Timely, supportive care is vital for addressing the documented unmet needs of men with urological cancers. Such interventions prevent and manage adverse effects, reduce burdens and enhance quality of life throughout their cancer journey.

The Irish Cancer Society-funded ‘Liam Mc Trial’ is a cancer survivorship programme, designed with the input of patient representatives who highlighted the unmet needs of cancer survivors.

Cancer survivorship programme for men

An important aspect of the trial is research on how to enhance survivorship support for underserved communities of men with historically overlooked disparities in cancer incidence, prognosis, outcome and quality of life.

The trial aims to assess the feasibility and impact of a holistic and person-centred, 12-week survivorship programme on patients’ physical, social and psychosocial needs and their cancer-related symptoms. The trial will enrol men with genitourinary cancer malignancies — cancers of the urinary and reproductive system such as prostate, bladder and testicular cancer.

The goal is to make this programme a
standard component of clinical care for
all cancer patients in the future.

Individualised support provided by experts

The programme involves twice-weekly input from a physiotherapist, dietitian, specialist nursing, medical social worker and psycho-oncology specialists. Programme oversight is provided by medical oncologists. The main aim of the trial is to assess the feasibility of the Liam Mc Trial programme. Additionally, secondary outcomes will focus on measures such as quality of life; muscle strength and mass; weight maintenance; cancer-related symptom control; and cancer-related fatigue scores.

Helping more cancer patients in their survivorship journey

Study enrolment commenced in June 2023. Over the two-year study period, the total anticipated recruitment is 72 participants. If this intervention proves feasible, the experiences and findings will serve as the foundation for a quality improvement initiative. The goal is to make this programme a standard component of clinical care for all cancer patients in the future.

Early data from this ongoing trial shows high acceptability among men who were offered the programme, and those who participated expressed high levels of satisfaction with the programme itself. One Liam Mc Trial participant shares: “This programme has really helped me through my treatment.” Another discloses: “Up until now, I hadn’t really spoken about my cancer but, listening to the lads talking about theirs, I think I might tell people I have cancer.”

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Pádraig MacNeela

Active* Consent Programme co-lead, Head of School of Psychology,
University of Galway

Recent Irish surveys reveal that many college students report experiencing harassment and sexual assault. Yet, there’s also a prevalent positive attitude toward consent.

How do positive attitudes towards consent exist alongside traumatising sexual harassment experiences? To improve college-based education on consent, The Active* Consent programme is leading the way in Ireland.

Findings on sexual violence and consent in students

• The Active* Consent 2020 national survey of Higher Education students, conducted with the Union of Students in Ireland, indicated that 4 in 10 (42%) female first-year students (and one in five males) experienced unwanted sexual touching within six months of starting college.
• A majority of female college students surveyed agreed they had experienced sexual harassment in the past four years.
• In secondary school pupils, most participants agreed that a smile was enough non-verbal consent for intimacy, such as oral sex.
• Up to one-third of transition-year male pupils surveyed agreed with incorrect rape myth beliefs.
• Despite this, over 80% of young people surveyed say it’s important to talk about consent.

Sustainable consent education and support
for young people requires an equal focus on
institutional ownership and staff capacity.

Changing culture: partnership, youth engagement, staff support

Empowering students nationwide to shape a safer campus, The Active* Champion programme — launched at the University of Galway — provides comprehensive consent training. Rooted in 10 years of research, it promotes a sex-positive perspective and inclusivity. Student Champions, from diverse backgrounds, contribute to a supportive environment where no one is judged for their sex choices.

• Last year, over 22,000 first-year students participated in consent workshops.
• About 90% of workshop participants would recommend it to a friend while 91% learned something useful.
• Workshops led to improvements in self-reported consent management skills, knowledge and confidence that peers consider consent important.

Sustainable consent education and support for young people requires an equal focus on institutional ownership and staff capacity. Over 1,500 staff have trained as consent workshop facilitators since 2016. We partner with Galway Rape Crisis Centre to provide 12-hour First Point of Contact training.

Consent literacy: consent is for everyone

Consent is ongoing, mutual and freely given (OMFG). Consent is for everyone — all relationships, genders and sexual orientations — and each type of intimacy. Young people in Ireland must reach the four signposts for consent literacy:

• Knowledge: accurate information on consent attitudes and behaviours; how alcohol and drugs affect consent; digital intimacy; laws on consent and sexual assault.
• Communication skills: verbal and nonverbal behaviour; what helps or hinders consent; how to talk about consent.
• Confidence: seeking support for themselves or their peers, whether from school, college or a professional service.
• Challenge: being part of the change in our culture that recognises and responds to non-consenting attitudes or actions.

The programme also offers resources for consent awareness, education and training.

