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Brian Lenihan has cancer

by Frank Schnittger Wed Jan 6th, 2010 at 05:46:53 PM EST



Brian Lenihan has only been a cabinet Minister for two and a half years: firstly as Minister for Justice, and latterly as Minister for Finance in Brian Cowen's first - and likely only - Government.  As such he does not quite share the opprobrium heaped upon his immediate predecessor (and current Taoiseach) Brian Cowen for Ireland's economic and fiscal crises.  Indeed he his widely seen as having inherited the most unenviable task to have faced any Finance Minister in the history of the state.


As such he has introduced three draconian budgets within 14 months to try to reduce Ireland's soaring budget deficit largely through swingeing cuts in public expenditure - including pay reductions and increased pension contributions for Civil Servants - and also led the charge to create the National Asset Management Agency (NAMA), a bad bank designed to take over the toxic loans of the banking sector for a price €7 Billion more than their estimated current market value.

Many Governments have fallen and political careers ruined for much less than this.  It is remarkable that this Government has survived, Lenihan's political reputation has remained largely unscathed, and he is widely acknowledged as one of the most capable ministers in the Government.

On 26 December, 2009, TV3 reported that Lenihan had been diagnosed with pancreatic cancer - a diagnosis he had only just been apprised of - and before he could inform members of his extended family.  There was widespread anger at this intrusion into his private life and sympathy for the Minister himself.  On 4th. January Brian Lenihan announced that he would remain in Office and fulfil his duties as Minister for Finance during his chemotherapy and possible subsequent radiotherapy.

I have argued vehemently against his Nama proposals, but shared a concern that the bitter and personalised tone of much political discourse in some other countries should not become the norm in Ireland.  Hence this letter in today's Irish Times:

Brian Lenihan's illness - The Irish Times - Wed, Jan 06, 2010

Madam, - As my previous letter (July 7th, 2009) will testify, I was as opposed as anyone to Brian Lenihan's approach to bailing out the banks through over-paying for their toxic loans.

However that opposition never extended to questioning his integrity or dedication. I had to acknowledge somewhat ruefully that there wasn't much in the way of alternative talent available for his position - particularly after the abysmal failure of the Greens to stand up for their principles and oppose the Nama legislation.

His decision now to carry on in the face of a serious medical condition confirms his stature as one of the few people of real substance in Irish political life, a situation sadly emphasised also by the recent passing of Justin Keating. Let us hope Mr Lenihan makes as full a recovery as possible, as quickly as possible.

The public response to his predicament is also quite a tribute to the maturity of the Irish people. The lack of bitterness and bile directed at him personally in the wake of one of the most draconian budgets of all time is quite remarkable. The sympathy now felt towards him seems quite universal.

Fianna Fáil may have got us into an almighty mess. But it has also provided us with one of the few leaders who may be capable of leading us out of it - his mistaken approach to dealing with the banks notwithstanding! - Yours, etc,

FRANK SCHNITTGER,

I may not approve of Brian Lenihan's policies or politics, but I value the fact that Irish political discourse generally plays the ball rather than the man - i.e. criticises the policy rather than their proponents - and feel that the mature tone of much of the public debate so far has been a major factor in sustaining the stability of the state in what might otherwise be an incendiary situation.

Of course a revolutionary socialist might well welcome instability at this time.  I'm prepared to give the current political processes some more time to succeed.  I don't think Ireland can have a socialist revolution in isolation from what is happening elsewhere within the EU, and at present other EU member states are showing precious little sign of even a mild move to the left.

However I am fully aware than my views could easily be condemned as taking a very conservative position. I would be interested in seeing what take readers here would have on the situation.  The parallels with (and divergence from) Iceland may be interesting and instructive to consider.

Display:
National debt €12bn higher as tax take sinks by 19% - The Irish Times - Wed, Jan 06, 2010

The exchequer deficit stood at €24.6 billion at the end of 2009, compared with a deficit of €12.7 billion at the end of the previous year.

Despite pressures on the budget of the Department of Social and Family Affairs due to swelling numbers on the Live Register, the Government cut net expenditure by almost €2.2 billion last year, according to the end-of-year exchequer returns data issued yesterday.

