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Second Report 2001-2002 

www.allirelandnci.org

IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

Across

Research

Cancer

BORDERS

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TABLE OF CONTENTS

Introduction....................................................................................................................................................1

Message from the Directors ........................................................................................................................2

Highlights of Progress: 2001-2002 ............................................................................................................4

Origins of the Consortium..........................................................................................................................6

Funding of Consortium Initiatives ............................................................................................................8

State of Cancer/Health Services on the Island of Ireland ....................................................................9

Year in Review: Our Programmes in Practise ........................................................................................11

Clinical Trials Network ......................................................................................................................13

Scholar Exchange and Training ........................................................................................................15

Cancer Registries ................................................................................................................................18

Information Technology Sharing ....................................................................................................19

Nursing..................................................................................................................................................21

Prevention ............................................................................................................................................22

How the Consortium Operates ................................................................................................................24

Spotlight on Consortium Scholars............................................................................................................26

Partners and Institutional Members ........................................................................................................34

Consortium Participants ............................................................................................................................36

About the Implementation Group Members ........................................................................................38

Outreach........................................................................................................................................................44

Consortium in the News............................................................................................................................45

2003 All Ireland Cancer Conference........................................................................................................46

Appendix ......................................................................................................................................................47

Memorandum of Understanding

Implementation Plan

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INTRODUCTION

IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 1

Each year, as called for in the 1999 Memorandum of Understanding establishing the IrelandNorthern Ireland-National Cancer Institute Cancer Consortium, the Board of Directors of the

Consortium delivers an annual report to account for the progress made toward fulfilling its

mandate. That mandate is an ambitious one––to engage the cancer communities of the United

States, Ireland, and Northern Ireland in enhancing the island of Ireland’s ability to conduct

world-class cancer clinical research and thereby improve cancer care and treatment for the

people in all of Ireland. A secondary, but equally important, goal is to encourage collaboration

between the governments of Ireland and Northern Ireland through joint programmes in the

area of health care, as called for in the Good Friday Peace Accord of 1998.

The Consortium endeavors to accomplish these goals through a robust scholar exchange

programme among all three partnering jurisdictions, information technology sharing, cancer

registry data harmonisation, and the establishment of a network of hospitals in Northern

Ireland and Ireland to conduct joint clinical trials. This report covers activities in those areas

from July 2001 through December 2002. Future reports will cover Consortium activities

during twelve-month calendar year periods.

The report is provided directly to the Ministers of the Department of Health and Children of

Ireland, and of the Department of Health, Social Services and Public Safety of Northern

Ireland, and the Secretary of the Department of Health and Human Services of the United

States. This document is also meant to inform the research community, policymakers, and

anyone else interested in the friendly collaboration among nations in the fight against cancer.

We provide this annual report in the hope that all who read it will be inspired by the

remarkable progress that can be made when people work together toward defeating a common

enemy––such as cancer––that knows no political or geographic boundaries.
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MESSAGE FROM THE DIRECTORS

The second year of the Ireland-Northern

Ireland-National Cancer Institute Cancer

Consortium was one of impressive progress

toward implementing the major programmes

set forth when we established this unique

partnership in 1999. Our goals then were

ambitious––even daunting––but it was our

hope that the results would bolster the island

up in the ranks of its European peers in the

ability to provide world-class cancer care to

its people. We set out to accomplish this by

utilising the vast biomedical research

expertise and resources of the U.S. National

Cancer Institute and by relying on the firm

commitment and collaboration of the health

departments of Ireland and Northern

Ireland.

No one could have predicted whether

bringing three governments together in this

manner would work or anticipated the

opportunities or obstacles we would

encounter as we moved forward. After an

initial year of foundation-building, the pace

and intensity with which the Consortium has

made progress this year continued to amaze

us. We are delighted to report that for the

period of 2001-2002, the Consortium has in

place several tangible initiatives in each of

the four major areas––scholar exchange,

clinical trials network, information

technology sharing, and cancer registry

collaboration.

In 2001 and 2002, the Consortium

sponsored cancer research training for 43

scholars from Ireland and Northern Ireland.

Seven nurses, two epidemiology fellows, and

34 specialists from a variety of disciplines

working in cancer prevention on the island

trained at the National Cancer Institute on

the campus of the United States’ National

Institutes of Health (NIH) in Bethesda,

Maryland.

This year marked a major breakthrough in

establishing a clinical trials network in

Ireland. This was a critical and timeconsuming undertaking, handled adroitly by

Ireland's Health Research Board. Under this

initiative, Ireland awarded government

funding for the first time to nine hospitals to

build their capacity to conduct cancer clinical

trials. The Irish network will work with

Belfast City Hospital and the NCI in

conducting joint clinical trials that will

benefit the entire island.

In the area of information technology

sharing, Belfast City Hospital and St. Luke’s

Hospital in Dublin achieved full

implementation of TELESYNERGY®–– a

multimedia medical-imaging workstation that

enables scientists in multiple laboratories and

in multiple locations to interact

simultaneously with one another. We are

excited about the application of this new

technology, which marks the first time it has

been installed outside the United States.

After the publication of the first All-Ireland

Cancer Statistics Report, the Consortium is now

sponsoring an all-Ireland case-control study

of oesophageal adenocarcinoma and

Barrett’s oesophagus––a nonmalignant

precursor. The report found this cancer to

be prevalent on the island of Ireland but

poorly understood. The study, known as

FINBAR (Factors Influencing Barrett’s

Adenocarcinoma Relationships), will make

use of 10 years of data housed at the

Northern Ireland Cancer Registry and is

funded by a cross-border grant from the

Health Research Board in Dublin and the

Research and Development Office in

Belfast. It is anticipated that the study will

shed light on the apparent increase in

oesophageal adenocarcinoma and the

determinants of progression to malignancy

on the island.

2 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 3

In 2001, the Consortium experienced our

first change in leadership among the Board

of Directors. In September, we learned of

the resignation from NCI and the

Consortium Board of our friend and

colleague, NCI Director Richard Klausner.

Dr. Klausner lent vision, passion, and

generosity to the Consortium since its

formation, and we deeply appreciate his

contributions.

While this year was marked with great

achievements, we still have much ground to

cover before realising our ultimate goals. We

continue to address key issues such as

retaining our trained personnel on the island,

bringing Ireland’s hospital system up to

today’s standards to conduct clinical trials,

and making clinical research a higher priority.

No summary of 2001 would be complete

without reflecting on the terrorist attacks of

September 11 because indeed they touched

us all. The people of the United States and

Ireland have a special bond that goes back

generations and is as strong as ever. The

attacks on our freedom are all the more

reason to embrace an initiative such as this,

which strives to bring people together in

peace toward improving the lives of all.

The theme of this year’s annual report is

unity. In this report, we celebrate the people

who are involved early on in this unique

undertaking and who will help bring us a

brighter future.

Dr. James Kiely

Chief Medical Officer

Department of Health and Children

Ireland

Dr. Henrietta Campbell

Chief Medical Officer

Department of Health, 

Social Services and Public Safety

Northern Ireland

Dr. Andrew von Eschenbach

Director 

National Cancer Institute 

United States

On behalf of the entire

Consortium, Henrietta

Campbell and James

Kiely extend a warm

welcome to our new

Board member, Andrew

von Eschenbach.

Appointed as NCI

Director in early 2002, Dr. von Eschenbach

is a recognized leader in the challenge to

understand cancer and thus improve the

care and treatment of people with cancer.

Dr. von Eschenbach looks forward to

contributing to the Consortium’s worthy

goals with colleagues from the North and

South of Ireland as well as the States.

A long-time leader in the battle against

cancer, Dr. von Eschenbach comes to NCI

from The University of Texas M. D.

Anderson Cancer Center in Houston, where

he was Director of the Genitourinary

Cancer Center and Director of the Prostate

Cancer Research Program. He has also

served as Vice President for Academic

Affairs at M. D. Anderson and as Executive

Vice President and Chief Academic Officer,

leading a faculty of almost 1,000 cancer

researchers and clinicians. Dr. von

Eschenbach has contributed more than 200

articles, books, and chapters to the scientific

literature. He is an editorial board member

of four leading journals and serves on the

board for the National Coalition for Cancer

Research. He was a founding member and

leader of the National Dialogue on Cancer

and, before his appointment as NCI

Director, was President-elect of the

American Cancer Society. 
4 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

JULY 2001

NCI hosts Northern

Ireland Health Minister

• The Honorable Bairbre

de Brún, Minister of

Health, Social Services

and Public Safety for

Northern Ireland, visits

NCI

AUGUST 2001

NCI Summer Curriculum

in Cancer Prevention

• First Consortiumfunded participants

complete NCI Cancer

Prevention coursework

OCTOBER 2001

Annual report

• Consortium publishes

its first annual report

NOVEMBER 2001

Cancer clinical research

centre awards

• Health Research Board in

Dublin announces first

awards to hospitals to

develop cancer clinical

trials capacity

• Major awards: St.

Vincent’s University

Hospital/St. Luke’s

Hospital, Dublin;

University College

Hospital, Galway; Cork

University Hospital;

Beaumont Hospital,

Dublin

• Planning grants:

Limerick Regional

Hospital and Mater

Misericordiae Hospital,

Dublin

HIGHLIGHTS OF PROGRESS: 2001-2002

DECEMBER 2001

Prevention Working Group

established

JANUARY 2002

New Board of Directors

member

• Consortium welcomes

new NCI Director

Andrew von

Eschenbach

Cancer clinical research 

• HRB initiates new call

for cancer clinical

trials development

proposals 

FEBRUARY 2002

All-Island Cancer Clinical

Trials Cooperative Group

• HRB and R&D Office

invite ICORG and

CRSC to submit joint

application to form

cooperative group
IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 5

APRIL 2002

• Belfast City Hospital

and St. Luke’s Hospital

in Dublin form joint

clinical users’ group as

TELESYNERGY®

implementation

continues

• Launch of

Consortium-sponsored

all-Ireland case-control

study of oesophageal

adenocarcinoma and

Barrett's oesophagus

Clinical trials training 

• Three Irish oncology

nurses complete

clinical trials training

programme at NCI

MAY 2002

First Prevention Working

Group meeting, Dublin

• Identifies

establishment of

cancer prevention

fellowship programme

as a priority

• Begins formulating

initiatives and planning

workshops to address

prevention of specific

cancers

Nursing Working Group

Information Day, Dublin

• Showcases Consortium

training opportunities

JUNE 2002

Epidemiology fellowships

• First epidemiology

fellows complete year

of postdoctoral study

in cancer epidemiology

at NCI, and return to

Northern Ireland and

Ireland, respectively,

for remaining two

years of fellowships

All-Island Cooperative

Group

• Panel begins review of

ICORG and CRSC

application for

cooperative group

Clinical trials

• Awards to St. James’s

Hospital and Mater

Misericordiae Hospital

• Planning grants to

Adelaide and Meathe

Hospitals

OCTOBER 2002

Clinical trials training

• Second round of Irish

nurses begin clinical

trials training at NCI

Cancer Care 2002 Ireland

• Consortium co-sponsors

conference at Waterfront

Hall in Belfast

NOVEMBER

2002

TELESYNERGY®

• Three-way

demonstration at St.

Luke’s Hospital in

Dublin launches

telemedicine efforts

JULY 2002

Palliative care

• Irish delegation attends

NIH conference
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ORIGINS OF THE CONSORTIUM

6 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

A Sign of Good Things

to Come

The Ireland-Northern Ireland-National

Cancer Institute Cancer Consortium was

established with high hopes at a ceremony at

Northern Ireland’s Stormont Parliament

Buildings in Belfast in October 1999. The

goal of the Consortium was to dramatically

enhance cancer research and care across the

island of Ireland. The ceremony, attended by

more than 200 oncologists, cancer

researchers, and government and business

officials from the three partnering countries,

featured the signing of the Memorandum of

Understanding (MOU) by the Health

Ministers of Ireland, Northern Ireland, and

the United States.

Speaking at the ceremony, former U.S.

Senator George Mitchell, who chaired the

talks the previous year that led to the Good

Friday Agreement in Northern Ireland,

praised the MOU, saying the cooperation at

the core of the Consortium is a model for

political progress on the island. “The people

of Northern Ireland deserve a better future,

a more stable political and social

environment free from violence and

despair,” he told his audience. “It is not my

intention to politicise this or to implicate

other areas except to express the hope that

when you work together you can do things

that you might not be able to do separately.”

The Good Friday Agreement called for the

establishment of a North-South ministerial

council and implementation bodies to ensure

its success. “This is a good example of the

kind of area where cooperation can be

mutually beneficial,” he said.

George Howarth, former Northern Ireland

Health Minister, welcomed the development,

saying, “We are certain the outstanding

collaboration will benefit us all.” Ireland’s

Health Minister at the time, Brian Cowen,

described the agreement as “a significant

step in developing further a cooperative

approach to the fight against cancer.”

Richard Klausner, NCI Director from 1996

to 2001, said the potential for the agreement

“is tremendous. We hope the Consortium

sparks a spirit of cooperation in the global

quest for a cure for cancer and serves as a

model for how countries can work together

to improve the quality of life for all their

people.” He added that, with the agreement

signed, the proof of the Consortium’s intentions

“lies in the work we have ahead of us.”

The signing ceremony was covered

prominently in the newspapers and

broadcasts of the Irish and U.K. news

media. It came as hundreds of cancer

specialists from Ireland, the United States,

Europe, and around the world arrived in

Belfast for a three-day cancer conference,

the first initiative of the new Consortium

and one of the largest of its kind in Europe.

Early Concepts: 

A Vision Rooted in

Friendship

The Consortium was the brainchild of a

number of individuals in the Irish and U.S.

cancer research communities, many of

whom trained and worked together at NCI,

including Patrick Johnston, now the Director

of the cancer centre at Belfast City Hospital.

At the core of their vision was the desire to

radically change the state of cancer care on

the island of Ireland, where cancer rates are

among the highest in the Western world.

Cancer is the second biggest killer in Ireland

and is set to overtake heart disease as the

number one killer in the North. Over time,

this group of colleagues took their idea of a

collaborative partnership between the three
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 7

countries to their Directors and ultimately to their

respective governments.