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Dr Robert Scully

Medical Director, Student Health Services,
Maynooth University (ISHA Vice President)

The Irish student population (estimated at 350,000 people) bear a disproportionate burden of sexually transmitted infections (STIs), with 40% of all STIs notified occurring in the under-25 age group.¹

Although STIs are usually easy to treat, some can cause serious health issues. Chlamydia is the most common STI but can be asymptomatic in 50–80% of infected individuals. The asymptomatic nature of many STIs means young people often do not seek treatment for their infection.

Helping students prevent STIs

The Irish Student Health Association (ISHA) find students often do not have the skills or experience to negotiate safe sexual health practices. Students are often establishing their identity and making the transition into adulthood. This may lead to experimental sexual behaviours, including high-risk encounters and/or multiple partners.

Equally, not all students are sexually active, and students should not feel pressured into having sex. Importantly, students should be educated and empowered to protect themselves from STIs. They must also ensure consent is always given and that sexual encounters are safe, consensual and enjoyable.

Access to condoms for protection

Studies have found that 47% of Irish students reported inconsistent condom use.² Despite widespread awareness of the consequences of STIs, young people often ignore safe sex guidance, and this places them at risk. One of the most effective public health tools to prevent STIs are condoms. In 2015, the HSE Sexual Health and Crisis Pregnancy Programme (SHCPP) set up the National Condom Distribution Service (NCDS) to supply free condoms and lubricants to target elevated-risk populations, including Irish Higher Education.

Students will receive education from student
health professionals, which is non-judgmental,
confidential and supportive.

Student health services offer advice and STI screening

 Student health services provide an ideal setting for targeted campaigns to reach this at-risk group, promote safe sex practices (including consent) and encourage STI screening. Testing is essential for identifying STIs and limiting their onward transmission. Students are often embarrassed or frightened to seek help, but the methods used today are a lot less invasive than those used in the past, so there’s little to worry about in terms of the testing experience.

Students will receive education from student health professionals, which is non-judgmental, confidential and supportive. Student health professionals have extensive training and expertise in managing the sexual health needs of students. Most institutions offer free or subsidised care. Free, at-home testing through SH:24 is available for students who are not comfortable attending the health centre in person. It is available in every county in Ireland, ensuring access to all students.

Initiatives promoting sexual health practices

Sex education is normalised through Higher Education health promotion campaigns, such as SHAG (Sexual Health Awareness and Guidance) events. The key message is to use condoms correctly every time you have sex (oral, anal, vaginal) and get tested regularly, particularly if you have new or multiple partners.

Staff in student health centres will empower young people to look after their sexual health and provide them with the tools to make safe and informed decisions, which should continue throughout their lifetime.

[1] Sexually Transmitted Infections (STIs) in Ireland: Trends to the end of 2022 Health Protection Surveillance Centre Acknowledgements (2023). Available at: https://www.hpsc.ie/a-z/sexuallytransmittedinfections/publications/stireports/Sexually%20Transmitted%20Diseases%20(STIs)%20in%20Ireland%202022.pdf
[2] Dolphin, L., Fitzgerald, A. and Dooley, B. (2018) ‘ Risky sex behaviours among college students: The psychological profile,’ Early Intervention Psychiatry, 12, pp.1203-1212. Available at: DOI:10.1111/eip.12526.
[3] Lally K, Nathan-V Y, Dunne S, McGrath D, Cullen W, Meagher D, Coffey JC, Dunne C. (2015) Awareness of sexually transmitted infection and protection methods among university students in Ireland. Irish Journal of Medical Science. 2015 Mar;184(1):135-42. doi: 10.1007/s11845-014-1073-8. Epub 2014 Feb 8. PMID: 24510451.

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Bowel incontinence, also known as faecal incontinence, is an inability to control one’s bowel movements. However, effective solutions now exist.

Throughout early life, I was misdiagnosed with ‘diarrhoea predominant IBS,’ and I lived with this diagnosis for 25 years. I would have catastrophic episodes of incontinence. It only got worse. 

Psychological impacts of bowel incontinence 

Every time I lose control of my environment, the panic attacks would begin; the adrenaline would flow; gut motility would increase. I would have no control over my bowel functions. It’s life-altering, and people suffer from it for years because no one wants to talk about it.  

When I was finally willing to talk about it, I felt liberated. It affects your social life; sexual life; mental health — every element of life. The panic attacks could be severe. That doesn’t disappear as soon as you put in the SNS (sacral nerve stimulator).  

More patients and healthcare providers
should be more aware of the success
of finding the right treatment. 

Journey of seeking help for incontinence: ups and downs 

I have had two stimulator devices (also known as sacral nerve stimulation) fitted. Before that, I had seen several GPs and three good gastroenterologists, but they didn’t seem aware of the life-changing treatment available.  