However, this was more than cancelled out by the tax declines, the Anglo payment, a €1 billion increase in the interest payments on the national debt and a €1.3 billion rise in the payment to the National Pensions Reserve Fund compared to 2008.

Mr Lenihan said the €1 billion rise in debt servicing costs was "clear evidence of the need to take action to achieve long-term sustainability of the public finances".

About one in every €12 collected in tax went to service the national debt in 2009. By the end of 2014, the Department of Finance estimates, more than €1 in every €5 collected in tax will be required to pay the interest on Ireland's debt.

Tax revenues reached €33 billion in 2009, which took the annual tax haul back to 2003 levels. The tax receipts for the year were down from €40.7 billion in 2008 and also fell short of the €34.4 billion target set at the supplementary budget last April.



notes from no w here
by Frank Schnittger (mail Frankschnittger at hot male dotty communists) on Wed Jan 6th, 2010 at 07:54:43 PM EST
You say prostate in the title and pancreatic in the text - very different cancers...

In France it was discovered that president Mitterrand had suffered from cancer from nearly the beginning of his presidency (and kept it secret). It seems he was suffering greaty during the last year of his second term. At which point does one's physical ability to exert their political duties is to be taken into account ? chemotherapy and radiotherapy are quite difficult to endure. Keeping such a person in an important position is possibly risky... And does smack of personalisation of politics.

Un roi sans divertissement est un homme plein de misères

by linca (antonin POINT lucas AROBASE gmail.com) on Wed Jan 6th, 2010 at 10:28:25 PM EST
Probably metastatised. It almost always does - in my mother's case, to the liver.

"The future is already here -- it's just not very evenly distributed" William Gibson
by ChrisCook (cojockathotmaildotcom) on Thu Jan 7th, 2010 at 06:11:17 AM EST
[ Parent ]
If he has pancreatic cancer, particularly as a secondary, then I fear his prospects are extremely poor. AFAIK there is no effective treatment for this condition, the best you can do is postpone the inevitable by a few months.

Patrick Swayze and Pavarotti are recent victims. As was Bill Hicks.

However dedicated he should remember the famous dictum of the dying, "Nobody wishes they'd spent more time in the office". He should seek the comfort of his family. He and they have my sympathy.

keep to the Fen Causeway

by Helen (lareinagal at yahoo dot co dot uk) on Thu Jan 7th, 2010 at 06:39:24 AM EST
[ Parent ]
That's why I was pointing the difference - prostate cancer has a rather much better prognosis.

And then there are the two French president that died right after leaving power (De Gaulle and Mitterrand). In some cases the desire to keep on doing one's main activity is what keeps one alive

Un roi sans divertissement est un homme plein de misères

by linca (antonin POINT lucas AROBASE gmail.com) on Thu Jan 7th, 2010 at 07:17:56 AM EST
[ Parent ]
There has been no mention of his pancreatic cancer being a secondary although there has been some mention of "managing" rather than curing the disease.  See also my reply to Linca above.

notes from no w here
by Frank Schnittger (mail Frankschnittger at hot male dotty communists) on Thu Jan 7th, 2010 at 07:53:24 AM EST
[ Parent ]
No - just a senior moment on my part! See comments below

notes from no w here
by Frank Schnittger (mail Frankschnittger at hot male dotty communists) on Thu Jan 7th, 2010 at 08:07:19 AM EST
[ Parent ]
linca:
You say prostate in the title and pancreatic in the text - very different cancers...

It's pancreatic cancer he has.  I must have had a senior moment last night. The Irish Times has this to say about the disease:
Keeping a normal routine helps patients come to terms with illness - The Irish Times - Tue, Jan 05, 2010

A DOCTOR WRITES : There is no medical reason why Brian Lenihan should not continue to work, writes DR MUIRIS HOUSTON 

BRIAN LENIHAN'S statement yesterday that he has been diagnosed with "cancerous tissue at the entrance to the pancreas" and that he will begin chemotherapy later this week represents a very open and honest sharing of personal health information with the public.

