A Co Down man has opened up on being diagnosed with a less survivable form of cancer just over a year ago which led to months of gruelling treatment which included having his stomach removed.
Dad-of-three Paul Marshall was speaking as new data reveals that more than half (62%) of people in Northern Ireland diagnosed with a cancer of the lung, liver, brain, oesophagus, pancreas or stomach will die from their disease within one year.
The 60-year-old from Bangor was diagnosed with stomach cancer just four days before Christmas in December 2023 after experiencing a range of symptoms for around a year.
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Stomach cancer is a slow growing and silent form of disease with no screening mechanism while the symptoms tend to be non-specific. There are many possible symptoms of stomach cancer, but they might be hard to spot.
They can affect your digestion, such as: heartburn or acid reflux; having problems swallowing (dysphagia); feeling or being sick; symptoms of indigestion, such as burping a lot or feeling full very quickly when eating. Other symptoms include loss of appetite or losing weight without trying to; a lump at the top of your tummy; pain at the top of your tummy or feeling tired or having no energy.
Despite the disease being advanced by that stage, Paul, who works in photo/video/3D and virtual design, says he was fortunate that his cancer was diagnosed before it had spread more widely.
"Sadly, most stomach cancers are found too late for ‘cure’ because they have spread beyond the original tumour. This happens because the early symptoms are non-specific and easily disregarded as less serious stomach upsets. By the time it becomes obvious, it is too late,” he explained.
"My ‘good fortune’ was that I was diagnosed early enough for treatment and surgery to be a pathway when only one in five stomach cancers are identified early enough for curative options to be available, which is a tragedy. Statistically the vulnerable group are men aged 55+ with lifestyle components that increase risk such as smoking, lack of exercise and poor diet.
"I've spent the year since diagnosis receiving chemotherapy and having my stomach surgically removed at the Cancer Centre at Belfast City Hospital in May 2024 and recovering from the physical and emotional trauma. The impacts of the treatments have been and continue to be very challenging, between early weight loss and having had my stomach removed I went from weighing 80kg to 55kg."
Paul is now urging others experiencing any symptoms that are out of the ordinary to get checked without delay: “After ignoring persistent symptoms, I am cancer-free today because I eventually went to the doctor. If my symptoms had faded, I would have forgotten about them until it was too late. I now know that acting swiftly and not ignoring persistent issues in the stomach area is life-saving. Yes I am greatly weakened but I'm alive, without cancer, have been wrapped in love and feel grateful to be still here.
“The physical and emotional toll has been, and remains, enormous. Yes I won the war but now I’m struggling to come to terms with the life changing physical legacy that is the ‘peace’ and overshadowed by the knowledge that the cancer may return. I remain grateful however because every challenge met today means I have a dawn tomorrow. Giving up has never been an option but it’s not an easy path.”
As a result of his experience, Paul created Bodyshots, an art exhibition about stomach cancer and how resilience, community and love were important factors for him in facing the disease. It used images of Paul’s healed scar and weight loss to illustrate the impact of the various assaults on his body during the 12 months from diagnosis to completing treatment. Alongside the images were a selection of messages exchanged with friends and loved ones during that time.
Paul bravely shared his story as data released by the Less Survivable Cancers Taskforce today shows that more than half (62%) of people in NI diagnosed with a cancer of the lung, liver, brain, oesophagus, pancreas or stomach will die from their disease within one year.
The new analysis, released today by the Less Survivable Cancers Taskforce of existing cancer registry data shows that the average one year survival for a patient diagnosed with a less survivable cancer in NI is just 38%. This contrasts sharply with the overall one-year survival rate here for all cancers, which is 73%.
Over 90,000 people are diagnosed with one of the less survivable cancers in the UK every year and they account for nearly half of all common cancer deaths. These cancers are overwhelmingly diagnosed at later stages compared to other cancers. Only 28% of patients are diagnosed at stage 1 or 2, compared to 54% for all cancers. This late-stage diagnosis limits the potential for treatments that could significantly improve survival rates.
Despite their prevalence, the less survivable cancers receive a fraction (16.6%) of research funding of more survivable cancers.
Formed by charities supporting patients, the Less Survivable Cancers Taskforce is calling for government-level commitments to prioritise early detection, research funding and the development of new treatment options for these cancers with the aim of reducing the stark inequalities in prognosis.
Anna Jewell, Chair of the Less Survivable Cancers Taskforce, said the reality that more than half of people diagnosed with a less survivable cancer will not survive beyond a year is simply unacceptable.
She added: “It is essential that all UK governments take immediate steps to develop and implement national action plans dedicated to less survivable cancers to improve the outcomes for patients with these devastating diseases. We can change the narrative and improve one year survival by setting specific targets, prioritising early diagnosis and improving treatment pathways to give every patient a fighting chance.”
In response, a Department of Health spokesperson said: "The Routes to Diagnosis Report, funded by the Cancer Strategy and published by the Northern Ireland Cancer Registry in June 2024, highlights that many patients with a less survivable cancer are diagnosed at stage 3 or 4, rather than at stage 1 or 2. Sadly, for many of these patients, an early diagnosis would increase survivorship and quality of life. For some of these cancers, an early diagnosis would allow for curative treatment.
"The Cancer Strategy recognises the importance of early diagnosis and prevention. Many of the less survivable cancers will initially present with vague, but worrying symptoms, and for this reason, Rapid Diagnosis Centres, delivering a vague symptom pathway, have been established.
"In addition, Northern Ireland was the first part of the UK to commit to the development of a pancreatic cancer optimal care pathway. Ensuring early diagnosis, and rapid access to treatment, is key to improving 1 year survival for any patient diagnosed with a less survivable cancer."
They added: "The Department of Health has implemented a number of cancer-related screening programmes, such as cervical, breast and bowel screening, based on the advice of the UK National Screening Committee. The UK NSC made a recommendation to introduce a targeted lung cancer screening programme in people with a history of smoking, aged between 55-74 years old.
"We are at the early stages of scoping out what the requirements of this new programme for Northern Ireland will be. It is anticipated that this work will begin this year, subject to further discussions and financial considerations.
"The Department is working closely with Trusts on short-term measures, including Trust wide patient transfers to expedite diagnosis and treatment to ensure the most effective use of the resources available within the system. Non-recurrent funding is also being used to support waiting list initiatives, including partnerships with the independent sector.
"Continued progress will depend on securing additional funding in future years. The Minister remains fully committed to delivering the most effective service possible within the available budget to reduce waiting times and deliver a cancer care system that meets the needs of patients and their families.
"It is, however, the case that it is only through continued reform, innovation and investment, that we can achieve sustainable improvements in cancer outcomes for all."
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