Seeds of the Consortium germinated during a time

when sweeping changes in the organisational structure

of cancer care delivery were being undertaken in both

jurisdictions. In addition, there was a shared belief

that peace would come to Northern Ireland. Cordial

relations already existed among the three cancer

communities and could be counted on to form a

long-term partnership, the economies were strong in

all three jurisdictions, and cancer research and clinical

trials were recognised globally as the optimal way to

improve cancer care delivery.

In the relatively short period of two years, the

partnership was agreed upon, the initial programme

concepts developed, the Memorandum of

Understanding drafted, and the Consortium launched.

NCI All Ireland Cancer

Conference: Three Days of

Unity and Collaboration

The signing ceremony signaled the opening of the

three-day NCI All Ireland Cancer Conference in

Belfast’s architecturally intriguing Waterfront Hall.

More than 600 cancer specialists from across the

world attended the biomedical conference, which

addressed key challenges in cancer research through

topics such as radiation oncology, applications of

cancer registry information, the impact of clinical

research in cancer care, cancer prevention, and

developmental therapeutics. The conference generated

enthusiasm and energy to move forward with

implementing the four initial programmes that shaped

the Consortium: scholar exchange, information

technology enhancement, clinical trials infrastructure

support, and cancer registry consolidation and

cooperation.

On the last day of the conference four working

groups, comprised of experts from each jurisdiction,

convened to begin work on initiating programmes to

advance research in their area of expertise. Through

follow-up meetings and conference calls over the next

several weeks, the working groups submitted plans to

the Consortium’s Board of Directors that would

become the basis for building the island’s clinical trials

infrastructure in the months ahead.
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FUNDING OF CONSORTIUM INITIATIVES

8 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

Each partner country directly funds its share

of each programme established under the

Consortium. Members of the Board of

Directors present initiatives to their

respective governments for approval and

subsequent allocation of funds. Programmes

considered for funding must fall within the

areas of scholar exchange, information

technology, clinical trials, or cancer registries,

as identified in the Memorandum of

Understanding. Projects must be consistent

with policies and strategic cancer plans of

the health departments of the partners.

Finally, projects must demonstrate benefits

to cancer care and research in the three

jurisdictions, or serve as a pilot project in

one jurisdiction to demonstrate potential for

wider applicability.

In 2001 and 2002, the health departments of

Ireland and Northern Ireland committed

funds in the following areas:

 Palliative care––to underwrite costs for

Irish delegation to attend major NIH

conference

 Scholar exchange––to support a nurses’

clinical research programme, prevention

course, and epidemiology fellowships 

 Clinical trials network––to fund nine

hospitals to develop the capacity for

clinical trials

 Information technology––to implement

a uniform patient data collection system

and TELESYNERGY®

 Cancer registries––to harmonise data

systems and spur new epidemiology

research

In addition, the National Cancer Institute

provided in-kind expenses, travel support,

and on-site expenses for information

technology installation and scholar exchange

programmes.
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STATE OF CANCER/

HEALTH SERVICE ON THE ISLAND

IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 9

Ireland

Hospital care for patients with cancer is free

at the point of delivery in Ireland apart from

nominal initial charges for some. Patients

can, however, insure for private care.

Although 40 percent of the 3.9 million Irish

citizens have private health insurance, the

majority of patients with cancer (more than

80 percent) receive care within the public

hospital system. Practically all care is

provided within the country.

There are two publicly funded radiotherapy

centers––one in Dublin at St. Luke’s

Hospital and one at Cork University

Hospital––and two smaller private centres in

Dublin. Currently, plans exist to expand

services to include two or perhaps three

regional centres, pending a report from the

Radiotherapy Review Committee.

Cancer screening programmes are currently

limited and evolving. A population-based

breast screening programme, Breast-Check,

has been offered since 2000 to women aged

50 to 64 years and is currently available to

about 50 percent of this population. A

cervical screening programme is also being

developed and will be piloted in one healthboard area. The National Cancer Forum is

currently examining screening for colorectal

and prostate cancer.

Two major reports will be available shortly

––one on palliative care and one on

radiotherapy services. These, along with the

major initiatives undertaken in the wake of

the National Strategy for Cancer Services

launched in 1997, will serve as a template for

the further development of services for

cancer patients in coming years.

There has been a significant increase in

medical oncology appointments in the past

four years, with the complement of

oncologists increasing from 4 to a total of

18. This has led to additional posts in

Dublin, Cork, and Galway, as well as new

posts in Letterkenny, Sligo, Limerick,

Tullamore, and Waterford.

Northern Ireland

In Northern Ireland, health care is free at

the point of delivery. The population of

Northern Ireland is approximately 1.7

million, and the population’s health services

are organised within the National Health

Service system. Northern Ireland has four

Health and Social Services boards, and a

regional Department of Health, Social

Services and Public Safety. All residents are

registered with a general practitioner that,

apart from accidents and emergencies, is the

first point of call when a patient has health

concerns. Northern Ireland has a relatively

small private health care market that

represents less than 10 percent of the overall

population.

Screening programmes such as populationbased breast screening have been offered to

all women aged 50-64 since 1993, and

population-based cervical screening has been

available to all women over the age of 20

since the late 1980s. Discussions are

currently under way to consider screening

for colorectal cancer and prostate cancer.

Since 1996, cancer clinical services have

been significantly reorganised in Northern

Ireland following the release of Cancer

Services: Investing for the Future, also known as

the Campbell Report. This report acted as

the major catalyst for the redevelopment of

cancer services in Northern Ireland and has

now resulted in the development of a cancer

centre for Northern Ireland at Belfast City

Hospital, as well as the opening of four
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10 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

regional cancer units in Altnagelvin, Antrim,

Ulster, and Craigavon Hospitals. The goals

of this new cancer clinical service are to

coordinate cancer treatment, prevention,

screening, education, training, and research

programmes throughout Northern Ireland,

and to provide a patient-centred service.

Moreover, the construction of the new £60

million cancer centre at Belfast City Hospital

is under way, with the facility expected to

open in 2005. There are now

multidisciplinary specialist cancer teams for

each of the major disease subsites in the

cancer units and the cancer centre, and

integrated patient care pathways are being

developed. Day hospital therapy has now

become the norm in each of the hospitals,

and cancer clinical trials are coordinated

through the Clinical Trials Unit within the

cancer centre funded by the Department of

Health, Social Services and Public Safety.

These recent changes have already resulted

in a significant improvement in cancer

services for people in Northern Ireland.

These improvements will increasingly be

underpinned by high-quality clinical research

and teaching, and a quality patient-centred

environment where clinical services are

geared towards the needs of the patient.
YEAR IN REVIEW:

OUR PROGRAMMES IN PRACTICE

Clinical Trials Network

Scholar Exchange and Training

Cancer Registries

Information Technology Sharing

Nursing

Prevention

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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 13

Clinical Trials Network

Background

As outlined in the Memorandum of

Understanding in 1999, the overarching goal

of the Consortium is to foster the provision

of better prevention, early detection, and

treatment of cancer for all people on the

island of Ireland. A key part of achieving

this goal involves enabling people with

cancer to gain access to clinical trials––the

study of the cancer process in humans and

the assessment of the effectiveness and

toxicity of cancer treatments.

Clinical trials are an essential part of

developing better cancer preventive and

therapeutic strategies, and are generally

acknowledged worldwide as the optimal way

to advance cancer care at the bedside.

Clinical trials also play the added role of

ensuring uniformity of practise and can even

lead to improvements in practise. Thus, as

clinical trials become the global standard for

effective cancer prevention and care, it is of

paramount importance that the island of

Ireland enter the mainstream of cancer

clinical care by enhancing its abilities to

conduct trials, and thus improve patients’

access to new therapies.

To facilitate all-island participation in trials

and to compete for trials on an international

level, the Consortium has started organising

a network of hospitals and cancer centres in

Ireland and Northern Ireland to build

capacity in cancer clinical research. The

network, which will be organised through a

coordinating body, will involve the Belfast

City Hospital Cancer Centre in Northern

Ireland and a number of hospitals in

Ireland.

Because of the relatively small population on

the island (approximately 5.4 million people

in Ireland and Northern Ireland combined),

it is essential that the two jurisdictions

collaborate with one another and with the

United States and other countries in order to

create a pool of participants large enough to

generate meaningful findings. To participate

in multi-centre clinical trials, organisations

must demonstrate the requisite

sophistication to recruit suitable patient

populations, administer the complex

therapies, and track the huge volumes of

data.

With a robust, all-island clinical trials

network that will enhance cancer care as the

major goal of the Consortium, all major

programmes outlined in the Memorandum

of Understanding––enhancement of

information technology, sharing of cancer

registry data, and scholar exchange––become

the building blocks that will enable the

network to flourish.

Five years ago, the Northern Ireland

Department of Health, Social Services and

Public Safety began an effort to restructure

cancer services to enhance its clinical

research abilities, resulting in a coordinated

clinical services programme that includes an

integrated regional clinical trials network and

a basic cancer research programme.

Under the Campbell Commission, led by

Chief Medical Officer Henrietta Campbell,

Northern Ireland now has a cancer centre

based at Belfast City Hospital and one

cancer unit in each of the country’s four

regional health boards (Altnagelvin, Antrim,

Ulster, and Craigavon Hospitals. Belfast City

Hospital serves as the coordinating hub of

this activity, providing a setting for support

and interaction of the research staff, which

includes data managers, administrative staff,

a research radiographer, and seven clinical

research nurses. Under the direction of

Patrick Johnston, an NCI-trained oncologist

and Professor of Oncology at the Queen’s

University Belfast, Belfast City Hospital and

neighboring Belvoir Park Hospital have

opened 50 phase I, phase II, and phase III
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14 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

clinical trials to patients. These trials involve

chemotherapy, vaccine therapy, radiotherapy,

and surgery.

In Ireland, despite the major initiatives

undertaken under the National Strategy for

Cancer Services, cancer care is less

centralised and the development of true

tertiary care centres has not occurred,

especially in the Eastern region. Cancer care

takes place mainly at the major academic

teaching hospitals in Dublin, Cork, and

Galway, regional and county hospitals, and

St. Luke’s Hospital, Dublin, which functions

as a major radiotherapy centre with a

national remit. The majority of paediatric

cancer care takes place at or is coordinated

by the unit at Our Lady’s Hospital in Dublin.

The report Cancer Services in Ireland: A

National Strategy, developed in 1996 by the

Department of Health and Children,

identified organisational issues and personnel

shortages as major limiting factors towards

full participation by Ireland’s hospitals in

clinical trials. It was recommended that these

deficiencies be corrected by the

reorganisation of cancer services and the

development of a coordinated approach to

clinical research, including clinical trials.

The establishment of the Consortium in

1999 represented an opportunity to build on

the initiatives undertaken by the

governments of Ireland and Northern

Ireland to establish a coordinated approach

to cancer research on an all-island basis.

To date, both Northern Ireland and Ireland

have committed significant funding to these

initiatives, and the National Cancer Institute

has been an active and enthusiastic partner

in establishing and operating the network.

Through the Consortium, NCI provides

guidance, training, information technology

sharing, and expertise to make the network a

reality.

Building Cancer Clinical Trial

Capacity in Hospitals

To enhance the capacity of hospitals in the

Republic of Ireland to conduct high-quality

clinical trials, the first call for proposals for

funding was launched by the Health

Research Board in May 2001. Eight

proposals were received and reviewed by an

international panel of experts nominated by

NCI. Awards to four hospitals were

announced in November 2001––St.

Vincent’s University Hospital/St. Luke’s

Hospital, Dublin; Cork University Hospital;

University College Hospital, Galway; and

Beaumount Hospital, Dublin. Two smaller

planning grants were awarded to Mater

Misericordiae Hospital, Dublin, and

Limerick Regional Hospital to enable them

to begin making progress and to compete

more effectively in subsequent calls under

this initiative. The total funding under this

first call amounted to approximately 4.6

million over 3 years. Hospitals have since

been actively involved in staff recruitment

and training as a result of Consortium

funding. They will produce annual reports

describing how they are implementing their

proposed activities and highlighting the

progress achieved during each year of

funding. Subject to passing an interim review

by the international panel after three years,

where the effectiveness of the clinical trials

units will be evaluated, further funding may

be issued.

As a sign of commitment to this initiative,

additional funding was made available by the

Department of Health and Children in 2002

to support the next phase of development.

A second call for funding to hospitals was

issued in January 2002. Six applications were

received, and after evaluation by the

international review panel in June 2002,

awards were made to St. James’s Hospital

and to Mater Misericordiae Hospital, with

two smaller planning grants awarded to the

Adelaide and Meath, incorporating the
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 15

National Children’s Hospital Tallaght

(AMNCH), and Waterford Regional

Hospital. Funding for this second call

amounts to approximately 3 million over

three years. The fact that Mater

Misericordiae Hospital received a major

award in this call highlighted the significant

progress that can be achieved in a short time

period with a Consortium planning grant.

Establishment of a Clinical Trials

Network

In order to reap the dividends of the

funding awarded to hospitals across the

island, the Consortium’s Board of Directors

proposed a structure for all-island

participation in clinical trials where a

network of the major hospitals treating

cancer patients on the island would be

organised in the manner of the National

Cancer Institute Cooperative Groups. This

network, which encompasses several major

U.S. cancer centres, implements cancer

clinical trials at multiple sites throughout the

United States. At a meeting in Dublin in

May 2000, it was proposed that the Irish

Clinical Oncology Research Group

(ICORG) could become the coordinating

agency for the newly established cancer

clinical trials network for the island of

Ireland, with offices in Dublin and Belfast.

In October 2000, the Health Research Board

of Ireland and the Research and

Development Office of Northern Ireland

proposed to the Consortium’s Board of

Directors a plan for establishing this

network. The objective of the network is the

generation and conduct of clinical trials

consistent with priorities in Ireland and

Northern Ireland, and to provide the

organisational, statistical, and scientific

support to member hospitals.

The proposal requested that ICORG make a

formal application for funding and resources

to reorganise itself to serve in the all-island

coordinating capacity. A key requirement for

the Cooperative Group model to work

effectively is for the statistical and data

management function to be provided

separately from the headquarters function.

