All Ireland Cancer Atlas 1995-2007

Hats off to the cross-border research by the Northern Ireland Cancer Registry at Queen’s and National Cancer Registry, Ireland down in Cork for their co-production of the All Ireland Cancer Atlas 1995-2007. The conclusions and discussion are surprisingly accessible (all sections are linked below). While it may make for chastening reading (or help sharpen up ideas for a New Years Resolutions), it hopefully will inform health service provision, which is timely in light of the appearance of the Compton Review. Of particular interest in terms of shaping health care provision, the report states (p.200 in the Conclusions as linked below):

One value of an all-Ireland atlas is the ability to compare two populations living in close proximity with a presumed similarity in lifestyle and genes, but with different health services. This may serve as a “natural experiment” to separate the effects of health service organisation and its contribution to cancer risk, from individual factors such as genetics and lifestyle. However, it was not our primary aim to look at NI/RoI differences. … The limited data available did not indicate any major differences in cancer risk factors between NI and RoI and there were few systematic differences in cancer risk. For a number of cancers we observed north-east/south-west gradients which might have been related to NI/RoI differences; however there was no evidence of a sharp gradient in the border areas, which would have been expected if this were the case. Some clear differences in relative risk existed between NI and RoI.

 

Some of the higher incidences of particular cancers may be better detection, or, late detection, but at least it is now possible to make some assessment of it.

The sections on individual cancers are below and are worth a look for the maps alone.

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  • Rory Carr

    When I opened my laptop and logged on and discovered this thread jumping out at me I thought, “Damn, John O;Neill’s been reading my mail !”

    That is because, only last week, I found that a prostate biopsy I had taken a few weeks ago has indicated positive for the presence of cancerous cells of medium-range aggressiveness. Tomorrow I begin further testing (with a bone scan) to test if the cancer is contained within the ghetto of the prostate or whether it may instead be a fan of John L. O’Sullivan and Manifest Destiny and decided to spread further afield. The results will determine the treatment regime to be decided upon and this is where my anxieties lie.

    My first concern will be to avoid surgery and secondly, if that is unavoidabe to postpone surgey until after the end of January. This is because my youngest daughter is to be wed on 28 January and the recovery period post-operative lies in the 4-6 week range.

    Since prostate cancer cells thrive among testosterone (indeed depend upon it in order to survive) the eradication of testosterone becomes important and possibly even an infusion of oestrogen hormones which is likely to lead to, er…changes (as the consultant delicately put it), which may include breast enlargement. I joked with my wife this morning that, if we postponed the wedding for six months, instead of accompanying my daughter down the aisle to give her away, I could walk behind her as another bridesmaid.

    Indeed it is strange the amount of humour I am able to mine out of the whole situation and, since one’s mortality suddenly becomes all too certain, stranger still how unimportant impending death now seems. I would hasten to add that this has nothing whatsoever to do with bravery or even with striking an attitude, it is just a mindset that pops up uninvited but, a most welcome guest for all that. I am fortunate to have gained the friendship of two men who are in treatment and recovering (and one who is not recovering) and Herself is treating me extra special which is totally unnecessary since I have no symptoms whatsoever other than the micturation urgency which prompted me to seek investigation in the first place.

    Warning: Guys, if you are over 50 and peeing habits change then seek medical advice. A simple blood-test will determine if your PSA (antigens in the prostate) are abnormally high which may – and, I emphasize, only may – indicate the presence of cancer cells.

    In any case, generally prognosis is good with early treatment unless the cancer has advanced beyond the ability to contain or eradicate and naturally, I hope to have been diagnosed early enough, but that is all in the lap of the Gods as I write, and I really won’t know much more until after the holidays, which is nice.

    Now, if I may return to the body of the thread – I would imagine that the real benefits of the proposed study would be to compare effectiveness of early detection and of treatment regimes in the
    territories participating in the study. This, I would imagine is a case where early harmonisation of testing and treatment throughout the two jurisdictions could be counterproductive when the results gleaned from differing methods may, potentially, lead to more effective methods being observed in the longer term.

