The Claire Byrne Show
Is Ireland prepared for a surge in cancer cases expected in the future?
30 Apr 2026
Transcript generated automatically by AI and may contain errors.
Chapter 1: What is the main topic discussed in this episode?
The Clare Byrne Show on Newstalk. With Aviva Insurance. My next guest has warned that Ireland may be unprepared for a surge of cancer cases that are expected in the near future. Professor John Kennedy is retiring co-director of the Trinity St. James's Cancer Institute with over four decades of experience in cancer treatment and research. And he's here with me now. You're very welcome. Morning.
Thank you for being with me.
Chapter 2: What warning does Professor John Kennedy give about cancer cases in Ireland?
So congratulations, I suppose, on reaching this point in your career where you're ready to hand over the mantle. How do you feel about it?
I feel mixed emotions. I think most people would answer the question that way and I would too. I've really enjoyed my time working. It's been a fantastic time to be involved in cancer care in Ireland because services have improved so dramatically over the last 30 years. It's been fantastic to be part of that. Internationally, care for cancer has really improved as well.
Outcomes are far better for patients. That's been incredibly gratifying.
And you've witnessed all of that change because you were in America for the first 10 years of your career. Is that right?
Yeah, I graduated in 1983, did my basic training in Ireland, did a little bit of oncology and then went to America for 11 years. I was at Johns Hopkins for 11 years doing cancer research and care there. And I saw how... I mean, it was quite a revelation to me at the time. I saw how cancer care should be delivered, and that was not the way it was in Ireland in those days.
And I remember seeing a lady one morning who came in to me with severe headaches, and I was quite concerned. She had brain metastases, and she had an MRI scan at lunchtime confirming that, and she started radiation the following morning. And I thought to myself, that was the way to do it.
And now, thankfully, in Ireland, that is the way we do it because of all the advances that have been made and the improvements in service.
So when you came back to Ireland then, the difference must have been stark between what you had seen in America, right?
The difference is always substantial between what you see in America and what you see in a publicly funded healthcare system like we have in Ireland because it's a different funding system. There's an awful lot of money in the system. It is different. There's no doubt about it. And, of course, Irish people, trainees who go to work in America, go to the very best centers.
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Chapter 3: What improvements have been made in cancer care in Ireland over the last 30 years?
There are a variety of reasons for that. Firstly, we have an increasing population. So the population has increased by 15% over the last 10 years, but the population of people over 65 has increased by 36%. And those are the people that get cancer. So the first thing to say is that pure, simple demographics tell us that we have an increasing demand all the time.
Secondly, we have far better therapies for patients. So there is a much wider range of active treatments for patients that are effective. And therefore, those patients require more treatment. They live longer. They require more follow-up, more scanning. There's just a series, a host of factors that are increasingly pushing on demand and resource allocation.
And that's only going to go in one direction.
So a lot of this then is about aftercare as well. People who've been through cancer treatment will need follow-up care.
So the great news is that we have about a quarter of a million people in Ireland who have been probably cured of their cancer and all likelihood have certainly survived their treatment and look like they're doing very well. But they will have toxicities of treatment and toxicities of their disease that will last and that will require ongoing care. So that's kind of the price of success.
And that is an area that has been focused on recently, but we'll need more of that.
Okay, and is there a lack right now when it comes to those services, or are you predicting this is what's going to happen into the future?
Those services are in evolution. They are improving. The NCCP has done quite a bit of work developing those. Individual cancer centres develop those as well. But we need to be able to provide services for patients who've had surgery for prostate cancer, who've had radiation therapy to their head and neck. I mean, all these things produce long-term ongoing issues.
The other point I would make out is that we have a host of new treatments for cancer that are based on immune therapy and they have produced phenomenal results for diseases that previously were very difficult to treat like malignant melanoma and lung cancer, etc.
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Chapter 4: How does the healthcare system in Ireland compare to that in America?
Cancer is a lifestyle disease associated with aging. But it's increased by obesity, it's increased by alcohol, it's increased by lack of exercise, by exposure to ultraviolet light, and by smoking particularly. So there's a huge lifestyle implication for cancer. I would like to make one point, which is very interesting, and you've just brought it up there.
