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New clinical trials the key to beating cancer

Denise McNamara

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The value of clinical trials has been highlighted with the announcement that terminally-ill cancer patients could be “effectively cured” using a new combination of drugs heralded by scientists as a once-in-a-generation breakthrough.

The results of the trial have been described as “spectacular” with nearly 60% of patients with advanced melanoma having their tumours shrunk or brought under control by the use of the immunotherapy, which uses the body’s own immune system to attack cancerous cells.

Professor Roy Herbst of the Yale Cancer Centre in the US said immunotherapy could replace chemotherapy as the standard cancer treatment within the next five years and the potential for long-term survival or “effective cure was definitely there”.

In the international trial, 945 patients with advanced melanoma were given the drugs ipilimumab and nivolumab. The treatments stopped cancer advancing for nearly a year in 58% of cases, with tumours stable or shrinking for an average of over eleven months.

Mary Higgins from Annaghdown is one of 13,000 Irish patients who have taken part in a clinical trial.

In 2013, there were 16 Irish hospital sites participating in 102 clinical trials affiliated with The All-Ireland Cooperative Oncology Research Group (ICORG) – a 30% hike on the previous year.

Clinical trials get access to medicines not yet available in pharmacies but which have in the main been approved by overseas drug authorities.

It is now thirteen years since Mary was diagnosed with breast cancer as she was about to turn 41. She underwent a mastectomy and had her ovaries removed. She had chemotherapy in Galway and radiotherapy in St Luke’s Hospital in Dublin and was given the all-clear.

Eight years later a metastatic tumour was discovered in her hip. She had a pin inserted into the bone to reinforce the hip and underwent radiotherapy.

Last year she woke up with a horrific pain in her ribs overnight.

An x-ray revealed the cancer had returned, this time in her spine and ribs.

“When I say horrific pain, I mean really excruciating, I was barely able to get out of bed. They decided to treat the most severe areas with radiotherapy and that gave me some relief. I had scan after scan, check up after check up and my consultant Prof Maccon Keane who’ve I’ve been under from the beginning, said to me I’d be a great candidate for a clinical trial,” explains Mary.

“He said I’d have a one-to-one nurse, more checkups, very regular assessments and the chemotherapy was less severe.”

The clinical trial involved the chemotherapy drug Capecitabine, which is given orally instead of intravenously every day. After a year Mary and her medical team are extremely happy with the results.

“I have very little symptoms. I’m not sick. I haven’t lost my hair which is a huge factor. I’m able to function. I don’t look sick. I do it at home, I go in every six weeks for a scan and a check up and come home with my bag of tricks, which has the medicine for six weeks. It’s brilliant,” she says.

“I don’t want to count my chickens but it’s certainly working for me. This time last year I felt as if my ribs were broken. Now not a bother. I’m back walking again, I can do all my housework, baking, meet friends for coffee. I couldn’t paint the house now, but right now is Mary time so that’s fine.”

Mary took redundancy a year ago from an office job at O’Connor’s TV and Electronic Repair Services after 34 very happy years. She has the support of a “wonderful” husband Michael, three children, who are now aged between 23 and 17 and her sisters, which she describes as “class acts”.

“It’s been horrific on them. My youngest son was only four when I was diagnosed. They have more questions now, I can’t fob them off, I didn’t want to be using the word cancer, but now I tell them everything. They’re a great help,” she muses.

The main source of complaint from Mary is the financial burden of the disease – up until March she had to pay €144 a month for medication after being continuously refused a medical card but she still has to cough up for consultants (at one stage she was under three different ones) and hospital parking.

“There’s no point in lying down and crying about things. I take every day as it comes. You just get up and go. I had a privileged life except for the illnesses. I had the world travelled. I had wonderful holidays, a wonderful job. I’ve always been a positive person.”

Mary advises anybody going through cancer treatment to enquire about the possibility of a clinical trial.

“I still have a lot to go through myself, but I would encourage anyone who is considering treatment options to ask your doctor about clinical trials to see if they are an option for you. A clinical trial can offer you the best treatment and there is something nice about knowing that you are helping patients who are coming after you.”

Oncologist Dr Ray McDermott, interim head of the Ireland Cooperative Oncology Research Group (ICORG), said significant strides had been made in cancer treatment which is largely as a result of clinical trials.

“Every medicine that is available now is available because of the people who have participated in the trials that preceeded.,” he stated.

“Participating in clinical trials is not something to fear and our research demonstrated that almost 50 per cent of people participated in order to get access to medicines that are not currently available and at the same time contribute to the treatment options that will be made available to other people living with cancer in the future.”

CITY TRIBUNE

Designated drinking zones in city centre are ‘only solution’

Stephen Corrigan

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From this week’s Galway City Tribune – Properly staffed designated areas are the only solution to out-of-control outdoor boozing, according to the city councillor who drafted the city’s drinking bylaws.

