Dr. Janice Walshe:

With regard to the first question pertaining to the C case, this was a lady who got pregnant on remission from cancer and got information via the Internet. Currently, somebody in the position of C will present to her medical oncologist where a detailed discussion will be held based on prognosis of that woman and the best way to proceed in terms of her treatment. We will discuss the risks to the mother as well as risks to the foetus. She will also have an interaction with the oncology liaison nurse, and we may involve a psycho-oncologist if we felt that was appropriate.

In terms of resources available, they are available in all of the units and therefore it would be a fairly uniform approach in most units one would encounter in Ireland.

In terms of the information packs, to my knowledge there is no specific information out in this regard but it would be important going forward because this scenario is so rare and variable according to the cancer that arises. It would be an important matter. In terms of my envisioning this Bill changing practice, currently I do not see that it would change practice.

With regard to the percentage diagnosed in the first trimester, we do not even have numbers of cancers diagnosed in pregnancy in Ireland. We are extrapolating from international data and, therefore, I do not have those type of numbers but I can tell the member that if someone presents to us with cancer in pregnancy, in the vast majority of cases we navigate that very successfully. We will treat them with chemotherapy from their second trimester onwards with agents we know are safe in that regard, with very good success for both the mother and the foetus. We will strive for foetal maturity rather than foetal viability so we will bring them up to about 35 weeks gestation and then discuss the best way to proceed with delivery, depending on the cancer involved.