe that every patient with pancreatic cancer should be on a clinical trial at every point in their journey. Huge breakthroughs are being made in drugs that can target the very specific gene mutations that occur in pancreatic cancer. She expects these will lead to \u201cextraordinarily different\u201d treatments in five years\u2019 time.<\/p>\n

\u201cI\u2019m about to meet a patient today and it\u2019s breaking my heart because I can\u2019t get him on a clinical trial and he\u2019s very fit for clinical trial.\u201d She has contacted centres in the UK, Spain and the US to try and get him on one.<\/p>\n

\u201cSo that\u2019s not good enough for our patients. We should be able to have our trials here and that\u2019s what we\u2019re trying to do.\u201d The creation of the Pat Smullen<\/a> chair in pancreatic cancer in UCD, to which O\u2019Kane was appointed last year, was a huge leap forward.<\/p>\n

It is named after the nine-times champion flat race jockey who died of this cancer at the age of 43 in 2020 and funded by a foundation set up in his memory. Led by his widow, race trainer Frances Crowley, and supported by the horseracing community, they \u201care doing an incredible amount to help us fund clinical trials\u201d, says O\u2019Kane. A few, looking at a precision oncology approach, have started. <\/p>\n

\u201cIf we can really deliver in cancer research, then you\u2019re more likely to attract industry and to have big clinical trial portfolios.\u201d<\/p>\n

She thinks it is patients living with pancreatic cancer and their care-givers who are going to change things for the better. They are more informed, asking more questions and looking for second opinions abroad. \u201cIt\u2019s brilliant and it should be embraced.\u201d<\/p>\n

Doctors need to be challenged and it is easier for both sides when it\u2019s a two-way journey and patients are thinking about their own healthcare. She also pays tribute to the work of the new charity, Pancreatic Cancer Ireland<\/a>, headed by Rachel Duquesnois and Niall Rochford, who have lost loved ones to the disease, and Pamela Deasy, who is a pancreatic cancer survivor. O\u2019Kane believes they are a driving force of change.<\/p>\n

\u201cFighting against the system here is extraordinarily tough,\u201d she adds, \u201cand that\u2019s why I think the patients are the only people who can make a real difference.\u201d <\/p>\n

\u2018She was deeply, deeply upset\u2019: A mother\u2019s pancreatic cancer diagnosis\"BernieBernie Condron <\/p>\n

\u201cI\u2019ve had this kind of niggling pain in my left side and it\u2019s around for a while.\u201d Those words from Bernie Condron, a week ahead of her 75th birthday in November last year, was the first inkling her daughter Aislinn Swanick had that her \u201cextremely fit\u201d mother might have an issue.<\/p>\n

\u201cShe walked 5k about four days a week, did about three yoga classes,\u201d says Swanick. She advised her mother, who was staying that weekend with her in Belmullet, Co Mayo, to go to her GP the following Monday when she was back home in Roscommon.<\/p>\n

The GP recommended an ultrasound, and Bernie wondered if it could be gallstones. There was a wait for the ultrasound but she got in after a cancellation and nothing untoward was found. Less than 10 days later Aislinn\u2019s sister-in-law rang her to say she was concerned that Bernie was unwell.<\/p>\n

\u201cWe arranged an admission for her into hospital in Galway the following day,\u201d says Aislinn, who is manager at the GP practice she and her husband Keith, a GP, set up in Belmullet. They have two children, Julian (11) and Rosa Pearl (eight). \u201cThat evening she called to tell me that she had pancreatitis, diagnosed on a CT scan.\u201d<\/p>\n

At 4am the next morning, Aislinn jumped awake with the realisation that her mother had also mentioned there was a mass on her pancreas. She had not processed that information earlier. But it was a great relief when the biopsy of that mass later came back normal.<\/p>\n

\u201cMum was quite a religious person with a deep faith, as am I. So we went down to the chapel in the church and I said, \u2018Mum, you\u2019ve just dodged a bullet. She said, \u2018I know\u2019. We sat there together and prayed. And she said, \u2018but I wonder what is it though?\u2019\u201d<\/p>\n

The diagnosis was \u201cautoimmune pancreatitis\u201d, which Aislinn mentioned to a medical friend of her husband after she bumped into him by pure chance in a local coffee shop. He advised that her mother should go to a specialist unit in St Vincent\u2019s hospital in Dublin to have the mass checked out.<\/p>\n