It was only when I went to a specialist hospital, that I got the help I needed. However, even with the wonderful care I had, there was no attention to looking after the psychological effects. 

I had the Interstim II fitted and had that for seven years. Unfortunately, it ran out of battery just as the pandemic hit. I was back to square one for nine months and had to go back to adult nappies. It was very emotionally distressing.  

More advanced solution to bowel incontinence  

When I finally had the operation, I opted for the latest rechargeable microdevice (InterStim Micro). It allowed me to get full-body MRI scans, and the battery lasts up to 15 years. It can completely stop bowel urges.  

The previous one gave me more time. This second one gave me control. This treatment gave me back my life. Currently, there is a new recharge-free battery available. I’m pleased to know there are options I can choose from when it comes time for a battery replacement. More patients and healthcare providers should be more aware of the success of finding the right treatment. 

The post How life-changing bowel incontinence treatment ended my 25 years of suffering appeared first on Health News.

People who suffer symptoms of urinary incontinence are encouraged to seek out a range of approaches that could help ease their condition.

Urinary incontinence can be effectively treated, rather than simply managed with incontinence products and pads. Lifestyle changes, physiotherapy, medical interventions and surgical devices are options that can make a significant difference.

Types of urinary incontinence

James Forde, consultant urologist at Beaumont Hospital and Blackrock Clinic in Dublin, says urinary incontinence is a common problem, affecting men and women, with two main types: (1) stress incontinence, where people experience a loss of urine during exertion; and (2) urge incontinence, which is involuntary leakage of urine and associated with an overactive bladder.

Overactive bladder factors

Studies have shown that it affects about 12% of the population; around 350,000 people over the age of 40 in Ireland have overactive bladder symptoms. Forde, who has a specialist interest in voiding dysfunction says: “Overactive bladder is a condition where people experience urinary urgency, which is a compelling need to pass urine and is associated with increased urinary frequency when you void more frequently than normal.

“A lot of patients suffer in silence or are embarrassed and do not like to tell anyone about it. Nocturia, waking up during the night to go to the toilet, is also associated with urinary incontinence.”

Conservative incontinence management

Forde underlines the importance of raising awareness and urges people to talk to their GP or healthcare professional if they suspect a problem. “They may rule out conditions that are making incontinence worse — such as infections or other medical conditions — and, from there, recommend conservative management options that can improve everyday quality of life,” he adds.

Conservative options for an overactive bladder can be as basic as patients detailing their fluid history — such as if they consume a lot of caffeinated drinks, which can be bladder irritants — or physio such as pelvic floor exercises to train their bladder and reduce overactive and urinary incontinence symptoms.

“We ensure patients maximise all conservative options prior to starting them on medication because, in certain cases, conservative management can be more effective than medication,” Forde continues.

Up to 80% of patients report a
significant improvement with botox.

Surgical interventions for incontinence

For those not improving with medication, surgical options such as botulinum toxin (botox) injections into the bladder can be effective at slowing down bladder activity. Up to 80% of patients report a significant improvement with botox. Though, there can be side effects with some patients (around 10%) having trouble emptying their bladder or developing a urinary tract infection.

Another type of surgical treatment that has increased in popularity is sacral neural modulation, developed by companies such as Medtronic, for overactive bladder patients with urge incontinence.

Forde explains: “That involves inserting leads through the lower back, which produce an electrical current that helps modulate or slow down the activity of the bladder and can be a very effective technique. About 70% of patients see an improvement.” The treatment is a long-lasting solution, aided by prolonged battery.

Seek advice to get effective treatment

In cases of stress incontinence, there are also various procedures and surgical interventions that can help. These also start with conservative management techniques and physiotherapy.

Forde’s overarching message to people who have, or fear they have, urinary incontinence issues is that they should not be embarrassed to seek advice and treatment. “There are lots of treatment options available, including very successful conservative management techniques that we build on to try and improve patients’ quality of life,” he says.

With well-established guidelines and pathways with suitable, safe and effective treatments, there are a range of options — beyond continence materials and pads — that can effectively address urinary incontinence.

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Mr Martin Sweeney

Prostate cancer patient and Patient Advocate

Support groups play a critical role for prostate cancer patients dealing with sexual function challenges post-surgery or radiation therapy, as emphasised by clinicians and patient advocates.

Surgery or radiation therapy can have a lifelong impact on urinary, bowel and sexual function, but clinicians and patient advocates stress that there is support available to help men address this and improve their quality of life after having prostate cancer.

Prostate study on sexual impact

In Ireland, the Irish Prostate Cancer Outcomes Research Programme (IPCOR), funded by Movember, assessed the quality of life impact on men with prostate cancer. It compiled a database of nearly 900 men from 16 hospitals, gathering information on the effects of diagnosis and treatment on sexual, urinary and bowel function.

