The Government should act now to give cancer patients in the southeast a proper service or the opportunity will be lost, according to the consultant oncologist for the region, Dr Seamus O'Reilly.
Dr O'Reilly, who leaves his post at Waterford Regional Hospital next summer to take up a position in Cork, says cancer patients in the south-east encounter significant hardship in getting access to essential radiation treatment.
He chairs a charity, the South East Cancer Foundation, which is campaigning for a cancer centre to be built in Waterford at a cost of £15 million. "If we don't get it now, if it doesn't happen now, when will it happen?" he asks. "Because after a boom ends there's recession, and other things take priority."
The extent to which the region is disadvantaged was highlighted by Dr O'Reilly when he told The Irish Times last month that some women with breast cancer may be opting to have mastectomies rather than face travelling to and from Dublin or Cork for radiotherapy.
The numbers, he says, are not quantifiable, but he is sure some women have taken this decision. "I cannot say this particular person or that one did, because the factors involved are complex. There are medical, social and psychological reasons.
"But when you see the look on a patient's face when you tell them they must travel to Dublin for therapy which could be available locally, you know that that is also a factor."
Breast cancer patients are not the only ones affected. Of the 1,000-odd people diagnosed with cancer in the south-east every year, between 400 and 500 will require radiotherapy. Treatment lasts three to four minutes a day, five days a week.
"That means someone will spend up to 500 hours away from home for a total of two hours of treatment," he says. Hardship is caused not just by the travelling time but by delays of up to three months in providing what may be life-saving therapy, or therapy to relieve pain and suffering.
"Radiotherapy is a seminal part of cancer care. It is used for all of the common cancers that we treat, such as lung, breast, colorectal and prostate cancer. To truly provide a regional cancer service we must be able to provide radiotherapy in the area."
The picture Dr O'Reilly paints is not entirely bleak. There have been improvements since a medical oncology service was provided in the region in 1998. The service, based at Waterford Regional Hospital with dedicated in-patient beds, has chemotherapy units throughout the south-east and caters for more than half the people diagnosed with cancer in the region each year.
Funds raised by the foundation have been used to refurbish in-patient and day wards and a research unit with clinical trials for the most common cancers treated.
But the lack of an on-site radiotherapy unit remains a "glaring deficit", Dr O'Reilly says. The Minister for Health and Children, Mr Martin, has said the issue cannot be addressed until a working group set up to examine the need for such units on a national basis reports to him.
The cancer centre envisaged for the south-east, however, would have much more than this one unit. "This is not about a public patient in Mooncoin getting the same treatment as a private patient from south county Dublin, but that both should have the same access to the cutting-edge treatment that's available in Washington, Brussels or Paris. That's the gold standard that we should all be aiming for."
A purpose-built cancer centre in Waterford would provide a centre of excellence for patients and their families, providing treatments, counselling and support services as well as research and education, and would have a major impact on people's lives, says Dr O'Reilly.
A tele-medicine link-up with St Luke's Hospital in Dublin would call on existing expertise and avoid unnecessary duplication in Waterford. The benefits would be felt well beyond the region as the centre would relieve pressure on services elsewhere.
In a proposal prepared for the South Eastern Health Board on the need for a cancer centre, the foundation pointed out that there was a shortfall in clinic space, in-patient beds, isolation rooms, rooms for family members, private rooms for patients who were dying, facilities for chemotherapy and office space.
These shortfalls were apparent only a year after the oncology service had come into being and would increase significantly with population growth.
The south-east "suffers a bit because it's near two major population centres", says Dr O'Reilly. "People don't see it as a distinct region in the way they see the west of Ireland. But this is a major region and is surely entitled to have a cancer centre."
The cost of building such a centre, £15 million, would be a one-off, he says. "The running costs would not be much greater than that of the existing service." The foundation believes the funding should come from the Government, as attempting to raise it locally would have a detrimental effect on other charities.
A meeting of the South East Cancer Foundation will be held at Waterford Regional Hospital on the evening of Tuesday, December 5th. People wishing to assist the organisation are invited to attend.
