Catherine Callaghan (Carlow-Kilkenny, Fine Gael)
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I would like to use my time to suggest a way to improve cancer care outcomes in counties Carlow and Kilkenny. In figures given to me by the Irish cancer Society, excluding non-melanoma skin cancer, in 2024, 47% of Carlow people diagnosed with cancer died from the disease. In the same year, 47% of Kilkenny people diagnosed with cancer died from the disease. We have made significant progress in improving survival rates and expanding access to cancer care. I pay tribute to the men and women who support oncology patients as well as volunteers in the likes of Éist in Carlow and Cois Nore in Kilkenny among other services available in my constituency. However, 365 men, women and children from Carlow and Kilkenny died from cancer in 2024.

That is almost one person per day. As somebody elected to represent these people and their families, I find this quite upsetting. This is why today I want to make the case for a decisive and necessary step in Ireland's fight against cancer. This is the introduction of next generation sequencing, NGS, testing as a core part of cancer diagnostic and treatment services.

While traditional NGS relies on tissue biopsies, blood-based NGS is a critical tool in modern oncology. In other words, it is a simple blood test that is capable of detecting more than 50 types of cancers simultaneously. To quote a medical consultant I spoke with recently, a publicly available blood tests to detect multiple cancers simultaneously and to detect inherited cancer risks will be a game changer for cancer care in Ireland. This game changer will only happen if we choose to integrate NGS fully in our public health service. This blood test would allow us to reduce delays, improve accuracy, provide equitable access to patients regardless of geography and guide targeted therapies that depend on understanding the genetic profile of tumours. This is precisely the sort of early detection and precision medicine our national cancer strategy envisaged when it set out its outcome goals of detecting cancer earlier, reducing inequalities and improving patient outcomes.

In 2022 the HSE launched Ireland's national strategy for accelerating genetic and genomic medicine, which sets out a clear vision for bringing genomics into routine care. This strategy emphasises improved disease prevention, better diagnostics and more targeted treatments for patients and families across the country. To deliver this vision the HSE then established the national genetics and genomics office in 2023 to build national capacity for genomic testing and to ensure Ireland can retain and expand accredited testing. We can see that a lot of the ground work has been done but to deliver fully on the promise of genomic medicine we must now make NGS the standard platform for cancer testing.

Simon Harris (Wicklow, Fine Gael)
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I thank Deputy Callaghan for raising this issue. She is right to say there is not a family or community not impacted by cancer. We all have to do more and challenge ourselves and our system, and support our health service, researchers and scientists in terms of what more we can do to prevent cancer and to earlier identify cancer. I think of our colleague, Deputy Peter Roche, who lost his brother Vincent in the early hours of this morning, and I extend my sympathies to him.

I met the Irish Cancer Society last week and we discussed a range of issues, including this in the context of developing the next national cancer strategy. I thank Deputy Callaghan because raising this is timely as we prepare to develop the next national cancer strategy. Deputy Callaghan has been a vocal advocate for cancer care, cancer prevention and cancer treatment. We are absolutely committed to improving cancer care. As I have said, we must also continue to see what more we can do in terms of being innovative in better early identification and better prevention.

The current national cancer strategy identifies the need for genomic testing and hereditary cancer care management. The national cancer control programme hereditary cancer model of care highlights the need to further improve access to genetic testing for patients with cancer and their relatives. We are committed to ensuring this happens. Where a cancer patient is suspected of having an underlying cancer predisposition syndrome, they are typically offered multigene panels to look for changes in relevant genes, if identified, and there is testing for close family members also. It is important to note the HSE does this in line with best international practice rather than through broader population screening programmes. A genomic test directory for cancer is constantly being developed in the health service as well, and the national cancer control programme is now funding a number of tests in adult cancer, including colorectal, melanoma, lung, ovarian and other cancers. Tests have been developed, I am pleased to say, at CHI Crumlin for all known significant mutations in paediatric and young adult solid cancers. On foot of Deputy Callaghan raising this today, I will specifically speak with the Minister for Health and ask that she further engages with Deputy Callaghan and anyone she has been working with in Carlow and Kilkenny on this. There is an opportunity to try to progress this in the next national cancer strategy.

The hereditary cancer steering group oversees the implementation of the hereditary cancer model of care. They are now working to mainstream genetic testing as part of the hereditary cancer model of care. They hope to have this in place in a number of cancer centres in our health service by the third quarter of this year. This will make pre-test counselling and genetic testing available through the treating oncology team for certain patients with a diagnosis of cancer, including breast cancer, which will be a significant step forward. We have also provided funding for posts to include two genetic counsellors, three service support staff, four advanced nurse practitioner posts and two consultant medical oncologists with a special interest in genetics. This is the immediate move that will take place this year as we begin to develop the next national cancer strategy and the next steps forward. I will speak to the Minister, Deputy Carroll MacNeill, and asked that she engage further with Deputy Callaghan.

Catherine Callaghan (Carlow-Kilkenny, Fine Gael)
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I want to be associated with the expression of sympathy to Deputy Roche and his family.

My proposal to introduce a publicly available blood test for detecting multiple cancers at once is scientifically sound, economically sensible and morally necessary. Every delay in adopting this technology represents a missed opportunity to detect cancers early, to treat them more effectively and to save lives. As the Tánaiste has outlined, we have the strategy, the structures and the investment almost ready. I am looking forward to working alongside the Tánaiste and the Minister, Deputy Carroll MacNeill, to see this genetic testing progressed in the next strategy.

I urge the Government to commit to the nationwide roll-out of NGS in the HSE to ensure every patient, no matter where they live, benefits from the most advanced cancer diagnostics available. Patients in Carlow and Kilkenny deserve nothing less than the best that modern medicine can offer. The blood test will help us deliver exactly this. Today my thoughts are with a friend of mine in Thomastown, without whom I know for certain I would not be standing in this Chamber. As long as I am in this Chamber representing the great people of Carlow and Kilkenny, I will fight for better cancer care outcomes for those people. I look forward to working with the Minister, Deputy Carroll MacNeill.

Simon Harris (Wicklow, Fine Gael)
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I thank Deputy Callaghan and I send my thoughts and best wishes to her close friend in Thomastown. Deputy Callaghan's experience and story is one we in the House all share. It is something that touches and impacts all of us in our lives, our work, our communities and everybody in this country. We have made good progress as a country. Our doctors, medics, scientists, nurses and healthcare system have made good progress in our cancer survival rates but, as I say this, there can be no room for any sense of complacency. We have to continue to see how we can do more and do better in terms of prevention and early detection. Deputy Callaghan is quite right to be bringing forward ideas as to how we use the best innovations and best science, and what is recommended by international evidence, to do better in our health service. I know the Government, Deputy Callaghan, and the Minister, Deputy Caroll MacNeill, are fully committed to this. I take heart from the fact the hereditary cancer model of care will be rolled out by quarter 3 of this year in a number of cancer centres. This is a big step forward in terms of offering genetic testing and pre-counselling to those at most familial risk. I will talk to the Minister, Deputy Carroll MacNeill, and ask that she engages with Deputy Callaghan and we will keep in touch on this.