Amid concern about increasing cuts in the health service, one cancer patient who has faced a battery of treatment in recent years tells Anne Dempsey why she'll keep fighting the battle against cancer, as well as campaigning for better research funding which could help save lives
Over the past few years, Anne Burns changed from being a honey blonde to sporting a rich chestnut crop. Today, her hair colour is a fairish brown, and she currently awaits another change of shade. But the reason is not vanity, it's survival. She has lost her hair twice following chemotherapy and each time it has grown back a different colour. Now, as she begins a course of radiotherapy, she knows she will be bald for the third time. It's the least of her problems, however.
At the start of 1998, Anne and husband John had everything going for them. Comfortable, successful, they had refurbished a gracious old house in Ranelagh, Dublin, and were thinking about starting a family. Then, in spring of that year, she underwent a mastectomy for a cancerous breast lump. A diagnosis of bone and liver cancer followed and Burns was given a short time to live.
"I didn't really believe it. I was fit and healthy, I still felt well, I didn't think I was going to die.
"Because my cancer was so aggressive, they wanted to treat it with new radical chemotherapy, which would kill all the fast-growing cells. However, it would also kill all the other cells as well. So they took stem cells out of my body, harvested them and later replaced them, enabling them to kick in and fight back.
"The chemo lasted four months and brought me close to death. I was in hospital, being fed intravenously, my weight fell to five stone and I lost my nails and my hair. The treatment ended in the autumn, and then the long tough journey back began.
"Cancer does not let go easily, and in May 1999 we had a setback, with residual cancer in my breast. I was given the all-clear again in October 1999," says Burns.
The therapy affected her internal organs and Burns is now infertile, although adoption remains an option for the future. She returned to her work in marketing management, went back to the gym, saw her weight creep up towards its usual nine-and-a-half stone and her hair grow back in its new surprising shade. "I went scuba diving, trekked in the Borneo jungle, I lived very intensely," she says.
Burns's oncologist is Dr John Crown, head of the Cancer Chemotherapy Research Unit at St Vincent's Hospital, Dublin. While benefiting from his department's pioneering techniques, this patient did her homework and realised that cancer research funding in the State compares poorly with other countries.
"I always said if I get out of this, I want to give something back. I also wanted a personal challenge and the idea of a triathlon emerged. I could cycle and run with no bother, but I had always been afraid of water. I decided to learn to swim and when friends heard, they offered to sponsor me. Then more people became involved. The idea grew."
Hundreds of people took part in the first "Tri to Beat Cancer" last summer. More fundraising followed and a second triathlon took place last month. Burns has now raised €200,000 for cancer research and is confident she will reach her target of €250,000 by next January. "Every single cent raised goes into the fund, there are no administrative costs," she says.
However, Burns has been unable to compete in either event. "A month before the first triathlon, I developed back pain. I thought I had pulled something, but a scan showed up cancer in the bones in my back and in my liver. It was a huge shock. I couldn't have the stem-cell transplant again, the cancer was inoperable so we were talking about control rather than cure."
She began chemotherapy again and went on a new drug regime, intravenously taking herceptin, an antibody which works by inhibiting the growth factor of the tumour, and which produced no adverse side-effects. "It is suitable for one in five people," explains Burns. "You have to be receptive and that's where research comes in - for example, understanding why some do well on it and some do not.
"At that stage, I had a lot of cancer in my body. I was on chemotherapy and herceptin for a year, ending this July because I was so worn out. Dr Crown gave me as much chemo as he could, but it really wears you down, and I recently had pneumonia because my immune system was so low. My hair fell out again and has grown back curly and a lightish brown, which looks more like me. The clinical results were positive, my liver is in remission, the bone cancer is being managed with another drug, and everyone was really pleased.
"But a month ago, I had two episodes of feeling dizzy and off balance and a subsequent scan has shown up spots on the brain. I freaked out at that. I suppose we all have our fears, and when I heard about the brain I panicked, because you worry about some loss of mind control. But Dr Crown assures me that long-term the brain is more treatable than the liver and that I have been in far more danger than I am now.
"So this is not the end of the line. I am due to begin more radiotherapy, The fact is that there is a lot of cancer in my body - I'm fighting a battle in which there will always be blips. At the same time, because of all the advances, there is hope.
'IF I had contracted this cancer five years ago, I would be dead by now. There is treatment available to me now that was not around when I first got sick, and there are more cancer-curing drugs continuing to come on stream. So it's a case of beating the clock, and I'm very hopeful."
Over the past four years, Burns has experienced the health service at first-hand and while praising the dedication of many people, the lack of resources is very visible, she says.
"I was in hospital yesterday for a treatment which should have taken one-to-two hours and took seven hours because the machine broke down. Some people had travelled up from the country and they were still waiting at 11.30 p.m. In some ways, the system is in a shambles and I can only think it will get worse because the budget cuts will show themselves in spending cuts."
Burns is clear about her fundraising aim. "There are only two ways to beat cancer - detect it early or treat it more effectively. Clinical research is poorly developed here, in spite of the worldwide reputation that St Vincent's Hospital has gained in recent years. We don't have a national cancer research body as there is in Britain or the US where there is a huge research lobby, which is why all the drugs we are using originated in the United States.
"Twice as many women recover in the US, where clinical research is heavily funded. Much of this is down to the work of one woman, Frances Visco, a breast-cancer survivor who has persuaded the US government to spend millions of extra dollars on cancer research. She was in Ireland last year to show what can be done. I think we can have an embarrassment in talking about breast cancer and there is still some kind of stigma here attached to cancer generally."
Visco is a good role model, and Burns realises that some view her as the person who could raise the profile of cancer research in this State in a similar way.
"I want more people here to get the treatment they need," says Burns. "I worried when I was taken on by the research unit that someone was pushed off the other end. We have the Irish Cancer Society, which does great work, but in Ireland we have tended to concentrate on counselling and care, which are important, but won't save lives.
"I want to make a difference. I can't see myself fundraising forever. I really want to raise awareness of the need for State and private funding of cancer research. But first of all, I have to get well."
'Breast cancer should be the central feminist agenda of our time, but Irish feminists virtually ignored it. They should hang their heads in shame," says Dr John Crown, director of the Cancer Chemotherapy Research Unit at St Vincent's Hospital, Dublin.
Dr Crown brought American cancer funding campaigner, Frances Visco, here in an effort to raise women's awareness of their role in achieving better outcomes in this State. "A woman is more likely to die here from the disease than a woman in the US. Breast cancer needs advocacy groups, in America the philosophy [of rapid implementation of new disciplines\] was driven by consumers, by the women's movement," he says.
Last year, his unit used triathlon funds for research of drug-resistance programmes, in drug trials for new therapies herceptin and taxotere.
"This year, in addition to clinical research, triathlon funds will be used in laboratory research to identify the cellular mechanism of cancer in order to unravel the mystery of why some cancer cells are responsive to treatment and others not," says Dr Crown.
"We are also using novel treatments to identify weaknesses in the cancer cell, and we have started a major collaboration with the University of California and Dublin City University. Last year, we got a big chunk of Government funding, but traditionally our funds come from industrial and philanthropic sources."
Tri To Beat Cancer is a registered charity. For further information, contact 39 Mount Pleasant Square, Ranelagh, Dublin 6. Tel: 01-4968213 or see www.tritobeatcancer.com