Bernie was quite unwell after an invasive biopsy there but her husband, PJ, and Aislinn were able to bring her home on December 8th last.<\/p>\n

She showed \u201cenormous strength\u201d in the next three weeks, living life to the full, says Aislinn. There was some pain but it was manageable.<\/p>\n

They were called back to St Vincent\u2019s on December 20th where Aislinn went in with her to hear the \u201charrowing news\u201d that the biopsy showed Bernie had adenosquamous carcinoma, an aggressive form of pancreatic cancer.<\/p>\n

\n

I need to tell you something. I\u2019m not going to engage in the chemotherapy treatment<\/p>\n

\u2014 \u00a0Bernie Condron<\/p><\/blockquote>\n

\u201cShe was remarkably strong and resilient, but she was deeply, deeply upset. I think really that I would say half of her died that day. She knew enough that she was going to be faced with an enormous challenge.\u201d An appointment with an oncologist in Galway was arranged for December 23rd.<\/p>\n

The oncologist suggested triple therapy, \u201cthe same kind of treatment that would be offered to a 45-year-old, because she was so fit and healthy,\u201d says Aislinn. \u201cThey were going to give it the best shot they could.\u201d <\/p>\n

But the next day Bernie was called into hospital due to very abnormal liver function and before the end of December had a stent put into her biliary duct. She was on the oncology ward for this complication of the disease, upset at being surrounded by very sick people and relieved to be able to go home some days later.<\/p>\n

In the first week of January, Bernie had her port inserted in preparation for chemotherapy but Aislinn noticed she had become very quiet on the phone and then stopped answering text messages. Concerned, she had to wait until the thawing of a cold snap before it was safe to drive to Roscommon to visit her.<\/p>\n

Aislinn could see immediately that Bernie had psychologically declined. \u201cShe was irritable and she was withdrawn.\u201d The next day she was vomiting and Aislinn rang her husband, who suggested she take her mother for a scan.<\/p>\n

When Aislinn asked Bernie if she would like to go into hospital for this right away, she replied, \u201cNo, I\u2019d like to get my hair done\u201d. Before they left for the hairdresser, Bernie turned to her daughter and said: \u201cI need to tell you something. I\u2019m not going to engage in the chemotherapy treatment.\u201d<\/p>\n

Aislinn knew then, \u201cwhatever hope we had of treating this tumour, it wasn\u2019t going to be treated now anyway. She was officially palliative.\u201d But she just said, \u201cWell, mum, that\u2019s fine. That\u2019s your decision. We\u2019ll make the arrangements around that.\u201d <\/p>\n

\u201cThat evening she ate a slice of pizza and we sat up chatting until 10.30pm. She told me, \u2018No matter what you do in your life, always prioritise your children. Everything else will fall into place for you\u2019.\u201d Aislinn gave her mother her medication before going to bed ahead of her.<\/p>\n

\u201cThe next morning, we woke up at 6.20am and she was dead at 6.50am. Cardiac arrest.\u201d<\/p>\n

It is some comfort to Aislinn that Bernie, a very independent and kind former secondary school principal and farmer, died \u201con her own terms\u201d in her own bedroom. \u201cShe departed in a very dignified way.\u201d<\/p>\n

Having become involved in fundraising in recent weeks for Pancreatic Cancer Ireland, Aislinn has been glad of opportunities to talk about her mother. The Swanicks will be turning their GP surgery purple on November 20th to mark World Pancreatic Cancer Day. That same day her son Julian, a church singer, will be recording a Christmas carol that is going to be released on Spotify.<\/p>\n

Working in primary care, she would like to see fund-raising enable a community-based awareness campaign, with a focus on preventative measures rolled out via GP practices.<\/p>\n","protected":false},"excerpt":{"rendered":"Pancreatic cancer is one of the fastest-killing forms of the disease for several reasons, not least that it…\n","protected":false},"author":2,"featured_media":186610,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[78],"tags":[110,18,135,19,17,104874,104873,15913],"class_list":{"0":"post-186609","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-cancer","9":"tag-eire","10":"tag-health","11":"tag-ie","12":"tag-ireland","13":"tag-mercy-university-hospital","14":"tag-st-vincents-hospital","15":"tag-ucd"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@ie\/115569253755189210","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/186609","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/comments?post=186609"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/186609\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media\/186610"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media?parent=186609"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/categories?post=186609"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/tags?post=186609"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}