Dr. Janice Walshe:

There was a question on randomised trials. As a background point, randomised trials are the cornerstone of cancer therapies. We perform prospective randomised trials in all areas of cancer management. The only thing that holds us back in terms of cancer in pregnancy is the dearth or the small number of cancer cases. It is very difficult to perform large randomised trials. I am comfortable with the data that is there. There are many retrospective cohort studies, case series and case reports that are all consistent no matter what country they have been performed in. In that regard I believe that the data can be extrapolated to the Irish situation and in that I am completely comfortable.

With regard to the question of Senator Crown on the challenges that we face for appropriate therapy of pregnant women with cancer, there is no question that we have to make small compromises, but they are recognised to be internationally acceptable. Where the real difficulty lies, however, is in the treatment of women where we do not have time to wait and in the first trimester. As a result of that we are certainly compromising in terms of the agents that we can offer.