    But, what would I know? I’m only a patient.

  • John Ó Néill

    Rory, I’m sorry to hear that. Fingers crossed that everything goes okay.

    For my part, I doubted anyone who posts or comments on here hasn’t direct experience of cancer themselves or in someone close. I just wanted to flag this as a step towards improving future provision of services. Good research, like this, provokes as many questions as answers and should be promoted.

  • aquifer

    Rory Good luck.

    Other stuff in the media suggests that perhaps half of other cancers can be prevented by diet and behavioural changes. Preventative healthcare could save us a lot of trouble later.

  • Mark

    Rory ,

    And just when Arsenal were starting to show a bit of form …

    I hope everything works out for you Rory and I’m sure your youngest is very proud of her old man .

  • Cynic2

    Rory

    We dont always agree but good luck with that. I hope you are successful. If its any consolation its often one of the slowest developing cancers and my own father had it for over 25 yeasr before he died of a heart attack

  • Rory Carr

    Thanks to all for your kind wishes. The goodwill of Cynic in particular mirrors my own response to this morning’s news of the death of Christopher Hitchens in Huston, Texas at the age of 62 from pneumonia, a complication arising from oesophageal cancer.

    I first fell out with Hitchens at the bar of a hotel in Blackpool during a Wilson-era Labour Party Conference sometime in the mid-70’s. The disagreement was ostensibly over Cambodia and an article his fellow journalist, university buddy and SWP member, James Fenton had written thereon (both Fenton and Hitchens were right, and I was wrong), but the reality was that we were both drunk and just took an instant dislike to each other as happens sometimes but is magnified with youth, liquor and testosterone. It was a bit of a shock to discover that he was half a decade younger than myself as we had always seemed of an age.

    I continued to disagree with much of what he wrote over the years while being in deep admiration of his keenly honed ability and many times I found myself warmed by a mellow tone in his writing that gelled with my own emotions on a subject. For his skill, if not always for his opinions, he will rightly be much missed, indeed the moreso perhaps by old antagonists such as myself as I have long realised that we often miss our old enemies as much, if not more, than our old friends. He stayed true to some elements of a shared rebelliousness longer than I in any case – a heavy drinker and smoker and avowed atheist until the end, whereas I packed in the booze some while ago, and tobacco within the last year, and my atheism became less and less certain over the years through openness, willingness and experience.

    Christopher Hitchens 1949-1962, may he rest in peace at last.

    His obituary from the New York Times may be found here:

    http://nyti.ms/tTZ8H7

  • Rory Carr

    Correction; the dates above of Hitchen’s life-span should read – 1949-2011.

    Apologies.

  • Congal Claen

    Hi Rory,

    Really hope you avoid needing the surgery.

    And thanks for the advice should anything start playing up with the waterworks. You may well have saved a few lives today by posting that.

  • Harry Flashman

    Dear oh dear, Rory, sorry to hear your bad news. All the very best with your treatment, enjoy your daughter’s wedding, and keep us abreast (ahem) of your developments.

    Good luck.

  • son of sam

    Rory, as one who has had direct experience of prostrate cancer although thankfully minimal,may I wish you all the best when the full results are known.In these situations the support of family and friends and even Sluggerites is important.

  • Greenflag

    Rory ,

    Sorry to hear of your prostrate problem .For what it’s worth my father in law ‘contracted ‘ similar back in the 1980’s and went on to live a further 13 years in good form with only the past month or so being difficult .

    I read recently somewhere -will try to find the link later and will post it that at certain ages ‘surgery ‘ may do more harm than good and that for people in certain age groups medical opinion seems to be that in more cases than not surgery is best avoided .

    Of course every case is different and I’m sure you will listen to the ‘advisers’ as to the best course of action in your case .
    Good luck in your treatment and enjoy the wedding.

  • Alan N/Ards

    Rory

    I’m sorry to hear your bad news. Hopefully you will soon be on the mend. Good luck

  • Tochais Síoraí

    Keep ‘er lit, Rory. Best wishes.