As part of its ongoing commitment to

providing infrastructural support to

Northern Ireland’s Health and Personal

Social Services, the Research and

Development Office in Belfast has been

working to establish a Clinical Research

Support Centre (CRSC) to provide a range

of support services, including statistical and

data management, for a variety of clinical

trials. This has provided an opportunity for

convergence with the needs of the

Cooperative Group. The CRSC will

incorporate a dedicated data management

service for the Cooperative Group and will

be headed by a senior biostatistician who

will function as the Group Statistician.

In February 2002, the Health Research

Board and the Research and Development

Office invited ICORG and the CRSC to

submit a collaborative application to form a

Cooperative Group to coordinate all-island

clinical trials. An international panel began

its preliminary review of the the application

in June 2002. The panel’s recommendation

was expected early in 2003. Further details

of the application are under review by the

panel, and recommendations are expected

shortly.

Scholar Exchange and

Training

Introduction

Developing a core of well-trained cancer

research specialists is crucial to enhancing

the island’s clinical trials infrastructure.

Through its scholar exchange programme,

the Consortium facilitates the exchange of

oncologists, nurses, researchers, and other

cancer personnel between their home

institutions in Ireland and Northern Ireland
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16 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

and the U.S. National Cancer Institute in

Bethesda, Maryland. Through the

Consortium, the governments of Ireland

and Northern Ireland have engaged in an

intensive effort to allocate funding to

fellowships and training courses in areas

with the greatest need and having the

greatest impact on the proposed clinical

trials structure. The Consortium has

identified several areas with acute shortages

of personnel and training: oncology

specialists, clinical trials staff, cancer

epidemiologists, and prevention specialists.

Joint training programmes in these fields

have been developed, or are being planned,

ranging from short-term training courses to

those in which a substantial period of time

may be spent at NCI.

The training opportunities available through

the Consortium must demonstrate an

identifiable long-term research outcome

toward cementing the collaborative nature of

the Consortium and present an opportunity

for sustained career development and

progression upon leaving the programme.

Funding for travel, accommodations, and

salary/stipend is provided through the

scholars’ home countries. On-site training

costs will be provided by the host country.

Outlined below is the substantial progress

that has been made over the last 18 months

in three major training areas: clinical trials,

cancer epidemiology, and prevention.

Clinical Trials

A clinical trials training programme was

established as part of the Consortium’s

effort to create capacity for cancer clinical

research on the island. Three clinical

oncology nurses––Catherine O’Brien (St.

James’s Hospital), Marie Sheehan (MidWestern Health Board), and Naomi Hill

(Belfast City Hospital)––completed the

three-month programme in April 2002 in the

United States. During that time, the nurses

rotated between the NCI Clinical Center and

its branch at the National Naval Medical

Center in Bethesda, Maryland. The nurses

described their experiences at NCI as “rich”

and “full.”

In October 2002, four Irish nurses began the

three-month second round of Consortiumsponsored clinical trials training. Participants

included Ruth Boyd and Mairéad Devine

(both from Belfast City Hospital, Belfast),

and Marie Cox (University College Hospital,

Galway), and Louise Sherwin (St. Luke’s

Hospital, Dublin).

The educational programme is designed to

give oncology nurses with degrees a chance

to experience all aspects of working in a

cancer clinical trials centre. During their U.S.

Irish and U.S. Nurse Participants in the Spring 2002 NCI

Clinical Trials Training

Second Round of Irish Nurses with Joyce Stocker, Nursing

Supervisor of the Navy Medical Oncology Branch of NCI
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 17

training, the nurses, with the help of local

oncology nurse-preceptors, focused on

managing clinical trials as part of a team.

In May 2002, the Nursing Working Group

held an Information Day in Dublin to

showcase Consortium training opportunities,

including the clinical trials training

programme. Interested applicants were in

attendance. The Consortium plans to send

four more nurses to the United States by the

end of the year to receive clinical trials

training.

Cancer Epidemiology

The first epidemiology fellows, Peter

McCarron of Northern Ireland and Paul

Walsh of Ireland, concluded their year of

postdoctoral study in cancer epidemiology at

NCI. For the remaining two years of their

fellowships, Drs. Walsh and McCarron are

translating their experiences into cancer

research projects on the island. Utilising data

from the Northern Ireland Cancer Registry

in Belfast, Dr. McCarron plans to study

patterns of care for prostate cancer. Dr.

Walsh is developing a project on breast

cancer survival with the Irish National

Cancer Registry in Cork. It is anticipated

that the fellows will help to direct

collaborative research activity on the island

of Ireland, which is a long-term strategy of

the Consortium.

Prevention

Promoting prevention in the management of

cancer is a long-term goal of the

Consortium, and as a result, the Consortium

encourages scholar exchange in the area of

prevention. In 2001, Northern Ireland and

Ireland funded 16 positions for NCI’s

Summer Curriculum in Cancer Prevention.

In 2002, 15 Irish and 3 Northern Irish

applicants, including physicians, nurses,

research fellows, lecturers, and data analysts,

participated in the summer programme. The

five-week annual course includes a four-week

segment on the principles and practises of

cancer prevention and control, and a oneweek segment on molecular prevention.

The principles and practises course covers

the resources, data, methods, and theories

related to cancer prevention and control. It

includes an international day for participants

from around the globe to present to their

colleagues the unique characteristics of

cancer care and prevention in their home

countries. The molecular prevention segment

provides participants with information on

molecular biology and the genetics of cancer

as well as an overview of basic laboratory Drs. Paul Walsh and Peter McCarron, 2001 Epidemiology

Fellows

Prevention Working Group Meeting in May 2002

L-R back row: Dr. Kevin Balanda (IR), Dr. Fenton Howell

(IR), Dr. Doug Weed (U.S.), Dr. Liam Murray (NI), Dr.

Brian Gaffney (NI). L-R front row: Dr. Teresa Maguire

(IR), Dr. Patricia Riordan (IR), Dr. Kathy Rowe (NI), Dr.

Ruth Barrington (IR)
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18 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

approaches in epidemiology, bionutrition,

chemoprevention, biomarkers, and

translational research. The faculty consists of

approximately 100 experts from the National

Institutes of Health, NCI, other U.S.

government agencies, academia, cancer

centres, and public and private organisations.

Douglas Weed, the coordinator of NCI’s

Summer Curriculum in Cancer Prevention,

also serves as the leader of the Consortium’s

Prevention Working Group.

Future Training Opportunities

The Consortium is exploring other

fellowship opportunities for radiologists,

medical oncologists, molecular pathologists,

and basic scientists. For some of these

fellowships, the Consortium is investigating

the potential for collaboration with the Royal

College of Surgeons and the Royal College

of Physicians in Dublin. NCI has numerous

basic science positions available in its

laboratories at the Center for Cancer

Research (CCR) in Bethesda, Maryland.

Interested junior and senior basic scientists

from the island may pursue cancer research

training directly with the CCR. In addition,

the Nursing Working Group is finalising the

requirements for an international cancer

nursing research fellowship programme that

would entail research at NCI and at home

on the island of Ireland.

Cancer Registries 

The Cancer Registries Working Group has

regular conference calls and also met in

Finland 26 June 2002. The Registries also

have biannual research meetings.

Dr. Peter McCarron returned to Northern

Ireland after the first year as one of two

Consortium-sponsored Epidemiology

fellows who participated in formal

coursework and research projects at the

National Cancer Institute. He presented a

poster––“Height and risk of cancer: followup of Finnish male cigarette smokers”––at

the International Association for Research

on Cancer meeting. He contributed two

chapters to an NCI monograph on multiple

primaries on the areas of endocrine and

buccal and oral cavity tumours. He also

participated in an article on Black/White

differences in bladder cancer survival in the

USA. Currently he is undertaking a Master’s

in genetic epidemiology in Italy, a key area

identified in the recent Northern Ireland

Cancer Registry review, and is also working

with IARC on cancer trends in industrial

countries with a view toward future

collaboration with IARC.

Dr. Paul Walsh, the other Epidemiology

Fellow, also returned from the NCI and is

working on a range of projects, including

analyses of all-Ireland breast cancer data

(rates, stage and surgery) in relation to

differences in availability of mammographic

screening. Other projects include

comparisons of U.S. and Irish cancer data,

assessment of survival rates for major

cancers, and occupational influences on

cancer risk. He presented some results at

conferences in Belfast (October 2002) and

Newcastle, Co. Down (April 2003). He has

also shared his experience on the details and

difficulties in merging the all-Ireland datasets.

(L-R) Dr. Harry Comber (IR), Dr. Richard Middleton (NI),

Dr. Brenda Edwards (U.S.), Dr. Anna Gavin (NI), and Dr.

Peter McCarron (NI) at the International Association of

Cancer Registries meeting in Finland, June 2002
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 19

The second round of Epidemiology Fellows

was re-advertised in the autumn of 2002 and

Dr. Deirdre Cronin was appointed. She will

be based in Cork and will spend a year at the

NCI commencing June 2003.

Funding for the second All-Ireland Cancer

Incidence and Prevention Report was

provided by the Department of Health and

Children, Ireland. A call for a fellowship

opportunity to produce the report will be

issued early in 2003. The report is expected

to be available for distribution in mid-2004.

Information

Technology Sharing

The 1999 Memorandum of Understanding

identified information technology (IT)

exchange as a significant objective that

would underpin other strategic areas of

cooperative development prioritized within

the intergovernmental agreement. In

particular, the availability of common

informatics tools was recognised as a central

requirement for healthcare workers to

participate fully in cross-border and U.S.-

Ireland clinical trials and educational

activities. Two enabling informatics

technologies developed within the

NIH/NCI were identified as areas of initial

investigation and exchange: net-Trials® and

TELESYNERGY®.

TELESYNERGY® 

TELESYNERGY® is a multimedia medical

imaging workstation used within an

electronic imaging environment, utilising

either prototype Asynchronous Transfer

Mode or ISDN telemedicine networks. It is

designed for the simultaneous highresolution display of medical images from

numerous diagnostic-imaging modalities.

Within the NCI the initial application area

for TELESYNERGY® was in support of

treatment planning in a radiation oncology

environment; however, TELESYNERGY®

also enables remote consultations between

geographically distributed oncologists and

other medical specialists. Oncologists in

separate institutions can consult during the

development of a patient treatment plan and

can monitor progress during the course of

the treatment protocol.

Two TELESYNERGY® systems were

installed on the island during 2002 at Belfast

City Hospital (BCH) and St. Luke’s Hospital

(SLH), Dublin. The TELESYNERGY®

installations in Dublin and Belfast

represented the first use of the system

outside the United States. The investigation

of the clinical utility of TELESYNERGY®

within the NCI-All Ireland Consortium is an

important test of the system, particularly in

regard to its future international use and

development. Prior to the installation,

technical support groups at BCH and SLH,

in conjunction with colleagues at NCI and

the Centre for Information Technology ,

evaluated and approved system compatibility

with European telecommunications

standards. The system was installed at BCH

in July 2002 and subsequently at SLH in

September 2002. On November 13, 2002, a

three-way connection to each of the

participating jurisdictions and discussion of

future TELESYNERGY® projects was

convened through SLH with Dr. Elias

Zerhouni, Director of the NIH, Dr. Andrew

von Eschenbach, Director of the NCI, and

Ambassador Richard Egan, U.S. Ambassador

to Ireland, in attendance. The three-way link

demonstrated the anticipated use of

TELESYNERGY® in a number of areas

including:

Clinical case management

 Dr. Curly Morris detailed the recent use

of the system in facilitating the optimal

management of a patient that had

presented to Belfast City Hospital with
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20 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

A Cross-Border Collaborative

Study of Barrett’s Oesophagus

and Oesophageal

Adenocarcinoma

FINBAR Study - Factors Influencing Barrett’s Adenocarcinoma

Relationships

Investigators - Liam Murray, Northern Ireland Cancer Registry,

Harry Comber, National Cancer Registry of Ireland

Carcinoma of the oesophagus is a relatively common cancer

with a very high mortality rate. It is usually either a squamous

cell tumour or an adenocarcinoma. The last two decades have

seen a dramatic increase in the incidence of oesophageal

adenocarcinoma in the United States and Europe, including

Northern Ireland. The recent rate of increase in this cancer

exceeds that seen in virtually all cancers at other sites, and this

increase has been particularly marked in males. The reason for

the increase in incidence of adenocarcinoma is unknown. The

majority of oesophageal adenocarcinomas arise in a

premalignant precursor known as Barrett’s oesophagus, but only

a small proportion of cases of Barrett’s oesophagus develop

malignancy. The epidemiology of Barrett’s oesophagus is

increasing at a similar rate to oesophageal adenocarcinoma, but

the apparent increases may be artefactual.

This study will use 10 years of data from the first truly

population-based register of Barrett’s oesophagus (maintained by

the Northern Ireland Cancer Registry) to conclusively determine

whether this condition is increasing or not. If an increase is

confirmed, future research in this field can be expected to focus

on the determinants of the rise in Barrett’s oesophagus and on

why some patients with this condition develop a malignancy

while others do not.

Using a case-control study approach, this investigation will also

examine genetic and environmental factors that may govern this

progression. The results of this study will undoubtedly shed light

on the reasons for the recent increase in oesophageal

adenocarcinoma. This knowledge, combined with the possible

identification of triggers and mechanisms involved in malignant

progression within Barrett’s oesophagus, may provide future

opportunities to reverse the upward trend in oesophageal

adenocarcinoma.

Natural Killer cell lymphoma. The

pathology, radiology, and management

plan were discussed with NCI

colleagues using the TELESYNERGY®

system. This is an example of rare

cancer management for which

collaborative thinking and access to

NCI expertise were essential to achieve

the best outcome.

Technology exchange and treatment

development

 Dr. Cynthia Menard, on behalf of the

Radiation Oncology Branch/Radiation

Oncology Sciences Program of the

NCI, presented new developments in

image-guided prostate cancer

brachytherapy, combining a

presentation of patient history,

pathology, dynamic colour-enhanced

MRI imaging, and treatment. This

discussion highlighted the interactive

and multiplex image capability of

TELESYNERGY® and the potential

for cutting edge therapeutic approaches

to be shared and developed across the

three jurisdictions.

Clinical trial development and

translational research

 Professor Donal Hollywood presented

an outline proposal of the first clinical

trial that will use the TELESYNERGY®

system. The proposed esophageal

protocol combines novel neoadjuvant

treatment with prospective genomic and

proteomic studies on biopsy specimens

obtained from participating patients.