There's a substantial increase all through the Western world. in younger patients with certain cancers, particularly colorectal cancer. And we don't know why that is, but we think it may well be related to lifestyle changes, perhaps with diet. And they may have been lifestyle changes that began 30 or 40 years ago. And we're starting to see the effects now. So there's a lot to be teased out there.
What we are eating.
What we are eating.
Potentially. Potentially. Not a proven link yet, but the suspicion is there.
Well, it's got to be high on the list of possible causes.
We heard yesterday at an Oireachtas committee about our radiography machines. 80% of them need to be replaced. That's an astonishing figure.
So we're talking about radiation therapy, which is a very, very important core part of treatment for patients with cancer. We have a very old cohort of machines in the public service in Ireland for radiation and they need to be replaced. And some of them are more than 15 years old. And, you know, it's a real problem because it's not simple to get these machines in place. They're very expensive.
There's a huge program of work around getting them in. And you have to continue to provide a radiation service at the same time. I think it's a problem that has been allowed to develop, unfortunately. And I think it points to a bigger problem, which is a lack of...
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Chapter 5: What concerns does Professor Kennedy have for the future of cancer care?
That's an emergency. But I'm talking about very much routine care. If you're a patient diagnosed with colon cancer and you have superb surgery, radiation in this hospital, in this country, that you get the excellent therapy, you then need to be followed carefully to make sure you don't have recurrent disease.
And that involves having, for the first few years, having routine scans, routine endoscopy. Our ability to provide that in the appropriate time scale is really a problem because it tends to get pushed to one side because of emergency requirements. And we don't have the capacity to deal with that. And that needs to be addressed. There's no doubt about that.
I've been told by some of our senior nursing colleagues that they spend about 20% of their time trying to get patients into scans for important staging scans or follow-up scans that need to be done for proper management of patients. That's a waste of time. that's a massive waste of time. We should be investing in infrastructure and equipment and facilities.
So you mentioned you were involved in the National Cancer Strategy 10 years ago. As you leave the service now, are you happy that there is a plan, that there is a strategy?
There's going to be another National Cancer Strategy. One of the great kudos you get in Europe, if you go to Europe, is that you guys have had a National Cancer Strategy every year since the first one of 1996 by Professor Fennelly from St. Vincent's, which was the first of those. And It's a really important roadmap.
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Chapter 6: How is the increasing population affecting cancer treatment demands?
You may not deliver everything. It may not be perfect, but it says this is what we need to focus on for the next 10 years. And I think that it's taken very seriously by the substantial number of people that contribute to it. And I think it's a very good thing that we do that. And we will be doing it again. I understand that plan to do it again.
But I assume, you know, in the plan that you were involved in, you would have said about the machines and the infrastructure and the IT and so on.
And here we are. There was, I mean, a document like that is very long and it goes through a very large number of things, starting with prevention, early detection, access, treatment, follow up, survivorship, clinical trials. Some of the recommendations have been well implemented and they're ongoing. Some have not been implemented because COVID interrupted, for instance.
And others simply have not made it to the top of the pile of things to be done. I think one of the things that I would comment on, and this was recently brought out at the ā I think the PAC by one of the CEOs of one of the Dublin hospitals, is that the notion that every year there's an annual funding ā
discussion for cancer care, but other cares as well, obviously in major hospitals, is an issue. We need to be thinking about multi-year funding to get programmes delivered rather than having stop-start funding. That is very difficult to plan, highly complex, multidisciplinary care.
You can't do a multi-year plan on that basis.
It's very difficult and we need to think about that. How do we address that? It's a bigger problem.
So as you leave and head off, I hope to enjoy life, will you miss it?
I'll miss my colleagues. As I often say, I'll miss the nurses. They're great to work with. One of the huge strengths of the Irish system is the quality and extent of specialist nurses that we now have in cancer care. And we've always been very lucky in being able to bring back really top class physicians, doctors, surgeons, et cetera, from America.
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