His commitment to be positive about his illness while continuing to work as Minister for Finance is both brave and admirable.

Pancreatic cancer characteristically does not cause symptoms until it has reached an advanced stage, which is the case for 80 per cent of people diagnosed with the disease. Unfortunately, most patients are not suitable for surgical treatment, due to the cancer having spread locally in an area that contains a number of vital blood vessels. Some two-thirds of cancers are found in the head or entrance of the pancreas, with about a third developing in the tail of the gland.

The pancreas is a gland located behind the stomach at the back of the abdominal wall. Extending horizontally, it is shaped like a fish. Some six inches long, the gland has a wide head tapering to a narrow pointed tail. The pancreas contains two separate parts: the exocrine and endocrine glands. The exocrine part produces a cocktail of enzymes that help us digest fat, proteins and carbohydrates in food. Exocrine glands and ducts make up more than 95 per cent of the cells in the pancreas and are the source of the commonest type of pancreatic cancer. Just a small percentage of pancreatic cells, arranged in clusters, are called endocrine cells and it is these which manufacture the sugar-regulating hormone insulin.

What are the risk factors for developing cancer of the pancreas? By far the biggest is cigarette smoking. Almost 30 per cent of cases are thought to result directly from smoking. Age is another factor; pancreatic cancer is rare under the age of 50. Men are 20 per cent more likely than women to develop the cancer. Being overweight is a risk factor.

In terms of symptoms and signs of the disease, they are non-specific and manifest themselves late. The most common presenting symptoms are jaundice and weight loss. Tummy pain, when it occurs, is non-specific in nature, although it may radiate to the back. Other symptoms include weakness, loss of appetite, nausea and vomiting. The most accurate tests for making a diagnosis are a dedicated type of Cat scan or the use of a local ultrasound probe passed into the intestine. Unfortunately, there is no accurate blood or screening tests for cancer of the pancreas.

Jaundice is the result of a blockage in the common bile duct that is pressed on by the cancer developing in the adjacent pancreatic duct at the head of the gland. As a result, a substance called bilirubin accumulates in the tissues and the blood, leading to yellow eyes and skin.

If the person is lucky, jaundice occurs early in the growth of the cancer, leading to an early diagnosis. Potentially curative surgery - a Whipple procedure - can succeed in removing the entire cancer and reconnecting the bile duct to the small intestine. More commonly, a small tube (stent) is placed in the bile duct via a flexible telescope to resist compression from the surrounding tumour and prevent unpleasant symptoms later in the illness.

Chemotherapy is used to treat most patients with pancreatic cancer. The standard chemotherapy drug is gemcitabine, but other drugs such as cisplatin and 5-fluorouracil may be used. Chemotherapy is given in cycles, two weeks apart. The most common side-effects are nausea and tiredness; because of its effect on the immune system, the patient carries a higher risk of developing infection.

In this context it makes sense for the Minister to curtail his public engagements. But he is absolutely correct to continue to work; there is no medical reason for him not to do so. Indeed, from the point of view of coming to terms with his illness, the Lenihan family will benefit from as normal a routine as possible.



notes from no w here
by Frank Schnittger (mail Frankschnittger at hot male dotty communists) on Thu Jan 7th, 2010 at 07:49:06 AM EST
[ Parent ]
[ET Moderation Technology™]

I edited the title, which contained an understandable slip from "prostate" to "prostrate".

by afew (afew(a in a circle)eurotrib_dot_com) on Thu Jan 7th, 2010 at 01:49:37 AM EST
Title edited because I don't know where the bit about prostate cancer came from. The facts in the body of the story seem to be what's known.
by Colman (colman at eurotrib.com) on Thu Jan 7th, 2010 at 06:37:13 AM EST
[ Parent ]
Thanks.  I can't even get my senior moments right these days!  My dad had prostate cancer (but lived into his '80's).  Perhaps that's why I confused the two.

notes from no w here
by Frank Schnittger (mail Frankschnittger at hot male dotty communists) on Thu Jan 7th, 2010 at 07:56:25 AM EST
[ Parent ]


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