‘It affects your nervous system, your brain, your thought process’

When Dublin hurling coach Eoin Roche looks back at professional sports photos of him at the end of 2018, he can now see what he wasn't aware of then – a lump on his neck.

It was the following February before he noticed it and went to the GP. A non-drinker, a non-smoker, and fit and healthy through a lifetime involvement with GAA, he wasn’t particularly worried.

“What are you doing tomorrow?” was her first question to him after examining it. That was the beginning of his cancer “journey”.

“I don’t why people call it a bloody ‘journey’ because that makes it sound like you go on holidays,” says the 42-year-old of the “going through hell and out the other side”.

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The initial ultrasound and biopsy were inclusive; a puncture biopsy had to be done because the tumour was so hard. Even before the results were back, a consultant was telling him in mid-March: “I’m pretty sure you have HPV-related neck cancer” – and booked him in, there and then, for surgery on May 7th. The lump in his neck was a secondary cancer, with the cancer having originated in his tonsil.

As the father of two young boys – Clark was two at the time and Rian just four months – the diagnosis “frightened the shit” out of him.

“There is nothing as important as your kids and the fact that you might not be there to support them and mind them is a terrifying prospect.”

HPV stands for “human papillomavirus”, which is a group of more than 100 viruses. Eoin was aware that it is transmitted through sexual activity but he also knew that contact with HPV is extremely common – about 80 per cent of people encounter the virus – “so beating myself up about that wasn’t logical”. Nearly 550 HPV-associated cancers are diagnosed in Ireland every year and one out of four of these are in men.

After his surgery, a seven-week treatment programme of chemotherapy and radiotherapy sessions followed, starting on July 1st.

The initial plan was for him to have three large doses of chemotherapy and 35 radiotherapy sessions. However, after his first chemotherapy treatment he lost hearing in his left ear and had bad tinnitus, so it was decided he should have five, smaller doses instead.

“Horrendous” is how he sums up the treatment.  The cocktail of drugs needed to reduce the sickness from the chemotherapy “kicks off other stuff”, he explains. He had never realised that constipation could be such an issue and that was only one of many side-effects.

Thought process

“It affects your nervous system, your brain, your thought process. Not only are you sick, you’re not 100 per cent upstairs. When the mind is a little bit affected as well it doesn’t help. Then there is the pain.”

After the 35 sessions of radiation – for which lying completely still in a metal mask “feels like torture” – there was a lot of soreness in the inside of his mouth. “Ulcers start and you develop a form of thrush in your mouth that is quite painful.

“On the flip side of that,” he says in a more positive tone of voice, “if you do everything you’re told by the medical team, you cope with it.” He found it “massively” helpful that medical staff could outline “everything that would happen, literally to the day”.

His treatment finished on August 16th last, two days before the all-Ireland hurling final. But there was no way he could get out of bed to go to Croke Park.

For Eoin, it was only while recovering from the treatment and awaiting a PET scan in November that the fear of dying became very real.

“I had a purpose and an aim when I was going through treatment but when you are waiting for a PET scan there is nothing you can do and you have a lot of time on your hands. Obviously, your mind plays tricks and you have those moments of ‘what if?’.”

Just before Christmas he started to feel human again and he is hoping to start a phased-return to work within weeks.

Eoin is acutely aware that this ordeal, which has robbed him – and his family – of the best part of a year in the prime of his life “could have been completely prevented” if the universal HPV vaccination programme now running in schools had been available when he was a boy.

It is “absolute lunacy”, he says, for any parent not to let their child benefit from this medical advancement and his sons will certainly be vaccinated when their time comes.

“I can’t understand why you would take a chance”.

Boys were included in the HPV vaccination programme for the first time last autumn, nine years after it was introduced for girls only. And this week,(from February 24th) HSE public health teams are starting to go into secondary schools around the country to give the second of the two doses to first-year pupils.

Although figures for the uptake of the current round of vaccinations are not complete, the HSE is reporting that in Clare it is almost 90 per cent for both girls and boys. Clare is the native county of the prominent HPV vaccine campaigner Laura Brennan, who died of cervical cancer at the age of 26 on March 20th last year.

Cervical cancer

With uptake of the HPV vaccine for girls having dropped to a national all-time low of 50 per cent in 2017, on the foot of “scare” campaigns fuelled by social media, Laura dedicated the time she had left after her diagnosis of terminal cancer to show parents “the reality of an unvaccinated child”.

"In essence, she was just an ordinary girl facing death from a preventable illness and that was one of the reasons she was hard to ignore,"  her brother, Fergal Brennan, told a Global Vaccination Summit in Brussels last September.  "Laura gave this horrible illness that is cervical cancer a powerful, relatable and beautiful face."

Eoin was inspired, he says, by Laura trying to ensure that “people like her and people like me don’t have to go through this”. He contacted another of her brothers, Kevin, at the end of last year to find out more about the sports jersey initiative that the family had started, to raise awareness of the HPV vaccine.  As coach of DCU’s Fitzgibbon Cup hurling team, he wanted his players to have the logo on their training jerseys.

While “it would have been better if we won”, he remarks wryly of them losing to UCC in the fifth minute of added time in the semi-final, the team wore the branded training jerseys for the cup campaign.

He is intent on putting out the word that “male HPV cancer is a real thing”. He knows parents who have given consent for their sons to be vaccinated but still “they don’t seem to realise you can get head, neck, anus, penis cancer from this”.

Meanwhile, he is trying to make up for lost time with his family.

“I have only got to know Rian in the last couple of months.”

Eoin had been exceptionally busy when his second son was born, working, managing the DCU Fitzgibbon Cup team and being a coach-selector with the Dublin senior hurling team. “My time with him was basically three o’clock in the morning – then I get sick and I am no longer doing that.”

He would have been very tight with his eldest son Clark from the day he was born. He was often off work during the week and did a lot with him then. Then when illness struck, “as a two-and-a-half-year-old, he didn’t understand where his Dad was”.

As recently as a couple of weeks ago, Eoin was due to for a check-up and while he usually tells his son he is going to the hospital, this time he told him he was going to the shop. “And he turned around and said ‘no, daddy is sick in the mouth’.”

Clark would have seen him in the past, he explains, having a lot of difficulty brushing his teeth and getting sick. But Eoin and his wife Andrea hope it has not unduly affected him.

“He is three; every time he throws a fit, it may because his daddy was sick or it could be just because he is three.” They will never know.

Massively tough

Eoin says it has been “massively tough” on Andrea, who has had to “park her career” as a solicitor.  She became the sole carer of their two children, along with nursing her husband at their home in Celbridge, Co Kildare, and organising all his transport and food. Just to add to her difficulties, on week five of Eoin’s treatment, she fell down the stairs with Rian in her arms.

“It was on the August bank holiday; the one day I wasn’t in St Vincent’s, my wife was in St Vincent’s getting a boot put on her.”

She had damaged ligaments in her ankle. While she went to Sligo with the two children to get help with their care from her family, Eoin’s father took over his care at home – “41 years of age, being baby-sat by your 71-year-old Dad”.

But they all got through it and now the prognosis for Eoin is good.

“A three per cent chance of it coming back, very small,” he says. But, of course, “you can never be as definite about your health again. There are moments when it is more real than not, when you are going to meet your consultant and stuff like that,” he adds. “There are periods when you forget sometimes – but they are few and far between.”

Read
- What you need to know about immunising your child
- Every day I wish I could have availed of the vaccine