This is an early example of an NCI-All

Ireland clinical research protocol in

which the Consortium partners will

develop novel translation research
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 21

treatment protocols combined with

complex analysis of tissue samples and

the utilization of bioinformatics

expertise at the NCI.

In parallel with the November 2002

demonstration, multidisciplinary

TELESYNERGY® users groups,

representing a wide range of clinical

disciplines, have regularly convened in

Dublin and Belfast, enabling the training of

additional staff on the use of the system.

Professor Donal Hollywood, Dr. Norman

Coleman (NCI), Professor Patrick Johnston,

Dr. Seamus McAleer, and colleagues are

currently examining the clinical use and

potential benefit of TELESYNERGY®

particularly in the context of clinical trial

development and its potential integration

with net-Trials® or any future clinical trials

information management system.

net-Trials®

net-Trials® is a web-based information

management database that provides a

uniform patient data collection system to

enable the storage and exchange of complex

information related to clinical trials,

including trial design, development, and the

recording of patient accrual.

The net-Trials® system was installed at the

Clinical Trials Unit at Belfast City Hospital

during 2000-2001. The Belfast unit has

gained important initial experience in testing

the system and several ongoing clinical trials

have used the web-based system to support

clinical protocol development, patient

recruitment, patient screening and

registration, and preliminary analyses of

data. Although the platform has significant

strengths, the future use and support of netTrials® as the preferred clinical trials

information management platform is

currently under review by the NCI. It is

anticipated that the recently approved

clinical trials units in the Republic of Ireland

will have early access to net-Trials® or any

future development of this clinical trials

information management system.

Nursing

The Nursing Working Group welcomed

Mary McCarthy in October 2001 as the new

Chief Nursing Officer in Dublin, having

said a grateful farewell to Peta Taaffe, who

has retired.

Two nurses participated in the summer 2001

cancer prevention programme and brought

back a wealth of ideas for local

implementation. Three nurses (one from the

North and two from the South) attended a

12-week clinical trials training

programme––January to April

2002––gaining useful knowledge and

experience and sharing ideas with NCI

colleagues at both the U.S. National

Institutes of Health Clinical Center and the

National Naval Medical Center in Bethesda,

Maryland. A further four nurses attended a

similar programme––September to

November 2002––following meetings

between the two Chief Nursing Officers and

NCI nursing colleagues around the April

2002 Implementation Group and Board

meetings in Washington.

Chief Nursing Officers Mary McCarthy (IR) and

Judith Hill (NI)
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22 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

A call went out for a special international

cancer nursing research fellowship,

supported by an information day; however,

no fellowship was awarded in 2001 or 2002.

The fellowship is currently being reviewed,

and it is hoped it will be offered again in a

revised format in 2003.

Joyce Stocker and Georgie Cusack from the

NCI had the opportunity to meet colleagues

in Dublin and contribute to the development

of relationships and collaborative work. Ms.

Stocker was able to participate in an

information day in May when nurses who

had been to NCI reported on their

experience and encouraged others to seize

the opportunities offered by the

Consortium. Details of the day can be

found on the Consortium Web site.

Work is ongoing to develop opportunities

for NCI staff to visit the island of Ireland

and undertake a programme in palliative

care. Nurses and doctors from the North

and South attended the July 2002 State of

the Science meeting at NCI, and it is hoped

further collaborative work on supportive and

palliative care can be initiated.

Nurses participated in a major cancer

conference in Belfast in October 2002 and

shared their experiences while at the NCI.

The Nursing Group is developing a strategic

plan that includes development of a shared

research agenda in cancer nursing and

continued consolidation of the clinical trials

training initiative and palliative care

opportunities.

Prevention

The prevention of cancer has been an

interest of the Consortium since its

inception. Building on a strong foundation

of achievements of the Consortium’s

programmes in clinical trials, scholar

exchange, cancer registries, information

technology, and nursing, the Board of

Directors established the new Prevention

Working Group at its December 2001

meeting. The mission of this working group

is to enhance coordination and cooperation

on primary, secondary, and tertiary cancer

prevention research and practise activities on

an all-island basis. The group will stay

abreast of existing and developing

prevention programmes and activities on the

island, and will make recommendations that

will advance the Consortium’s objectives in

this vital area. The composition of the new

group is multidisciplinary, with

representation from the health ministries at

the national and local levels, the cancer

registries and health promotion agencies, as

well as from academia and from the allisland Institute of Public Health and the U.S.

National Cancer Institute.

Progress to Date

At its first meeting, held in spring 2002,

Prevention Working Group members

discussed prevention activities in their

respective jurisdictions and began to

formulate initiatives that could be

undertaken by the Consortium. Health

promotion activities on the island were

described; exemplary programmes have been

established in tobacco control and in the

prevention of melanoma. The cancer

registries’ role in prevention was discussed.

These registries provide valuable data on the

incidence, mortality, and survival rates of

cancer patients across the island,

information vital to the assessment of

progress against cancer through prevention

and treatment. Prevention activities of

academic institutions, the Institute of Public

Health, and the National Cancer Institute

filled out the meeting’s agenda.

The group identified several areas of need.

These include better coordination of current
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 23

prevention efforts in the North and South,

and the training of scientists, public health

investigators, clinicians, nurses, and other

health care personnel in all aspects of

prevention. A specific need for postdoctoral

research training opportunities in prevention

was identified. Members were particularly

interested in continuing efforts to participate

in the NCI’s Summer Curriculum in Cancer

Prevention––a Consortium-sponsored

activity under way since summer 2001. The

group was also keen to take advantage of

NCI’s Cancer Prevention Fellowship

Program, a highly competitive programme

that trains individuals from many health

science and medical disciplines in the field of

cancer prevention and control through

structured didactic education, mentored

research, and leadership training.

Members of the Working Group recognise

the many dimensions of cancer prevention,

from basic molecular prevention science

through epidemiology and behavioral

science to the application of scientific

findings in health promotion activities and in

population-based policymaking. Cancer

prevention is, in theory, an old idea and, in

practise, a relatively new facet of cancer

research, cancer care, and public health. As a

way to increase awareness of the dimensions

of prevention and to elicit support from the

many communities involved, members are

considering holding a series of workshops

on the island. These Consortium-sponsored

workshops would focus on the prevention of

specific cancers or on cancer risk factors

such as smoking and would serve to raise

awareness of the many dimensions of

cancer prevention among researchers,

practitioners, and policymakers alike. Initial

workshops may, for example, address those

cancers that utilise the greatest amount of

resources or that have the highest rates of

morbidity and mortality as described in the

Consortium-sponsored All-Ireland Cancer

Statistics Report. Prevention will also be a

featured topic at the Consortium’s upcoming

2003 All Ireland Cancer Conference in Cork.
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HOW THE CONSORTIUM OPERATES

24 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

The Memorandum of

Understanding

The Consortium operates under guidelines

outlined in the Memorandum of

Understanding (MOU) signed in 1999.

(Refer to the appendix for a copy of the

MOU.)

The major objective of the Ireland-Northern

Ireland-National Cancer Institute Cancer

Consortium is to intensify cooperation in

cancer treatment and research that will lead

to improved scientific programmes in each

partnering country in the areas of education

and training, cancer treatment and research,

information dissemination, epidemiology,

cancer prevention, surveillance, early

detection, quality control, and interactions

aimed at enhanced public health and patient

care.

To meet those objectives, the participating

countries have continued to focus on four

initial programmes:

1. Establishment of a clinical trials

network among cancer centres and

hospitals in Ireland and Northern

Ireland

2. Scholar exchange and training between

institutions in Ireland, Northern

Ireland, and the U.S. National Cancer

Institute

3. Information technology enhancement

to enable collaboration on clinical trials

4. Data sharing and collaboration among

the island’s two cancer registries

Consortium Governing

Structure

Board of Directors

The Consortium is governed by a Board of

Directors comprised of the Chief Medical

Officers of Ireland and Northern Ireland,

and the Director of the National Cancer

Institute.

The Consortium Board of Directors:

 Determines the Consortium’s scope of

activities

 Evaluates and oversees contributions by

each jurisdiction

 Establishes working groups to carry out

programmes where necessary

 Monitors progress of activities in

accordance with the Consortium’s

mission

 Submits an annual report to the

participating heath departments

The Board must meet at least two times each

year. Chairmanship rotates each year

between the Chief Medical Officers of

Ireland and Northern Ireland. In 2002, the

Chair was James Kiely of Ireland. In 2001,

the Chair was Henrietta Campbell of

Northern Ireland.

Implementation Group

The Implementation Group advises the

Board, and establishes and manages specific

programmes. Its responsibilities are to:

 Develop the detailed plans to assure

that the overall goals of the Consortium

are met

 Call together the necessary expertise to

assess issues and develop workable

plans for the Board to consider

 Identify areas that require the attention

of the Board members and their

respective governments

 Serve as liaison between the working

groups and the Board of Directors

The Implementation Group meets at least

four times per year, in person or by

conference call. In 2001-2002, the

Implementation Group was chaired by Joe
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 25

Harford, Director of the National Cancer

Institute’s Office of International Affairs. Its

members include the Chief Nursing Officers

of Ireland and Northern Ireland, as well as

scientific and administrative representatives

of the Health Research Board of Ireland

and the Research and Development Office

of Northern Ireland, the National Cancer

Institute, and the major hospitals and health

boards of Ireland and Northern Ireland.

Working Groups

When necessary to advise on a specific issue,

the Board establishes ad hoc working groups

whose role is to stay abreast of needs and

activities within their designated areas and to

make recommendations on activities that will

enhance the Consortium’s objectives. Ad hoc

working groups convened in 2001-2002

covered the areas of nursing,

telecommunications/information

technology, cancer registries, scholar

exchange, prevention, and clinical trials.

October 2001 Implementation Group, conference call

December 2001 Board of Directors, London

March 2002 Implementation Group, conference call

April 2002 Implementation Group, Washington, D.C.

Board of Directors, Washington, D.C.

July 2002 Implementation Group, conference call

October 2002 Implementation Group, Belfast

Board of Directors, Belfast

July 2001 - December 2002

Governance Meeting Schedule
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SPOTLIGHT ON CONSORTIUM SCHOLARS

26 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

In 2001 and 2002, the Consortium

sponsored three scholar exchange

programmes in disciplines identified as

having significant need for advanced training

in Ireland and Northern Ireland: research

nursing, cancer prevention, and cancer

epidemiology (population studies). The

concept behind each training programme is

for scholars to gain in-depth knowledge in

these areas of research so that they can

apply new perspectives and techniques to

their positions at their home institutions.

Various Consortium working groups

conceptualised the training programmes and

worked with personnel at NCI, and at the

hospitals, cancer centres, and cancer

registries in Ireland and Northern Ireland to

develop the course descriptions and define

eligibility requirements, travel logistics, and

certification details for the scholars to train

in the United States. A total of 21 scholars

from Ireland and Northern Ireland

participated in the first year’s programmes at

NCI. Profiled here are several scholars who

describe their experience at NCI and how

they are sharing their newfound knowledge

in cancer research with their peers at home.

Epidemiology

Fellowship 

Epidemiology - the study of disease trends

and patterns in the population - is growing

in importance on the island of Ireland as

both North and South strive toward a better

understanding of cancer trends among the

entire population. The number of trained

epidemiologists on the island is critically low,

accounting for only a handful of experts

trained in interpreting the statistics compiled

by the two cancer registries. In winter 2001,

the Consortium awarded its first

epidemiology fellowships to Peter McCarron

of Northern Ireland and Paul Walsh of

Ireland. In summer 2002, the two scientists

concluded their first year of postdoctoral

study in cancer epidemiology at NCI. They

will spend years two and three of their

three-year fellowships translating their

experiences into cancer research projects on

the island. Utilising data from the Northern

Ireland Cancer Registry in Belfast, Dr.

McCarron plans to study patterns of care

for prostate cancer. Dr. Walsh is developing

a breast cancer project with the Irish

National Cancer Registry in Cork. It is

anticipated that the fellows will help to direct

collaborative research activity on the island

of Ireland.

Peter McCarron, epidemiologist,

Northern Ireland Cancer

Registry, Belfast

Though I grew up in Derry, I had never

worked in Northern Ireland. I had received

my training in Dublin and in other parts of

the U.K. I learned about the opportunity to

apply for the Consortium’s fellowship in

cancer epidemiology through the British

Medical Journal and jumped on it, thinking it

would be a good opportunity to learn more

about a growing field and apply my expertise

at home.

Until a few years ago, most of my career had

been in public health medicine and

cardiovascular epidemiology. With the

startup of the cancer registries in Ireland

and Northern Ireland in the 1990s, there is a

great chance to study cancer epidemiology in

Ireland. Strengths such as coverage of the

whole island and the genetic homogeneity of

the population provide potential for

contributing to the understanding of cancer

etiology and enhancing preventive efforts.

For a researcher, the emphasis on

collaboration between North and South, and

on improving public health, provides

enormous opportunity to train in cancer

epidemiology here in Northern Ireland.

“With our

current

emphasis on

collaboration

between North

and South, and

on improving

public health,

there is

enormous

opportunity to

train in cancer

epidemiology

here in

Northern

Ireland.”

Back in Belfast

after a year at

NCI, Peter

McCarron is

working on a

study of geneenvironment

interactions in

the etiology of

prostate cancer.
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 27

I applied for the three-year fellowship and

within a short period of time found myself

at the National Cancer Institute just outside

of Washington, D.C. During the first

portion of the fellowship, I collaborated

with a number of U.S. researchers, analyzing

data from a large ongoing cancer study and

writing research papers. While at NCI, I also

took three courses in biostatistics and one in

genetics at the Johns Hopkins School of

Public Health in Baltimore. In addition, I

participated in the six-week summer cancer

prevention course taught at NCI, and took a

course on the methods used in cancer

registration. These courses were all enjoyable

and extremely useful, and the biostatistics

courses were very challenging, requiring me

to revisit mathematical concepts I had long

forgotten.