Cllr Peter Keane told the Galway City Tribune it was likely that councillors would seek to ‘tweak’ the existing bylaws in the near future to find a long-term solution that would enable young people to ‘enjoy a drink outdoors in a safe and controlled environment’, not just now, but in the future too.

To avoid a repeat of scenes around Spanish Arch over recent weekends, the Fianna Fáil councillor said providing areas where the consumption of alcohol was allowed would enable Gardaí to properly enforce the drinking bylaws throughout the rest of the city.

He said he could ‘absolutely appreciate the concerns of residents’ in the Claddagh and elsewhere where anti-social behaviour including urinating in gardens ‘and worse’ had been a blight in recent weeks, but said with proper control, those worst excesses could be avoided.

In the first ten days of June, 83 on-the-spot fines were issued in the city for drinking in a public place.

And last Saturday night, Gardaí closed off the Quincentenary Bridge after hundreds of young people gathered on the carriageway and turned it into a “highly-dangerous road traffic risk situation”.

“Control is the key word for me. Gardaí don’t have the resources, nor do they have the appetite as far as I can see, to deal with the lack of control there has been during the recent good weather.
“If you were to designate, say for example the Spanish Arch or a green area in Salthill, where the bylaws didn’t apply, you could put a number of wardens in place there to control the situation. You could provide adequate bins and toilets, and enough bodies to staff it, and that would allow gardaí to police the bylaws elsewhere,” said Cllr Keane.
This is a shortened preview version of this article. To read the rest of the story and coverage of the re-opening of the hospitality sector and outdoor dining, see this week’s Galway City Tribune. You can buy a digital edition HERE.

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CITY TRIBUNE

Dispute simmers between businesses and Council over outdoor spaces

Dara Bradley

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From this week’s Galway City Tribune – Friction between businesses and local government over the reclaiming of public space to facilitate outside hospitality marred the beginning of the city’s ‘outdoor summer’.

Galway City Council has come under fire over its handling of plans by bars and restaurants to use street furniture to facilitate outdoor dining and drinking.

Most city watering holes and eateries resumed trading on Bank Holiday Monday – serving outdoors only – for the first time since Christmas, and the authorities reported that it was successful for the most part, although it needed time to ‘bed in’.

The city vintners’ group said its members with adequate outdoor space were happy to be back and described the mood as ‘euphoric’ in places.

But several outlets expressed disappointment with the Council.

In Eyre Square, the Skeff Late Bar and Kitchen claimed it had to cancel 200 advance bookings – up to 800 people – for this week, after the Council refused permission for “extended outdoor seating”.

On Middle Street, Sangria Tapas Restaurant lashed the Council for refusing it permission to use certain types of awning and windbreakers to facilitate outdoor dining. “Surely the powers that be can take time to support the industry that supports the city?” its proprietor said in a complaint to City Hall.

‘Back the West’, businesses criticised the Council for rowing back on promises to provide additional outdoor space on Dominick Street Lower and Dominick Street Upper, in time for outdoor hospitality’s reopening on June 7.
This is a shortened preview version of this article. To read the rest of the story, see this week’s Galway City Tribune. You can buy a digital edition HERE.

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CITY TRIBUNE

Council chief: ‘landlords see 4% rent increase cap as a target’

Enda Cunningham

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From this week’s Galway City Tribune – The Chief Executive of Galway City Council has said that the 4% annual cap on residential rent increases is now seen as a target by many landlords.

Brendan McGrath said that affordability continues to be a major problem for renters in the city and that an increasing number of people availing of the Housing Assistance Payment (HAP) scheme have to pay ‘top ups’ to their landlords.

The HAP scheme replaces rent supplement for those with a long-term housing need – the individual finds a private rented accommodation within specific rent caps and the Council pays the landlord directly. The tenant then pays a rent to the Council based on their weekly household income.

The maximum monthly rents under the scheme range from €330 for an adult in shared accommodation to €900 for a single parent or couple with three kids.

Based on their household size, tenants can also apply for a 20% extra ‘discretionary’ payment on top of their HAP payment.

However, Mr McGrath said many on the HAP scheme in Galway have to pay top ups to their landlords.

“Rents as a percentage of income is increasing and affordability remains a major problem for the city’s renters. The majority of HAP tenants require additional discretionary payments to assist them in maintaining their tenancies, particularly single person households.

“An increasing number of HAP tenants now have to pay top ups to their landlords even with the 20% extra HAP discretionary payment applied for their particular household size,” Mr McGrath said in a report to councillors.
This is a shortened preview version of this article. To read the rest of the story, see this week’s Galway City Tribune. You can buy a digital edition HERE.

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