Mary Henry (Independent)

I welcome the Minister of State to the House for this extremely important debate. When someone telephones to say he or she has received some bad news about his or her health, this all too frequently refers to having cancer. This is most unfortunate because the international results for the treatment of cancer have improved significantly within the time that I have been involved in medicine. It is a great pity we cannot emphasise this more strongly but it is important to note that the earlier the cancer is detected, the more effective the treatment.

In some cases, for example leukemia, the survival rate has risen from 10% to between 70% and 80%. The same is true for some of the lymphomas. While the survival rate in Ireland for these cancers matches international standards, unfortunately we are way behind those standards in survival rates for other cancers. Anyone involved in politics should try to swear that he or she will not allow the aggregation of services for cancer treatment to become a party political issue.

Without a shadow of a doubt, if there are specialist areas in designated places the results will be much better. Services as close to home as Northern Ireland are achieving better results than ours in breast, bowel and several other cancer treatments. It is irresponsible of people to seek small stand-alone centres treating maybe one or two cases of a specific cancer every year, when they know the patient's results are not likely to be as good as if he or she were treated in a specialist centre.

People attending a large hospital such as St. James's where there are case conferences with the chemical oncologist, the radiotherapist, the surgeon who will do the work, a physician to deal with other aspects and the anaesthetist, achieve much better results than those attending a centre that treats single cases maybe once a month. I ask those who insist that local hospitals are kept open to ensure they are not being asked to do anything in those hospitals which may have a less than satisfactory outcome for the patients.

I was glad to hear Senator Glynn raise the issue of men's health and cancer. Some years ago the assisted human reproduction clinic in the Rotunda Hospital asked me to try to get funding for the freezing of sperm from young men with cancer, when the chemotherapy or radiotherapy might render them sterile. I asked approximately for how many cases a year it expected to need funding and was told it would probably be in the region of 20. They are receiving 200 cases a year, which is a large number of young men with cancer who want their sperm frozen. When asked if he would like to avail of this service, a young man will immediately believe he will survive the cancer. The psychological, as well as the practical, effect of such a request is extremely good for the patient concerned. I am glad the Department of Health and Children supported this initiative several years ago.

A programme instructing men to consult their doctors if they feel they have a problem is very necessary. Men are extremely bad at going to the doctor. A practical advertising campaign directed at men must be started to say it is a good idea to see a GP if they find a change in their testes, for example. This is better than going six months later when the testicular cancer may have spread.

Internationally, medical experts are not sure whether the incidence of prostate cancer is increasing or that the detection rate has improved. I am inclined to believe it is the former. The prostate-specific antigen test, the PSA, has not proved as useful in screening as originally believed. To launch a national screening programme for prostate cancer may result in many false positives, leading to misdiagnosis.

Bowel cancer is an area where a national screening programme could be successfully introduced, particularly with the faecal occult blood test, a home-test kit in effect. Patients over 50 years of age could be given specific test papers for testing their faeces for three days running, at home. If the test proves negative, they are fine. These home-testing kits have been shown to be very reliable. Such a programme would greatly benefit men as bowel cancer is the most significant cause of death among males.

We still do not have a population register regarding all screening programmes. A decade ago, I asked for such a register to be established but it still has not been. Every time a screening programme is begun, there is messing around with PRSI and VHI numbers and goodness knows what else.

The screening situation for women is only slightly better. However, it is only a matter of time before someone outside the Limerick area with cervical cancer sues the Department of Health and Children because it was not picked up in a cervical cancer screening.