After my time in the States, I am back in

Belfast where I am continuing my

fellowship. I am currently working with a

clinician here on a study of geneenvironment interactions in the etiology of

melanoma. We are planning to write a grant

application, to extend this study by possibly

investigating the differing contribution of

genetic and environmental factors among

people who develop melanoma in the United

States and in Ireland. In addition, using

unique data on prostate-specific antigen

(PSA), I am collaborating with a number of

colleagues in Belfast to determine the trends

in PSA testing in Northern Ireland, and the

outcomes for men undergoing the test. Also,

along with my fellow colleague from Ireland,

Paul Walsh, who was the main contributor to

the recent All-Ireland Cancer Statistics Report, I

will likely write a paper on some of the

important findings contained in the report.

Perhaps the best part about the fellowship

was the contacts I made with population

studies experts at NCI. They have been

invaluable in designing our research project

and offering ongoing advice.

Paul Walsh, Consortium Fellow,

Cancer Epidemiology, National

Cancer Registry (Ireland)

My involvement with the Consortium began

with work on compiling the All-Ireland Cancer

Statistics Report. While collaborating on the

report, I heard about the scholar exchange

programme. I didn’t think I had a chance of

being selected, but colleagues encouraged

me to apply. And I was learning a good deal

from working on the report, so enthusiasm

about that project carried me forward to

seek new opportunities.

My background is in zoology, and I was

looking forward to the opportunity to gain

formal training in cancer epidemiology. The

sciences of zoology and cancer

epidemiology overlap in that they use similar

statistical techniques to analyse populationbased data. I wanted to apply and expand

my existing knowledge, and to gain exposure

to research at NCI.

I benefited from both the formal training in

epidemiology and prevention techniques,

and the informal exposure to NCI

researchers. You can’t find a larger

concentration of cancer researchers

anywhere else in the world. NCI’s SEER

database is an impressive tool. And I learned

about statistical techniques not yet available

in Ireland because they are newly developed

at NCI. Access to other programmes, such

as the Johns Hopkins University School of

Public Health, was also valuable.

The potential for our registry to take

advantage of NCI’s SEER data, and their

potential to inform data collection and

analysis in Ireland, is exciting. For example, I

have been working with Irish data tabulated

in SEER format in order to use SEER data

analysis techniques. This will allow us to

create survival analyses, and we are already

making detailed comparisons with U.S. data.

“I look

forward to

continuing to

exchange ideas

and share

experiences

with

colleagues

from the

North and the

South as well

as the States.”

As an

Epidemiology

Fellow, Paul

Walsh

participated in

the NCI’s

Summer

Curriculum in

Cancer

Prevention.
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28 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

I also hope to link data to risk factors, and

to undertake case-control and cohort studies.

I remain in touch by e-mail with people I

met, and look forward to continuing to

exchange ideas and share experiences with

colleagues from the North and the South as

well as the States.

Nurses’ Clinical Trials

Programme

Ireland and Northern Ireland––like the

United States and other parts of the

world––face a severe shortage of nurses.

Hospitals and clinics throughout the island

find themselves launching international

recruitment efforts, looking for nurses to

relocate from remote places such as Africa

and the Philippines. Early on, the

Consortium’s Board of Directors recognised

the need to retain Irish nurses who are

already working in clinical research and to

provide them with special training

opportunities to maintain a strong nursing

workforce. It placed as a priority a scholar

exchange programme in the area of clinical

research nursing to enhance the skills of

Irish nurses, who in turn would train future

nurses in cancer research.

The field of research nursing is fairly new to

the island because neither North nor South

has launched a significant clinical trials

system until recently. The board recognised

that each country needed an ample number

of well-trained research nurses versed in a

uniform system of practises and

methodologies to sustain a clinical trials

system linking hospitals and cancer centres

throughout the island. As a result, three

clinical oncology nurses––Catherine

O’Brien, St. James’s Hospital, Dublin; Marie

Sheehan, Mid-Western Health Board,

Limerick; and Naomi Hill, Belfast City

Hospital––applied for and completed the

three-month nurses’ clinical research

programme in the United States. From

February to April 2002, the nurses shadowed

a research team in gastrointestinal cancers

carrying out clinical trials at NCI’s 500-bed

Clinical Center in Bethesda, Maryland, and

at the National Naval Medical Center, where

NCI conducts a clinical research

programme.

The training programme gave the nurses the

opportunity to experience firsthand all

aspects of working in a clinical trials setting.

During their course, the nurses worked

closely with NCI clinical and research

nurses, under the direction of NCI nurses

Joyce Stocker and Georgie Cusack, on

managing trials as part of a team of

scientists, oncologists, statisticians,

pharmacologists, and other technical experts.

The course provided the fundamentals of

clinical research, including the different

phases of clinical trials, ethical issues, patient

education, and trial documentation, as well

as an understanding of how treatment

options are decided and protocols are

reviewed, and the importance of clear

communications among all research team

members.

Upon the nurses’ return to their home

institutions, in May 2002, the Consortium’s

Nursing Working Group held an

Information Day at St. James’s Hospital and

Belfast City Hospital to introduce NCI and

the nurses’ programme to staff nurses.

Catherine O’Brien, Clinical Nurse

Specialist in Oncology, St.

James’s Hospital, Dublin

Having worked in oncology for more than

eight years, a large part of that in the clinical

trials setting, I was eager for the opportunity

to train at the National Cancer Institute to

learn more about how we could enhance the

nurse’s role in clinical research in Ireland. I

“The

experience has

highlighted for

me the

importance of

clinical trials in

advancing

cancer care in

Ireland.

Research and

clinical nurses

have a huge

role to play in

making this

happen.”
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commitment + progress + opportunity + commitment + progress + opportunity + commitment + progress + opportunity + commitment + progress + opportunity +

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commitment + progress + opportunity + commitment + progress + opportunity + commitment + progress + opportunity + commitment + progress + opportunity +

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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 29

found there was a gap between the role of

the research nurse and that of the clinical

nurse. My main objective was to observe

how these two roles integrated in the U.S.

and hopefully identify ways to strengthen

collaboration between both groups in

Ireland. At St. James’s, we have about 60

clinical nurses and only 3 research nurses, a

position introduced here about 5 years ago.

In Ireland, we do not initiate and coordinate

many of our own clinical trials yet. Typically,

they originate in the U.K. or another

country, and we participate in them. In the

future, St. James’s and other Irish hospitals

plan to coordinate more trials from here.

When that happens, the nurses will be a core

group that helps to set the trials up and

enables them to run smoothly.

The experience that I gained at NCI was

excellent. Through my job as a clinical nurse

here, I had a good understanding of the role

of the research nurse. But after spending

time actually being part of the NCI team, I

developed a much clearer insight into the

different roles that each member of a clinical

research team plays. When we first arrived,

NCI hosted a three-day course on the

fundamentals of clinical trials that walked us

through the life cycle of a clinical trial, from

the initial concept, through recruiting

patients, to enrolling them and initiating the

trial. We attended lectures and in-service

training days that were very beneficial. Then,

we followed and participated in trials as part

of the research team. I had never been

involved in this before. The experience will

be extremely helpful when the time comes

for us to initiate more trials in Ireland.

Since I returned to Ireland, I have conducted

presentations for our staff about my

experience. I brought back with me folders

full of materials on cancer, clinical trials, and

other information from NCI, so I am a

resource for others in the hospital. My goal

is to make sure every nurse in our oncology

unit is briefed about the course and has a

chance to learn what I learned at NCI.

These kinds of training programmes are

excellent, and I would not have had this

opportunity if it weren’t for the Consortium.

I did not realise the huge role that nurses

play in initiating and running a clinical trial.

Having a limited experience in this area at St.

James’s, the NCI experience exposed me to

the whole picture. I see opportunities now,

for how both clinical and research nurses in

Ireland can become more involved in clinical

trials. I have identified ways to strengthen

collaborations between both roles and,

hence, bridge that gap.

I would like to enhance my role as a clinical

nurse in the clinical trials setting, particularly

in the area of patient education and making

people aware that clinical trials are an option

for them. I want to shed some light on the

importance of clinical trials in advancing

cancer care and treatment. At NCI, I got a

look into the future of cancer care. It

convinced me that there are a lot of exciting

things happening––new treatment

possibilities on the horizon. I am hopeful

that there will be a huge role for clinical

research in Ireland very soon.

Naomi Hill, Clinical Research

Nurse, Northern Ireland Cancer

Clinical Trials Unit, Belfast City

Hospital 

My main objective in taking part in the

scholarship was to learn about phase I

clinical trials. The objective of a phase I trial

is to determine a safe dose that is

appropriate for use in phase II trials. In

Northern Ireland, we have conducted mainly

phase II and phase III clinical trials, and are

now further developing phase I clinical trials.

The Northern Ireland Cancer Clinical Trials

Unit has set up a team of clinicians and

research nurses who are involved and

interested in this area. The experience I

“Most

importantly, 

I developed

contacts with

many cancer

research

experts in the

U.S. who I still

call upon for

help and

advice. That

has been

indispensable.”
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commitment + progress + opportunity + commitment + progress + opportunity + commitment + progress + opportunity + commitment + progress + opportunity +

commitment + progress + opportunity + commitment + progress + opportunity + commitment + progress + opportunity + commitment + progress + opportunity +

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30 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

gained within the scholarship has been of

great benefit to this project.

The majority of my time was spent with the

GI research nurses in the National Naval

Medical Center. Through their expertise I

have gained a high level of knowledge in

caring for the patient involved in a phase I

clinical trial. All aspects were covered, from

setting up and coordinating a study to the

importance of close communication with

staff and the patient.

One of the advantages of spending time

working in the world’s leading cancer

research hospital was the opportunity to

make contacts with other research nurses. I

am able to maintain a strong network

through e-mail, to get help, advice, and

answers to my questions from my friends

and colleagues in the States. I, in turn, will

be able to advise my colleagues from the

North and South of Ireland should they

need support.

It is my hope that, through my positive

experience in the scholar exchange

programme, others will be encouraged to

take up the opportunity to take advantage of

the education available, make new contacts,

and on the whole, take part in working

together to improve cancer care delivery in

Ireland.

NCI Summer

Curriculum in Cancer

Prevention

More than 30,000 new cases of cancer are

diagnosed on the island of Ireland each year.

One in three people in Ireland and Northern

Ireland will develop some form of cancer by

the age of 74. After heart disease and stroke,

cancer kills more Irish people every year

than any other cause. Lung cancer, brought

on by smoking, is higher in Ireland than

other European countries, accounting for

about one in four cancer deaths. These and

other cancer patterns were reported in the

first All-Ireland Cancer Statistics Report,

compiled by the island’s two cancer registries

and announced by the Consortium in 2001.

While each year sees astonishing advances in

cancer treatment, the report pointed to the

critical need for a major effort in both parts

of Ireland for cancer prevention.

“Prevention is better than cure, and many

cancers are preventable,” said Northern

Ireland Health Minister Bairbre de Brún, in

remarks at the release of the report in May

2001.

Cancer prevention is the domain of a

breadth of health care specialists––dieticians,

oncologists, nurses, epidemiologists,

pathologists, geneticists––so the National

Cancer Institute opened its popular six-week

Summer Curriculum in Cancer Prevention to

Irish scholars from a variety of disciplines.

In 2001, more than 70 scholars competed

for positions sponsored by the Irish Health

Research Board and the Northern Ireland

Research and Development Office and 16

scholars from Ireland and Northern Ireland

were selected to participate. In 2002, 18

scholars––15 from Ireland and 3 from

Northern Ireland––joined approximately 75

other specialists from the United States and

around the world for the course at NCI. The

six-week curriculum comprises a five-week

segment on the principles and practises of

cancer prevention and a one-week segment

on molecular prevention.

The principles and practises course covers

the resources, data, methods, and theories

related to cancer prevention and control.

Among the topics discussed are causal

inference and evidence-based decisionmaking, biometric methodology, prevention

of organ-specific tumors, community-based

interventions, and health disparities and

special populations. Participants learned

Naomi Hill hopes

that her positive

experience with

the scholar

exchange

programme will

encourage others

to take advantage

of the education

available.
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 31

techniques for conducting bibliographic

searches and literature review.

The molecular prevention course covered

molecular biology and the genetics of

cancer, as well as an overview of basic

laboratory approaches in epidemiology,

bionutrition, chemoprevention, biomarkers,

and translational research. Topics covered

include oncogenes, DNA damage and repair,

apoptosis, angiogenesis, and cell signaling.

Liam Murray, Senior Lecturer in

Epidemiology, Northern Ireland

Cancer Registry, Department of

Epidemiology and Public Health,

Queen’s University Belfast

I recently took up a post with the Northern

Ireland Cancer Registry. My previous work

was mainly in cardiovascular epidemiology,

and I wanted to get up to speed on cancer

epidemiology, especially from a worldwide

perspective. The opportunity to gain

knowledge of the most current cancer

prevention research and to link with people

at NCI was of great appeal.

My experience in the scholar exchange

programme was marvelous. The prevention

course content fulfilled my high

expectations. I gained broad knowledge

about the main cancers from both a U.S. and

a global perspective. The information was

presented in a concentrated but easily

digestible format, and I appreciated being

able to experience the breadth of cancer

prevention work at NCI. A key advantage

was being instructed by people actually

doing the work.

During the course, there was sufficient time

to make contact with people working at

NCI. I found the openness and collaborative

spirit of the people at NCI to be most

stimulating and encouraging. Being across

the table from NCI researchers and

discussing research ideas was an

extraordinary opportunity.

Since returning to Belfast, we’ve become

quite involved in Consortium activities. I’ve

since joined the newly established

Prevention Working Group. The

ramifications of this tripartite group promise

to be substantial for cancer prevention and

epidemiology on the island of Ireland.

Short-term, we hope to establish a

significant cancer prevention programme in

our Department of Epidemiology and

Public Health, drawing on the experience

and expertise of colleagues from Ireland,

Northern Ireland, and NCI. My time at NCI

gave me ideas for focusing our research.

Perhaps in five years, we’ll have a research

programme of international significance.

Jennifer Quinn, Post-doctoral

Research Fellow, Oncology,

Belfast City Hospital 

The focus of my research is the BRCA1

tumour-suppressor gene and its role in the

development of the inherited and sporadic

forms of breast and ovarian cancer. Having

attended the signing of the NCI All Ireland

Consortium at Stormont in 1999, I was

particularly impressed by the objective of

the scholar exchange programme. Therefore,

I was delighted to have the opportunity to

participate in the NCI cancer prevention

course.

