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It’s World Cancer Day: here’s the good news…

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Cancer and the Irish community in England and Wales

By Dr Mary Tilki – World Cancer Day 2017

Irish people in Britain have some of the highest death rates from cancer in the population of England and Wales. Part of the reason for the high incidence of  cancer in the Irish community is because we are an older population. Cancer is more common and sadly less well treated in older people. More worryingly these high rates are also found in the second and third generations – our children and grandchildren. Rates of death from cancer are going down in the UK, but rates for Irish people are going down more slowly and some are even rising. 

Research has shown that people from Irish and other migrant communities are less aware about cancer. They don’t talk about it, they don’t go for screening, they don’t get treatment early enough and therefore there are high rates of premature mortality in those communities.  We Irish even avoid saying the word “cancer”, instead calling it the “big C” or talking about growths or masses.    

Good news about cancer!

Doctor

Being diagnosed with cancer is clearly frightening and fear is a natural reaction. But our fears should not prevent us seeking help and recognising that there is good news about cancer. The good news is that the earlier cancer is picked up and the earlier it is treated, the more chance of a cure or less taxing treatment there is.  

Great strides have been made in the detection and treatment of cancer and many are now successfully cured, especially if diagnosed and treated early. 50% of people diagnosed with cancer today will live 10 years and beyond. Two out of three women with breast cancer now live beyond 20 years if it is picked up early enough. 35% of women diagnosed with ovarian cancers will survive 10 years or more but if detected at the earliest stages there is a 95% survival rate. 63% of women with cervical cancer will survive 10 years or more and that rises to 95% if diagnosed at the earliest stage. 57% of people diagnosed with bowel cancer will survive 10 years, again this goes up to 90% if it is picked up early.

Sadly there is less progress with other cancers. Pancreatic cancer survival rates remain low and lung cancer incidence still an issue especially for Irish women. Survival rates have not shown much improvement for these cancers but the earlier they are diagnosed, the better the survival rates.  

Cultural reasons why Irish people do not seek help early

Obviously, there is a danger of assuming all Irish people behave in the same way, but our experience suggests there are some common factors which contribute to late diagnosis and therefore poorer survival.  Irish people are reluctant to accept the cancer screening that is on offer, seek medical help late and are diagnosed later so therefore treatment is more aggressive and less successful. 

Older people in particular are reluctant to bother the doctor thinking that their  problems are never as bad as anybody else’s.  

Although cancer rates are improving considerably, the rate is slower among older people.  Men are worse than women. They are big and strong and don’t fuss.  We need to encourage friends and family to seek medical help.

We Irish can be intolerant of people who we think are preoccupied with their own health, always ill or always going to the doctor. Also if the doctor tells them there is nothing wrong or they are being over anxious, they don’t argue. Many older people especially are afraid to question people in authority such as doctors. If they are fobbed off, they are less likely to go back, even though the symptoms persist.

Many Irish people are embarrassed to talk about bowels or waterworks. Some people have even thrown the bowel cancer test in the bin rather than fiddle with a bit of poo! We don’t like talking about our private parts. Vaginas, vulvas, anuses and penises are strictly taboo, so we don’t go for cervical screening, mammography and men are particularly reluctant to have prostate examinations.

Irish people are also reluctant to seek professional help if they think they might be in some way to blame for their health through smoking, drinking, bad diet etc. A few believe that their suffering is a punishment from God and it has to be tolerated. People will treat themselves with over the counter medicines. Others rely on prayer, novenas or candles. Although this is important coping strategy, it should not delay getting professional help.  If you believe in the power of prayer, pray for the courage to go to the doctor, pray that the doctor will listen, refer you quickly and if cancer is found, that you will have best consultant and the finest treatment.

What to do if you are worried?

Go to your doctor if you have signs you are worried about. Cancer can be difficult to diagnose in the early stages because the symptoms could be related to a number of different disorders which are not cancer.

Make a note of your symptoms, keep a diary if necessary, be firm but insistent that you want to be investigated.  Don’t be fobbed off.  Take somebody with you, if you don’t feel strong enough to insist on being investigated. 

If you don’t have cancer, the sooner you know, the less worry you have and if you have cancer, the earlier it is treated, the better chance of survival and less aggressive treatment you will have.

When cancer may run in a family

It is important to recognise that there is a strong genetic link to a number of common cancers.  If there is a genetic risk in your family, you, your children and grandchildren may be able to modify lifestyles, ask for screening or take action to reduce risk. It is possible your family may have an inherited cancer gene if:

More information on cancer in the Irish community

Cancer Factsheet 

Dementia and cancer in the Irish community 

Information specific types of cancer, investigation and treatment    

Cancer Research UK

Macmillan