Madam, - Prof Tom Keane, the State's new director of cancer control, wants most cancer recall check-ups in Irish hospitals to end (The Irish Times, January 22nd). He claims they are unnecessary and that patients do not want them.
On what research, carried out in Ireland, is this claim based? Naturally, patients experience some anxiety prior to a check-up, but the relief experienced on receiving an annual all-clear from the medical experts is better than winning the Lotto!
Prof Keane and Dr J. Reilly maintain that the majority of successfully-treated cancer patients (I am one of these) would be better served by attending their GP. Not so. On alerting my ever-attentive GP to a trivial symptom, a reasonable "wait and watch" policy was advised. However, at my routine cancer check-up at a centre of excellence (St Vincent's Hospital), my oncologist (Prof John Crown) demanded an immediate follow-up that resulted in urgent major surgery in Beaumont Hospital and further treatment at the Beacon hospital to avail of the high-tech equipment there not yet provided in public hospitals. Thanks to my regular check-ups, therefore, I am one of the carefully-monitored surviving cancer patients Prof Keane now wants to exclude from the state's centres of excellence.
Prof Keane also deplores the fact that current practices are physician-driven. Surely the decision to recall any patient must be prompted solely by the professional judgment of the physician dealing with the individual case. Would it not be contrary to medical ethics to base such a decision on the politically-motivated grounds advocated by Prof Keane, i.e. that this "represents money poorly spent"? - Yours, etc,
Madam, - Prof Tom Keane says the practice and culture of recalling cancer patients for years after they have been cured is wasteful, unnecessary and must stop.
I have to ask how this culture developed in the first place. As a doctor myself, I noticed this practice in many outpatients' departments during my training to be a GP and wondered, even then, why this wasteful practice occurred. We know that patients' families often take a lot of trouble to get their relatives to outpatients. Yet in many cases the patient will not be seen by a consultant and little new occurs.
Certainly there are many cases where their local GP could follow up on their care, but consultants seem to have difficulty letting patients go. This practice creates a sense of busyness that makes a bad problem of time management worse.
I hope this observation will be the first by Prof Keane and others to undermine the many wasteful practices in the health service and also support the many areas of excellence. - Yours, etc,
Dr PAUL HESLIN, Oisin Court, Dublin 4.