The course involved a series of lectures

given by world experts in the field of cancer

research. I was able to gain a clearer insight

into the fields of immunology and

xenobiotic metabolism, as well as the use of

animal models in cancer prevention studies.

I was also particularly interested in how

biomarkers could be used in epidemiological

studies. I also learned more about various

topics that relate closely to my own research,

“I found the

openness and

collaborative

spirit of the

people at NCI

to be most

stimulating and

encouraging.”

Liam Murray,

Senior Lecturer

in Epidemiology,

Northern Ireland

Cancer Registry,

Department of

Epidemiology

and Public

Health, Queen’s

University

Belfast,

participated in

the cancer

prevention course

at NCI and has

joined the newly

established

Prevention

Working Group.

“Prevention is

at the heart of

curing cancer.

Our goal is to

do research

with strong

clinical

implications.”

Jennifer Quinn of

Belfast City

Hospital says the

cancer prevention

course at NCI

was “a unique,

informative, and

enjoyable

experience” and

recommends this

course to others.
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32 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

such as hormonal carcinogenesis and the use

of microarrays and proteomics. An

understanding of these areas will be essential

for the future of cancer prevention and also

for improving the diagnosis and treatment of

cancer patients.

The cancer centre at Belfast City Hospital is

now a major centre of excellence within

Europe. Our goal is to become a leader of

clinical research, particularly with an interest

in the translation of basic science into

clinical practise. My attendance at the NCI

cancer prevention course provided me with

a greater understanding of how cancer

prevention could be better applied in the

future as well as enhancing my own research

ideas in terms of the clinic. In summary, the

cancer prevention course is a unique,

informative and enjoyable experience

combined with the opportunity to

experience NCI and Washington, D.C. I

would therefore strongly recommend this

course and other scholar exchange programs

to postdocs, principal investigators, and

specialist registrars.

Gerald O’Sullivan, Oncology

Surgeon at Mercy Hospital, Cork,

and Director of Cork Cancer

Research Centre, Cork, Ireland

Our focus at the Cork Cancer Research

Centre is on developing insights into new

treatments and prevention measures for

cancer. We are in the process of developing

a cancer prevention clinic in Cork that will

study the epidemiology of cancer, early

diagnosis, and ways to prevent cancer from

developing in the first place through

prevention.

This year, we are completing our first study

on probiotics and epithelial functions in

gene expression in colon cancer. We have

just completed the field work and now will

begin the lab work in the probiotics study,

which involves the feeding of live

bacteria––the bacteria that are good for

you––to people on study to test their

effectiveness in preventing colon cancer.

That is just one example. Our role in the

larger picture will be to apply some of our

key findings from prevention studies to

relevant cancer prevention campaigns

coordinated through the Department of

Health and Children.

Our hopes are high that we can build a

strong prevention programme here. We have

a good cohort of people, strong U.S. ties

that provide us training and guidance, and

the willingness of the people to succeed. We

must motivate people here to invest in

careers in cancer prevention. In my

observation, the Irish cancer community is

becoming better established. Recently, many

of our scientists have published wellrespected papers in international peerreviewed publications. We have high quality

medical care and a stable community, so

there is no reason why Ireland cannot

become a major cancer research community.

I found the Consortium’s cancer prevention

programme to be quite helpful. I have a

background in biostatistics, so the course

helped bring everything together in a

prevention and epidemiological context. At

my stage in life, you need to embrace life

and take advantage of opportunities like this

to expand personally and professionally, and

to share with younger people building their

careers.

“Ireland has

high quality

medical care

and a stable

population so

there is no

reason why

Ireland cannot

become a

major cancer

research

community. We

just need more

skilled people

entering the

profession. We

could do great

work.”

Professor Gerald

O’Sullivan and

colleagues are

developing a

cancer prevention

clinic in Cork to

study the

epidemiology,

early diagnosis,

and prevention of

cancer.
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 33

Siobhan O’Sullivan, Senior

Researcher, Genetic

Epidemiology, University College

Cork, Department of

Epidemiology and Public Health

I became interested in the programme

because of my work in epidemiology. My

chief research area currently is the study of

cardiovascular disease. There is a strong

overlap between cardiovascular and cancer

prevention, especially in the area of diet and

genetics, so the course was extremely helpful

to all that I do. I have a genuine interest in

disease prevention. With a Ph.D. in

biochemistry and lots of experience in lab

work, I was anxious to learn the broader

aspects of prevention, including nutrition

and prevention awareness.

The programme was superb. I couldn’t say

enough about it. The lectures were excellent

and very well organised. We had the

opportunity to talk to the lecturers each day

to learn more about their topics of interest.

We also participated in discussion groups

with people from different countries to learn

how they approached cancer prevention. It

was especially interesting to see how other

countries deal with this topic. Participants

included people from France, Italy,

Germany, Romania, Turkey, and China. I

have kept in touch with many of the people

I met. Back in Ireland, we have even had

reunions of some of the Irish participants.

It was a great opportunity to meet other

Irish people working in the area––I found

that some were geographically quite close to

where I work, but we had never met before.

The best part of the course for me was the

dietary and the molecular prevention section.

I also got a lot out of the section on

biometric statistics and methodology, which

covered their applications to clinical trials.

Back home, I use my course manuals a lot as

reference material when giving lectures on

genetic epidemiology. I bring in examples I

learned through the course.

People interested in furthering their career

need expertise and often need to go away to

get it. NCI has bigger departments, more

people, more money, so naturally they have

the resources, critical mass, and expertise,

and they are willing to share this through

this excellent programme. Genetic

epidemiology is a relatively new discipline in

Ireland. We are doing very good research in

epidemiology here, and with more exchange

programmes, it will be possible for Ireland

to become an internationally competitive

country in the field of cancer research.

Siobhan

O’Sullivan,

University

College Cork,

Department of

Epidemiology

and Public

Health,

participated in

the six-week

cancer prevention

course at NCI.

“The

discussion

sessions with

scholars from

NCI and

around the

world––from

Germany,

France, the

Czech

Republic, India,

China––really

opened my

eyes to the

different

approaches

that different

countries take

toward cancer

prevention.”
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PARTNERS AND INSTITUTIONAL MEMBERS

34 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

Ireland

Department of Health and

Children

Ireland’s Department of Health was

established in 1947, under the Ministers and

Secretaries (Amendment) Act of 1946.

Before 1947, the public health services were

the responsibility of the Department of

Local Government and Public Health, and

continued to be administered by local

authorities until 1970. The Health Act, 1970,

which established eight health boards and

abolished the Hospitals Commission,

increased the Department’s direct

involvement in the execution of health

policy. The emphasis on the curative and

regulatory aspects of the health services, and

on the need to develop the acute hospital

sector in particular, remained one of the

defining characteristics of health policy in

the decade following the passing of the Act.

The period from 1970 to the mid-1980s was

marked by a consistent development of

services in accordance with the policy

commitments in the 1966 white paper The

Health Services and Their Further Development.

The publication of the health strategy

Shaping a Healthier Future, in 1994, was the

culmination of a reappraisal of the health

services that had commenced in 1986 with

the discussion document Health: The Wider

Dimensions. Shaping a Healthier Future signaled

a significant change in direction, with its

emphasis on the achievement and

measurement of health gain and social gain

and its commitment to organise and manage

the system as an integrated whole.

A new health strategy for the next 7 to 10

years, Quality and Fairness, was launched in

2001. The new strategy is based on the

principles of equity, people-centredness,

quality, and accountability. Key elements

include the largest expansion in hospital bed

capacity in the health service’s history; a new

Treatment Purchase Fund to buy treatment

for public patients waiting more than three

months from initial referral; the addition of

more day care places, respite care places, and

residential capacity for people with

disabilities; development of an Action Plan

on Age; a statutory complaints procedures;

and establishment of a new National

Hospitals Agency and an independent

Health Information and Quality Authority.

The Department of Health became the

Department of Health and Children in 1997.

Ireland’s Health Minister is Micheál Martin.

Northern Ireland

Department of Health, Social

Services and Public Safety

Northern Ireland’s Department of Health,

Social Services and Public Safety (DHSSPS)

was established by the Department (NI)

Order 1999. The Department administers

the business of Health and Personal Social

Services (HPSS), which covers hospitals,

family practitioner services, community

health and personal services; Public Health,

which promotes and protects the health and

well-being of the population of Northern

Ireland; and Public Safety, which

encompasses the Fire Authority, food safety,

and emergency planning. The Department

endeavors to improve the health and social

well-being of the people of Northern

Ireland by ensuring the provision of

appropriate health and social care services,

both in clinical settings, such as hospitals

and GPs’ surgeries, and in the community,

through nursing, social work, and other

professional services. It also supports

programmes of health promotion and

education to encourage the community to

adopt activities, behaviours, and attitudes

that will lead to better health and well-being.

The Department has in place a three-tiered

corporate planning programme:

1. DHSSPS Corporate Strategic Plan

(1998/99-2002/03) to set strategic

direction
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 35

2. Regional Strategy (1997-2002), which

provides strategic direction for HPSS,

and Well into 2000, a 1997 publication

that sets the government’s strategic aim

and vision for HPSS

3. DHSSPS Corporate Key Challenges,

which sets priorities for the year ahead,

and HPSS Management Plan, which

identifies priorities for HPSS for 1999-

2002

A 2002 initiative, Investing for Health, for the

first time addresses issues of prevention of

ill health by adopting comprehensive policies

across government departments, rather than

the treatment of ill health after it happens.

The initiative aims to reduce inequalities and

improve the entire population’s health.

The administration of the Department is

advised by a number of professional

groups. The Medical and Nursing Groups

are represented on the Consortium. The

Health Minister for Northern Ireland is

Angela Smith.

United States

National Cancer Institute

Department of Health and Human

Services

The National Cancer Institute (NCI) is the

largest of the 27 branches of the United

States’ National Institutes of Health (NIH),

the world’s largest biomedical research

facility. NCI is responsible for overseeing all

U.S. government-sponsored cancer research

through two key programmes. Its intramural

programme encompasses the work of more

than 400 principal investigators working in

NCI’s own clinics and laboratories, the

majority of which are located on the NIH

campus in Bethesda, Maryland, and its

extramural programme, which encompasses

thousands of investigators at more than 50

cancer centres nationwide that receive

funding for clinical research through NCI.

NCI-supported scientists conduct research

around the cause, diagnosis, prevention, and

treatment of cancer, and communicate

findings to the medical community and the

public.

Tommy Thompson is the Secretary of the

U.S. Department of Health and Human

Services, under which the National Institutes

of Health is organised.

Other Major Participating

Agencies

Ireland’s Health Research Board

Ireland’s Health Research Board, in

conjunction with Northern Ireland’s

Research and Development Office, is

responsible for funding many Consortium

programmes, including the clinical trials

network and scholar exchange programmes.

The Health Research Board was established

in 1986 by Ireland’s Minister of Health. Its

main functions are to promote, assist,

commission, or conduct medical,

epidemiological, health, and health services

research.

Northern Ireland’s Research and

Development Office

Northern Ireland’s Research and

Development Office provides overall

direction for Health and Personal Social

Services research and development and

liaises with national statutory bodies and

health-related organisations, including the

Department of Health. The office also

supports a wide range of research and

development initiatives, from education and

training to direct commissioning. The

Research and Development Office is part of

the Northern Ireland Health and Social

Services Central Services Agency, established

to promote, coordinate, and support

research and development within the field of

health and social care. Its mandate is to

encompass the research needs of all sectors

of health and social care within Northern

Ireland, including those of the Department

of Health, Social Services and Public Safety.
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CONSORTIUM PARTICIPANTS

36 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

Board of Directors

Dr. Henrietta Campbell

Chief Medical Officer

Department of Health, Social Services and

Public Safety, Northern Ireland

Chairperson 2001

Dr. James Kiely

Chief Medical Officer

Department of Health and Children, Ireland 

Chairperson 2002

Dr. Andrew von Eschenbach

Director

National Cancer Institute, Department of

Health and Human Services, United States

Implementation

Group 

Ireland

Dr. Ruth Barrington

Chief Executive

Health Research Board, Dublin

Dr. David Fennelly

Consultant Medical Oncologist

Dublin 

Professor Donal Hollywood

Professor of Clinical Oncology

Trinity College Dublin

Dr. Mary Hynes

Regional Manager

Acute Services, Western Health Board,

Department of Public Health, Galway

Professor Mark Lawler

Associate Professor of Experimental

Hematology

Department of Hematology and Institute

for Molecular Medicine, St James’s Hospital

and Trinity College, Dublin

Chief Molecular Geneticist and Director

Cancer Molecular Diagnostics Laboratory,

St James’s Hospital, Dublin

Ms. Mary McCarthy

Chief Nursing Officer

Department of Health and Children, Dublin

Northern Ireland

Dr. Anna Gavin

Director

Northern Ireland Cancer Registry, Belfast

Ms. Judith Hill

Chief Nursing Officer

Department of Health, Social Services and

Public Safety, Belfast

Professor Patrick Johnston

Director, Cancer Research Centre

Queen’s University Belfast, Belfast City

Hospital

Mr. Raymond McMillen (Former Member)

Regional Project Manager

The Campbell Commissioning Project,

Belfast

(Retired August 2002)

Professor Robert Stout

Director, Research and Development

Northern Ireland Department of Health,

Social Services and Public Safety, Belfast
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 37

United States 

(National Cancer Institute)

Dr. Gregory Curt (Former Member)

Clinical Director

Center for Cancer Research 

Bethesda, Maryland

(Retired August 2002)

Dr. Joe Harford

Director

Office of International Affairs

Bethesda, Maryland

Dr. Richard S. Kaplan

Chief

Clinical Investigations Branch,

Cancer Therapy Evaluation Program

Bethesda, Maryland

Dr. Douglas Weed

Chief

Office of Preventive Oncology

Bethesda, Maryland

Working Group

Chairpersons

Cancer Registries

Dr. Anna Gavin

Director

Northern Ireland Cancer Registry, Belfast

Clinical Trials

Dr. Ruth Barrington

Chief Executive

Health Research Board, Dublin

Information Technology

Professor Donal Hollywood

Professor of Clinical Oncology

Trinity College Dublin

Nursing

Ms. Judith Hill

Chief Nursing Officer

Department of Health, Social Services and

Public Safety, Belfast

Prevention

Dr. Douglas Weed

Chief

Office of Preventive Oncology

National Cancer Institute

Bethesda, Maryland

Scholar Exchange

Professor Patrick Johnston

Director of the Cancer Research Centre

Queen’s University Belfast, Belfast City

Hospital
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ABOUT THE IMPLEMENTATION

GROUP MEMBERS

38 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

To assure that the Consortium adopts

programmes that are practical in nature, the

Implementation Group is made up of

representatives of the partners’ departments

of health, the National Cancer Institute, and

the island’s major hospitals, cancer registries,

health boards, and cancer centres. The

Implementation Group meets at least four

times a year to review and set in motion the

major programmes of the Consortium. It

serves as an advisory group to the

Consortium’s Board of Directors, working

out the details of activities initiated by the

working groups and recommending

direction for the Board to approve and act

upon.