Principal investigator David Galvin says the study found that less than 10% encountered difficulties with urinary or bowel function, but men reported a massive impact on sexual function.

Professor Galvin, Consultant Urologist and Associate Professor at Mater Misericordiae and St Vincent’s University hospitals, University College Dublin, says: “When a man cannot perform sexually, it has negative consequences on every aspect of his life and his relationships, confidence and self-esteem. It can impact on his state of mind as well.”

Support groups in recovery process

Professor Galvin underlines the importance of support groups in helping men and their partners adjust to the changes. “It is about making sure men have access to that support — and having it delivered at a timely point in their recovery and in a manner in which they would find appropriate and helpful,” he adds.

“This is not only for them but also their partner, whether they are heterosexual or homosexual couples, to help men enjoy intimacy and sex in ways that can be fulfilling.”

He says there needs to be consistency of advice, support and education of healthcare staff in the sexual function area.

Movember — a charity focusing on prostate cancer, testicular cancer, mental health and suicide prevention — has produced Clinical Guidelines for Sexual Health and Prostate Cancer. This evidence-based framework aids clinicians in assessing and managing sexual side effects of prostate cancer therapies — fostering shared decision-making among clinicians, patients and partners.

There needs to be consistency of
advice, support and education of
healthcare staff in the sexual function area.

Associate Professor David Galvin

Patient advocate: post-treatment challenges

Prostate cancer patient advocate Martin Sweeney was 49 when he was diagnosed in 2015.

He warns that failure to appropriately address the issues men face after having treatment can affect mental health. External support is valuable, but he cites concern about insufficient professionally trained support in Ireland outside the treatment pathway.

He adds: “Prostate cancer treatment is very invasive and can leave patients with lifelong residual issues. With sexual function, it is important men can explore ways of having intimate time with their partner.”

Support groups and the topic of quality of life and sexual recovery should be integral and central to the care pathways, insists Sweeney. “However, not every health professional is aware of the need to bring these issues up. Normalising the narrative is the most important thing, and men should understand that they should not suffer in silence.”

Treatment options and further research

Sweeney points to treatments such as Viagra and similar medication, penile injections or implants to improve sexual function as well as peer support and counselling. He also underlines the role of spouses and partners in the process.

IPCOR2, funded by Movember, is about to begin with patient partners included in the study process. Further research will see a biobank established to look for new targets to treat prostate cancer.

Professor Galvin is also working on a pilot prostate screening project for Ireland — similar to bowel, breast and cervical screening programmes — while additional advice is available through ARC Cancer Support Centres.

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Free contraception is now available to women aged 17–30. This initiative was introduced last year, initially for 17 to 25-year-olds and from 1 January, for 26-year-olds. Underpinned by €31.5 million in funding this year, it was expanded on 1 September to include women aged 27–30.

The scheme marks a significant stride towards an equitable health service that supports women through all life stages, a goal I have prioritised since becoming Minister for Health.

The evolution of women’s reproductive rights in Ireland is a long and difficult story, and I’m thankful that, today, we are far removed from the era when contraception was illegal and women were denied the dignity of bodily autonomy.

Five years on from the referendum on the 8^th Amendment to the Constitution that triggered a government commitment to introduce contraception, I’m very proud that the State is funding a fully end-to-end service for women aged 17–30.

What’s included in the 17–30 free contraception scheme?

The scheme covers the cost of consultations with GPs, family planning, student health and primary care centres and prescriptions for the wide range of contraceptive options available on the Health Service Executive (HSE) reimbursable items list.

These options include long-acting reversible contraception (LARCs), injections, implants and hormonal and copper intrauterine devices and systems (coils). The scheme also includes emergency contraception in addition to the oral contraceptive pill, patch and ring. LARC fittings, removals, injections and checks are also free of charge.

The breadth of options allows women to choose the contraception most suited to their needs, regardless of the price tag. In the context of the current cost-of-living crisis, this benefits not just women but their partners and families also.

I’m thankful that, today, we are far removed from the era when contraception was illegal and women were denied the dignity of bodily autonomy.

Responding to public demand

So far, almost 2,400 GPs and 1,950 pharmacies are providing services and products under the scheme, with tens of thousands of women accessing it every month.

In the space of just one generation, the daughters of women who couldn’t legally access contraception can now freely control their reproductive health without cost.

Investing for the future

The prioritisation of women’s health is further reflected in the substantial developments in services for endometriosis, fertility and menopause — to name just a few achievements under the Women’s Health Action Plan. But, we cannot stop here, and I look forward to continuing to deliver on my commitment to providing quality, equitable healthcare for all.

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