Based on new European Commission data, Ireland has the second-highest rate of new cancer diagnoses out of all European Union nations, with more than 24,000 new cases every single year.
As Professor Patrick Redmond, a GP, associate professor at RCSI, and leading cancer care researcher notes, cancer is now the leading cause of mortality in Ireland, causing 28% of deaths each year: “It’s a big public health issue. It’s taken over from heart disease as the major contributor in terms of mortality in Ireland.”
While survival rates have improved by 50% over the past decade, to the extent that 65% of Irish cancer patients, across all forms of the disease, now live for at least five years after being diagnosed, Redmond says that this can still be greatly improved by catching more of these cases earlier.
Screening programmes such as those already offered in Ireland for breast, cervical and bowel or colorectal cancers play a major role, and the Irish Cancer Society is now leading a pilot study of a new community-based lung cancer screening programme — the deadliest of all cancers in Ireland.
However, there is also much that each of us can do in terms of self-checking when it comes to spotting the early signs of disease.
Research suggests that it is particularly important to be aware that certain cancers are on the rise, especially in the young, with a study from the National Cancer Registry of Ireland (NCRI) highlighting that colorectal cancer rates in under-50s nearly doubled between 1994 and 2019.
Of course, not all cancers present with early signs which is why some such as prostate and pancreatic cancer, are typically diagnosed at a later stage.
There are some general signs which apply to all cancers such as aches and pains, or losing 5% of your body weight over six to 12 months when you are not intentionally looking to lose weight. This weight loss is linked to the metabolic effects of cancer on the body, weakening the muscles and driving inflammation while abnormally increasing the body’s metabolism.
But various cancers do come with more specific red flags.
Here are the main ones which we can watch out for.
When it comes to testicular cancer, Redmond says that it’s most important to be aware of what is normal for your own body: “It’s about noticing if there’s anything different for you. You know your own body. If you’ve had a lump since you were a kid in a certain position, it’s unlikely to be anything more worrisome now.”
Redmond explains that the majority of people who present with testicular cancer are diagnosed between the ages of 20- 40, and it tends to be in the form of a new lump or swelling which has suddenly emerged: “Anything like that is definitely worth being investigated, so see a GP, and sometimes that will be followed with a testicular ultrasound to evaluate it.”
When caught early, testicular cancer is very likely to be cured through surgery. And early diagnosis also means patients can avoid more intensive treatments such as chemotherapy or radiotherapy.
- 91%
Now the second most common cancer in Irish women after non-melanoma skin cancers, studies suggest that rates of breast cancer are on the rise, particularly among those in the 20-49 age bracket.
According to Col Conway, a community nurse with the Marie Keating Foundation, women should watch out for lumps, thickening or bumpy areas in the breasts that seem different as well as changes in the size or shape of one of the breasts.
Other warning signs include unusual discharge from one or both nipples, bleeding or a change in the direction or shape of the nipple, veins standing out more than usual in the breast, dimpling or redness of the skin of the breast, and swelling in the armpit or collarbone.
“Remember to check your armpits and up as far as the collar bones as breast tissue extends in these areas,” says Conway.
“Breast lumps are common and nine out of 10 are benign, so if changes are noticed, it is important not to panic, but visit a GP or talk to your practice nurse.”
Conway particularly recommends doing a self-check the week after a menstrual period has ended, as breasts may become lumpier or more tender during your period.
For post-menopausal women, she suggests checking around the same time every month.
- 88%
Key warning sign: Painful sex
Redmond points out that cervical cancer outcomes have improved greatly through the introduction of the HPV vaccine, which is now offered to all 12-13-year-old girls in secondary school, protecting against strains of human papillomavirus which cause the majority of these cancers.
He says early detection of cervical cancer will also improve through planned self-sampling tests, which will allow women to test their own cervix rather than needing to come into a clinic to receive a smear test, thus reducing inconvenience, embarrassment and stigma.
When it comes to self-checking, he says the classic early sign of cervical cancer is painful sex.
“Again, it’s about symptoms that are not right for you,” he says. “Painful sex is not right and should be examined, whether it turns out to be something else like an infection or endometriosis.”
In the case of cervical cancer, this typically manifests as post-sex bleeding. “This is because the cervix is irritated [due to the presence of the cancer] and so bleeds,” he says.
- 65%
The second most common cancer in Irish men and the third most common in Irish women, the risk of colorectal cancer increases with age and is most common in the over-60s.
However, with rates also rising in the young, Conway says it is important for all of us to be aware of sudden changes in our bowel habits, with no apparent reason.
“It’s important to know what your normal pattern is when it comes to passing stool, such as how many times a day or week, and what does it look like,” she says.
“Many things can have an impact on poo such as medications, stress, diet and other medical conditions, so knowing your usual will help you detect a change.”
Warning signs include needing to suddenly pass stool more or less often, loose stools, or sudden narrowing of the stool, over a consistent period of six weeks or more. Bleeding can also be a sign, especially blood which is either bright red or dark and tar-like.
Conway points to other possible early signs such as abdominal cramps, pain or bloating that does not go away, as well as feeling constantly tired and lacking energy, even with sufficient rest. For people experiencing any of these signs, she suggests going to see a GP or practice nurse.
- 97%
Many of us acquire moles, but detecting the benign ones from cancerous moles is something of a challenge. Redmond points to the ABCD rule where A stands for Asymmetry, B for Border Irregularity, C for Colour, and D for Diameter.
Moles which are either bleeding and painful, looking more lumpy than possible, or seemingly irregular or changing in shape, are cause for concern.
While a concerning mole should prompt a trip to the GP or dermatologist, there are also an emerging range of AI-driven apps, such as SkinVision, which people can use to help assess their own moles.
- 93%
As Ireland’s biggest cancer killer, contributing to 20% of all cancer-related deaths, more than any other form of the disease, Redmond says that doing more to catch lung cancer early is one of the country’s biggest health priorities.
As with all cancers, it is far more treatable if detected before it has spread beyond the lungs.
A persistent cough, shortness of breath and chest pain are all key warning signs of lung cancer, along with the most notorious sign of coughing up blood.
But Redmond says that while the majority of cases of lung cancer are seen in current or former smokers, 3 in 10 cases in Ireland occur in those who have never smoked.
“There’s a whole campaign around it each year, where we talk about some of these early symptoms,” he says.
- 25%