Ireland

Ruth Barrington, Ph.D.

Chief Executive

Health Research Board, Dublin

Dr. Barrington leads the Health Research

Board (HRB), the body charged with

responsibility for supporting and promoting

health research in Ireland. With strong links

to the research community in Northern

Ireland, the HRB is well placed to assist the

Consortium to achieve its goal of increasing

cancer research capacity on the island of

Ireland. The HRB has worked closely with

its Northern Ireland counterpart, the

Department of Health, Social Services and

Public Safety’s Research and Development

Office, to build capacity for clinical trials, to

encourage participation in NCI’s summer

programme in cancer prevention, and to

sponsor fellowships in cancer epidemiology

in association with the two cancer registries.

David W. Fennelly, M.D., F.R.C.P.I.

Consultant Medical Oncologist

Dublin

Dr. Fennelly serves as Consultant Medical

Oncologist at several Dublin health care

facilities, including St. Vincent’s Hospital, St.

Luke’s Hospital, St. Vincent’s Consultants’

Private Clinic, and the National Maternity

Hospital. Dr. Fennelly is widely published in

the scientific literature and belongs to the

Irish Society of Medical Oncologists

(ISMO). With the help of the National

Cancer Forum, ISMO has been pivotal in

directing the National Cancer Strategy. To

further develop training programmes in

medical oncology, ISMO has recently

initiated a specialist registrar programme.

Donal Hollywood, M.B., M.R.C.P.I.,

F.F.R.R.C.S.I., F.R.C.R., M.D., Ph.D.

Marie Curie Professor of Clinical Oncology 

Trinity College Dublin

Professor Hollywood is a Professor of

Clinical Oncology at Trinity College Dublin

and also serves as Head of the college’s

Academic Oncology Unit. For the

Consortium, he chairs the Information

Technology Working Group. Professor

Hollywood’s research interests include

molecular biology and the genetics of solid

“The Consortium

provides a unique

opportunity to

build cancer

research capacity

on the island of

Ireland, in

association with

NCI. Hospitals and

established

researchers

benefit from the

Consortium’s

clinical trials

initiative, whereas

young researchers

can take

advantage of

training

opportunities. ”

“I hope that with

the input of the

Consortium, we

may be able to

further direct and

enhance delivery of

care to patients

throughout the

country.” 

“The TELESYNERGY®

system and the

combined clinical

expertise will

facilitate the

delivery of optimal

clinical care to

patients, which we

envisage as an

innovative method

of enhancing the

adoption of

uniformly high

standards of care.”
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 39

tumours; the molecular basis of the

radiation response in tumour and normal

tissues; novel gene therapy and genetargeting strategies; and integration of

molecular therapies with physical dose

optimisation of radiation treatment.

Mary Hynes, M.B., D.C.H., M.R.C.P.I.,

M.P.H., F.F.P.H.M.I.

Regional Manager

Acute Services, Western Health Board,

Department of Public Health, Galway 

Dr. Hynes, as regional manager in the

Western Health Board, is responsible for

funding and coordinating the four acute

hospitals and the primary care unit of the

Western Health Board, the region along

Ireland’s West Coast that includes Galway

and surrounding rural areas. She brings to

the Consortium more than 25 years of

experience in public health in Ireland,

looking at the needs of the population as a

whole, from health promotion and

prevention, to screening, diagnosis,

treatment, and palliative care. Through her

role on the Implementation Group, she

advises the Consortium on training,

infrastructure enhancements, and other

needs that exist in Irish hospitals, and offers

input into practical solutions that affect

service providers and patients.

Professor Mark Lawler

Associate Professor of Experimental

Hematology

Department of Hematology and Institute

for Molecular Medicine, St James’s Hospital

and Trinity College, Dublin

Chief Molecular Geneticist and Director

Cancer Molecular Diagnostics Laboratory,

St James’s Hospital, Dublin

Professor Mark Lawler joined the

Implementation Group in September

2002. Currently the Honorary Secretary of

the Irish Association for Cancer Research,

he represents research scientists in Ireland

on the Implementation Group. He is

Chairman of the St. James’s Hospital Cancer

Strategy Group and also directs the Cancer

Molecular Diagnostics Laboratory there, the

first of its type in Ireland. He has an active

research group working on the molecular

basis of cancer, particularly haematological

malignancy. His work on chimerism and

minimal residual disease has been honoured

with awards such as the Ulster Cancer

Foundation lecture, the Eli Lilly Prize, and

the Vander Molen Prize for Leukemia

Research. He is the Lead Investigator of the

Cancer Programme for the Dublin

Molecular Medicine Centre and a Visiting

lecturer in Human Genetics, G’D’Annuzio

University of Chieti in Italy. He is both

the co-ordinator of the MSc in Molecular

Medicine and an Honorary lecturer in

Oncogenetics, Genetics Department, both at

Trinity College Dublin. He is also Scientific

Secretary of the Haematology Association

of Ireland and is a member of the European

Cancer Research Forum.

“My hope is that

the Consortium will

result in having

better information

available in relation

to all aspects of

cancer in Ireland so

that we will be in a

better position to

plan services for

our population,

participate in

clinical trials in an

informed way, and

compete in the

leading edge of

cancer care in a

way that would not

be otherwise

possible.”

"It is important

that research

scientists

participate fully in

the NCI-All

Ireland Consortium

as there are superb

opportunities for

cancer researchers

to contribute

significantly to the

consortium goals in

the areas of

training, education

and research."
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40 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

Mary McCarthy

Chief Nursing Officer 

Department of Health and Children, Dublin

Ms. McCarthy joined the Implementation

Group in October 2001, when she was

named Chief Nursing Officer at the

Department of Health and Children. She is

a registered nurse and midwife, with a

clinical background in intensive care. She

worked in nursing management for 12 years.

Before joining the Department of Health

and Children, Ms. McCarthy served as

Director of Nursing at the Adelaide and

Heath Hospital, where she was responsible

for merging nursing services and for

commissioning several key critical care and

medical services.

Northern Ireland

Anna T. Gavin, M.B., B.C.H., B.A.O.,

M.Sc., F.F.P.H.M.

Director

Northern Ireland Cancer Registry, Belfast

Dr. Gavin established the Northern Ireland

Cancer Registry and has served as its first

Director since 1994. She chairs the Northern

Ireland Action on Smoking and Health as

well as a strategic group for control of

malignant melanoma and other skin cancers.

Dr. Gavin represents Northern Ireland on

the Consortium’s Cancer Registries Working

Group. In this capacity and as Director of

Northern Ireland’s registry, she works to

provide population-based information on

cancers––examining patterns and trends and

identifying hazards, while reassuring the

public regarding perceived clusters.

Judith E. Hill, C.B.E., B.Sc., M.Sc.,

R.G.N., N.T.

Chief Nursing Officer

Northern Ireland Department of Health,

Social Services and Public Safety, Belfast

Miss Hill was appointed Chief Nursing

Officer of the Department of Health, Social

Services and Public Safety (DHSSPS) in

1995. Before that, she served as Regional

Director of Nursing for the South West

regional office of the National Health

Service Executive in England. In her current

position, Miss Hill strives to assure that

nursing practise results in quality cancer care

by drawing upon both technical skills and

supportive care that enable people to fully

benefit from advancing knowledge in

prevention and treatment approaches.

DHSSPS is seeking to enhance skills for

service delivery and leadership within cancer

nursing through the Consortium’s training

programmes and scholar exchange

fellowships. DHSSPS nurses are also

working as part of multidisciplinary teams to

take forward key initiatives in research,

information technology, supportive and

palliative care, and prevention.

“My vision is for

the people of

Ireland and

Northern Ireland to

receive cancer

services that reflect

the best in care

and treatment

approaches, and

that result in a real

difference in the

long-term incidence

of cancer on the

island, significant

improvement in

survival rates, and

the realisation of

patients’ personal

goals.”

“Nursing research

is a key focus of

both the

Consortium and the

Department of

Health and

Children. I look

forward to

improving cancer

care and treatment

on the island of

Ireland through our

mutual focus in

training research

nurses and

developing clinical

trials.”

“The Consortium

has greatly

enhanced the level

of cooperation

between the cancer

registries in Ireland,

resulting in the

establishment of a

common data set

for the All-Ireland

Cancer Statistics

Report.” 
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 41

Patrick G. Johnston, M.D., Ph.D.,

F.R.C.P., F.R.C.P.I.

Director, Cancer Research Centre 

Professor of Oncology

Queen’s University Belfast, Belfast City

Hospital

Professor Johnston was appointed as

Professor of Oncology at Queen’s

University Belfast in 1996 and Director of

the Cancer Research Centre in 1999. Before

joining Queen’s University, he served as a

Senior Investigator at the National Cancer

Institute in Bethesda, Maryland. Professor

Johnston and his colleagues at Queen’s

University contribute to the planning and

implementation of Consortium activities

such as clinical trials initiatives, scholar

programmes, and TELESYNERGY®.

Raymond McMillen (Former Member) 

Regional Project Manager

The Campbell Commissioning Project,

Belfast

(Retired August 2002)

A Regional Project Manager with The

Campbell Commissioning Project, Mr.

McMillen brings management expertise, with

a particular bias toward financial

management, to the Consortium’s goal of

improving cancer care. The Campbell

Commissioning Project is specifically

targeted at implementing the changes in

cancer care recommended in the Campbell

Report. Mr. McMillen’s responsibility with

the Project is to represent the management

and organisational aspect of cancer services

in Northern Ireland, with an emphasis on

implementing change. Whilst the Campbell

Report focuses on Northern Ireland,

pursuing its recommendations stands to

contribute to the Consortium’s goal of

improving cancer care throughout the island.

After a long career in health services, Mr.

McMillen announced his retirement in

August 2002.

Robert Stout, M.D., D.Sc., F.R.C.P.,

F.M.S.

Director, Research and Development

Northern Ireland Department of Health,

Social Services and Public Safety

Professor Stout is the Director of Research

and Development for Northern Ireland’s

Department of Health, Social Services and

Public Safety. The Research and

Development Office acts, on behalf of the

Department, as the lead Northern Ireland

organisation in the Consortium,

coordinating Northern Ireland’s

contributions to achieving the Consortium’s

goals. Professor Stout is currently President

of the British Geriatrics Society and has

developed undergraduate and postgraduate

training programmes in geriatric medicine, as

well as established research programmes in

aging and care of the elderly.

“I envisage the

Consortium forging

new collaborations

in research that will

lead to advances in

the prevention and

treatment of

cancer for the

benefit of patients

worldwide.”

“My vision for the

Scholar Exchange

Working Group is

to coordinate the

development of

training

opportunities in key

areas in order to

enhance the scope

and skills available

in cancer care,

prevention, and

research

throughout the

island of Ireland.”

“I look forward to

the continued

success of the

Consortium in

providing a forum

in which a wider

vision of cancer

services can be

maintained.”
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42 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

United States

(National Cancer

Institute)

Gregory Curt, M.D. (Former Member)

Clinical Director

Center for Cancer Research

Bethesda, Maryland

(Retired August 2002)

Dr. Curt oversees the largest clinical

programme at the Bethesda campus of the

National Institutes of Health, where some

400 NCI principal investigators carry out

more than 150 active cancer clinical trials.

Dr. Curt’s office is responsible for NCI’s

intramural research programme, which

translates basic laboratory research to the

clinic and maintains a special focus on longterm epidemiologic and genetics studies.

Through the Implementation Group, Dr.

Curt assists the island’s nascent clinical trials

network in organising its resources to initiate

island-wide clinical trials, advising on such

topics as protocol review and monitoring,

setting scientific standards for new clinical

studies, tracking adverse events, ensuring

regulatory compliance and quality control,

filing new drug applications, and managing

patient referral and recruitment.

Dr. Curt retired from the NCI in August

2002.

Joe Harford, Ph.D.

Director

Office of International Affairs

Bethesda, Maryland

Dr. Harford serves as Director of the Office

of International Affairs of the National

Cancer Institute. In this capacity, he has

responsibility for a number of bilateral and

multilateral interactions between NCI and

foreign cancer research institutions. His office

also tracks all funding going to foreign

investigators through NCI grants and

contracts, as well as other forms of

international collaboration, including training.

Dr. Harford serves as the Chair of the

Implementation Group of the IrelandNorthern Ireland-NCI Cancer Consortium

and is a member of the Scholar Exchange

Working Group.

Richard S. Kaplan, M.D., F.A.C.P.

Chief

Clinical Investigations Branch, Cancer

Therapy Evaluation Program

Bethesda, Maryland

Dr. Kaplan leads the Clinical Investigations

Branch (CIB) of the Cancer Therapy

Evaluation Program (CTEP), the unit in

NCI’s extramural programme responsible for

coordination of large-scale therapeutic trials,

“Their individual

talents

notwithstanding, the

most heartening

aspect of working

with the

Implementation

Group is the synergy

that is so apparentas wonderful as the

individuals are, the

whole is greater

than the sum of the

parts.”

“I hope that my

hard-won

experience will

prove of value in

strengthening the

clinical trial

infrastructure on

the island of

Ireland, and in

building

collaborations with

U.S. investigators

and studies. The

goal as I see it is to

have a robust set of

capabilities in

Ireland and

Northern Ireland

that can support

anything from

conducting smallscale

developmental

trials of novel

agents to leading

international

randomised trials.”

“Cancer knows no

borders and

respects no

political affiliation.

As clinical trials

often represent the

standard of care

for cancer

treatment, this

effort has the

potential to

improve the quality

and quantity of life

for people

diagnosed with

cancer on the

island of Ireland.”
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IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 43

including those falling under the realm of

the Clinical Trials Cooperative Group

Program. Enrolling 28,000 patients annually,

these trials study a variety of therapies. The

Cooperative Groups conduct prevention and

cancer control studies as well. Dr. Kaplan

brings to CIB extensive experience with

clinical trial design, development, logistics,

and analysis. His responsibilities include

overseeing CIB’s role as the linkage point for

collaborations with international clinical trial

organisations.

Douglas L. Weed, M.D., Ph.D.

Dean, Education and Training

Chief, Office of Preventive Oncology

Director, Cancer Prevention Fellowship Program

Division of Cancer Prevention

Bethesda, Maryland

Dr. Weed plays a multifaceted role in the

Division of Cancer Prevention, NCI’s

primary unit devoted to cancer research

prevention, serving as Dean of Education

and Training, Chief of the Office of

Preventive Oncology, and Director of the

Cancer Prevention Fellowship Program. The

Office of Preventive Oncology develops

cancer prevention and control principles and

practises for oncologists, other practising

physicians, and public health professionals.

The Office’s activities include the Cancer

Prevention Fellowship Program, which

provides state-of-the-art postdoctoral

research training in cancer prevention and

control.

“Prevention is an

important facet of

cancer research,

cancer care, and

public health

promotion. While in

theory a long-held

idea, in practise

cancer prevention

is relatively new.

Building a strong

infrastructure for

the future of

prevention is

critical. With a

robust Consortiumsponsored initiative,

the health of the

people will

benefit.”
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OUTREACH

44 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

The Consortium makes a priority of keeping

the public, cancer professionals, and public

health professionals in the three partnering

countries apprised of its activities and

programmes. The Consortium accomplishes

this through its Web site, newsletter, and

Help Desk.

Consortium Web Site

www.allirelandnci.org

The Consortium’s Web site is updated on a

regular basis with news and information

about the Consortium’s programmes.

Oncologists, nurses, scientists, students,

policymakers, and others can access

information about training and education

opportunities, download publications (such

as the first All-Ireland Cancer Statistics Report

from 2001), learn about upcoming meetings,

and more. In addition, the site provides links

to the partner organisations, including

comprehensive cancer information for

health professionals and the public from the

National Cancer Institute.

Newsletter

The Consortium published the second issue

of its newsletter in 2002. The newsletter is

disseminated to a broad group of cancer

researchers, health care practitioners, and

other interested individuals and

organisations in the three

jurisdictions and

elsewhere. The newsletter

covers recent activities,

highlights people

involved in the

Consortium, features

photographs of meetings

and other events, and

contains information on

contacting the

Consortium. The

Consortium seeks to

expand its mailing list for

the newsletter and invites

interested recipients to provide their contact

information through the Web site or Help

Desk.

Help Desk

The Consortium manages a Help Desk

through which anyone interested in the

Consortium can be connected to the

participating partners. The Help Desk

provides telephone and e-mail concierge

service, where a Consortium

representative will direct you to the right

person to talk to for training

opportunities or to get answers to

general questions about Consortium

programmes.

Telephone: 001-301-496-5534

E-mail: consortium@cancer.gov
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CONSORTIUM IN THE NEWS

IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM 45

The year 2001 saw the publication of two

articles featuring Consortium activities in The

Oncologist. And in 2002, U.S. Secretary of

Health and Human Services (HHS) Tommy

G. Thompson highlighted the Consortium’s

activities in his 7 February address to the

HHS U.S.–Irish Business Summit in

Washington, D.C.

“The NCI-Ireland

Consortium”

Consortium members Patrick Johnston and

Peter Daly authored “The NCI-Ireland

Consortium: A Unique International

Partnership in Cancer Care.”* The article

outlines the Consortium’s history, goals,

programmes, progress, and future plans, and

also provides information on cancer services

and morbidity and mortality on the island of

Ireland.

Dr. Johnston of Northern Ireland and Dr.

Daly of Ireland conclude, “There is no

doubt that the NCI All Ireland

Agreement...has become a major milestone

agreement for international cancer care. The

Consortium has successfully begun to join

both jurisdictions with the U.S. in a quest

toward improved cancer care and treatment

for our people and in the process has

fostered improved relations... Already

cancer patients and their families on the

island of Ireland are beginning to benefit

from this initiative.”

“Broadcast Quality

Teleconferencing for

Oncology”

Also published in The Oncologist, “Broadcast

Quality Teleconferencing for Oncology”**

was co-authored by Donal Hollywood and

Desmond O’Loan, members of the

Consortium’s Information Technology

Working Group, in conjunction with James J.

A. McAleer. The article describes how the

Memorandum of Understanding establishing

the Consortium facilitated the export of the

NIH-developed TELESYNERGY®

teleconferencing system to Ireland and

Northern Ireland.

The authors identify professional

applications of TELESYNERGY®,

including clinical case conferences, grand

rounds, expert case review, multicentre

radiotherapy planning, clinical management

protocol development, distance learning,

seminars, patient screening for clinical trials,

and non-oncology applications. “The

TELESYNERGY® system,” they explain,

“ensures that each patient, regardless of

location, will receive an expert assessment

and be given optimal therapy.”

U.S. HHS Secretary

Tommy Thompson’s

Remarks

Secretary Thompson’s 7 February 2002

remarks about the Consortium were

addressed to the HHS U.S.-Irish Business

Summit. The summit brought together

business and scientific leaders on behalf of

establishing better ties among the United

States, Ireland, and Northern Ireland.

Secretary Thompson described the

Consortium as “an exciting research

initiative” begun in October 1999. “We

forged this partnership to enhance cancer

research, care, and treatment on the island of

Ireland and to promote an international

dialogue in a quest for the cure,” he

explained. “The project involves scholar

exchange, nursing, information technology,

cancer registries, clinical trials, and

prevention. Working together on cancer

research, we can save lives.”

* Patrick G. Johnston, Peter A. Daly, “The NCI-Ireland Consortium: A Unique International Partnership in Cancer Care.” The Oncologist

6:453-458. Available online at www.theoncologist.com.

** James J. A. McAleer, Desmond O'Loan, Donal P. Hollywood, "Broadcast Quality Technology for Oncology," The Oncologist 6:459-462. Available

online at www.theoncologist.com.
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2003 ALL IRELAND CANCER CONFERENCE

46 IRELAND-NORTHERN IRELAND-NATIONAL CANCER INSTITUTE CANCER CONSORTIUM

Plans are underway for the second All

Ireland Cancer Conference, to be held 20-22

October 2003 in Cork, Ireland. The

scientific conference will feature

distinguished speakers from throughout

Ireland, Northern Ireland, and the United

States. It will be open to oncologists,

researchers, nurses, students, and other

health care professionals with an interest in

learning about and enhancing cancer

research on the island of Ireland.

This multidisciplinary conference is being

developed around the following themes:

 Cancer epidemiology

 Treatment and clinical trials 

 Cancer prevention 

 Translational research 

 Molecular bases for cancer 

 Survivorship and aftercare 

 Diagnosis and screening 

The conference will offer a forum for the

exchange of views and ideas between

professionals from the cancer care and

research communities in the U.S. and the

island of Ireland and cancer experts from

around the world. Attendees will have access

to the latest updates on developments in

cancer care and research.

Information is available on the Consortium

Web site.
APPENDIX

Memorandum of Understanding

Implementation Plan



3 October 1999 Belfast

3 October 1999 Belfast

29 September 1999 Washington, D.C.

Ireland-Northern Ireland-National

Cancer Institute Cancer Consortium

IMPLEMENTATION PLAN

I. DESCRIPTION OF CONSORTIUM

A. Membership

The Ireland-Northern Ireland-National Cancer Institute Cancer Consortium

consists of representatives of the Department of Health and Children of

Ireland, the Department of Health, Social Services and Public Safety of

Northern Ireland, and the National Cancer Institute of the United States

Department of Health and Human Services.

B. Origin

The Consortium was established as a result of a Memorandum of

Understanding (MOU) between the three governments, signed in Belfast

in October 1999. This MOU was a result of detailed consultation between

the three governments which recognised the fact that cancer was a major

public health and health-care problem causing premature morbidity and

mortality in all three jurisdictions and recognising that preventive and

therapeutic strategies could most effectively be implemented utilizing 

an international and collaborative forum. The potential for such

collaboration, particularly between the two Departments of Health on the

island of Ireland, was enhanced by developments in the broader

framework 

of relations, which were being devised under the terms of the Belfast

Agreement.

C. Duration

Under the terms of the MOU, the Consortium will, in the first instance,

exist for five years from the signing of the MOU.
II. MISSION

The Consortium’s mission is to continue to intensify co-operation

between the Department of Health and Children of Ireland; the

Department of Health, Social Services and Public Safety of Northern

Ireland; and the National Cancer Institute of the United States, in relation

to cancer, that will lead to improved scientific programmes in their

respective jurisdictions, including the areas of: 

• Education and training

• Treatment and research

• Information dissemination

• Epidemiology

• Cancer prevention

• Surveillance

• Early detection

• Quality control

• Interactions aimed at enhanced public health and patient care

III. SCOPE OF CONSORTIUM

A. Identify infrastructure improvements necessary for the island of

Ireland to further cancer research and clinical cancer investigations

B. Formalise and facilitate interactions between cancer research 

communities in the United States and the island of Ireland

C. Develop joint programmes that will enhance the environment for 

clinical cancer research leading to improved patient care

D. Develop educational exchange programmes for cancer personnel
IV. GOVERNANCE

A. The activities comprehended within the MOU will be managed by 

the Consortium Board of Directors, which will initially consist of the

Chief Medical Officer of Ireland, the Chief Medical Officer of Northern

Ireland, and the Director of the National Cancer Institute who each

may designate alternate members to represent them. The Chair will

alternate annually between the Chief Medical Officers of Ireland and

Northern Ireland, and the management of the Board's activities 

will be the responsibility of the Chair for that period.

B. While the Board will generally utilize the consensus method to obtain

decision, there may be instances when a vote of the majority is

required. Each Board member has one vote.

C. There will be, at least, two meetings of the Board per year and 

communication between meetings will be transacted by means 

of conference calls between Board members at a frequency to be

decided by the Board.

D. The Board will submit an annual report to the participating 

departments.

V. ACTIVITIES

A. The creation of the Consortium was to ensure the implementation and

funding of programmes, projects and training that facilitate the

objectives outlined in the MOU. In the first instance, the Consortium

will identify and develop potential for co-operation in the following

areas:

1. The enhancement and co-ordination of cancer registries in Northern

Ireland and Ireland

2. The enhancement of informatics and other infrastructure 

improvements to support the conduct and co-ordination of clinical 

trials throughout the island of Ireland
3. Development of education/training and scholar exchange programmes

B. This implementation plan outlines the two methods that will be used

to establish, review and approve all Consortium-sponsored initiatives.

1. Working Groups: The Board, at its discretion, will establish ad hoc

working groups in areas designated under the MOU. The Chair,

duration, responsibilities and membership of these groups will be

agreed upon by the Board. Generally, the responsibility of these

groups will be to stay abreast of needs and activities within their

designated areas and to make recommendations to the Board on

activities that will enhance the Consortium’s objectives in that area.

Proposals submitted by a working group should fully outline the

proposed initiative, funding required (including staffing, supplies,

travel, space and/or other resources required) and their

recommendation for funding sources and/or cost sharing by

Consortium parties. 

2. Request for Applications: The Board will be responsible for

identifying targeted Consortium initiatives, where an open 

and competitive review and award process is desired. For 

ach initiative, the Board will identify the scope of the project, funding

available, size and scope of awards and the specific procedures

associated with advertising the opportunity, application process and

scientific/ administrative review of the proposals. The Board may also

decide to handle proposals made by the working group, in a

competitive manner. 

VI. PROJECT FUNDING GUIDELINES

A. Proposals must fall within the areas of activity identified in the MOU.

B. Projects must be consistent with policies and strategic cancer plans of

the health departments of the partners.

C. Projects must demonstrate the benefits to cancer research in 

all three jurisdictions or, serving as a pilot project in one jurisdiction,

demonstrate potential for wider applicability.

D. Generally, each partner will directly fund its share of each 
project, keeping accountability for the use of funds within 

existing monitoring agencies at the funding source.

VII. BOARD APPROVAL PROCESS

A. All proposals, irrespective of origin, will be submitted to the Board

through its administrative unit.

B. Members of the Board, after initial consideration, based on the

guidelines outlined above and/or in the light of available resources or

other relevant information, may decide to accept or reject any

proposal. Alternatively, the Board may refer the proposal for further

review and recommendation to an independent assessor, or refer it to

the appropriate Department for action.

C. Those who have submitted proposals will be notified of the Board’s

decision via a document bearing the Chair’s signature, which will be

prepared by the administrative unit.

D. Successful applicants will be expected to report progress on their

funded projects by way of written submission to the Board, at least on

an annual basis or as otherwise requested by the Board.

VIII. ADMINISTRATION AND CONTACTS 

(Note: Tasks/level of effort must be within NCI-funded level for this

contract. Therefore, specific tasks should be coordinated through NCI.)

A. The Board has a centralised record-keeping and administrative unit

whose role it is to:

1. Maintain centralised correspondence files

2. Co-ordinate Board meetings and conference calls

3. Write, distribute, and file Board conference call and meeting minutes

4. Maintain and distribute budget spreadsheets

5. Prepare correspondence as requested by Board

6. Prepare and distribute annual report

7. Manage project applications process
B. The Board operates a Help Desk/Information Clearinghouse to:1.

Collate pertinent educational opportunities for cancer investigators 

and students in Ireland, Northern Ireland and at the NCI

2. Prepare relevant brochures to disseminate knowledge of programmes

3. Develop and maintain a Web site for Consortium Board to include 

education opportunities, and updates on information technology

development, all-Ireland clinical trials group, cancer registries, Board

activity, and proposal funding opportunities

4. Triage requests to appropriate authorities

5. Answer procedural questions

6. Track satisfaction of students and mentors in Scholar Exchange 

programme

7. Maintain demographic records of scholars in Scholar Exchange 

programme

8. Provide broker function between candidates and potential 

training programmes

9. Maintain activity log of all inquiries and status of requests

10. Report monthly to Board

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Department of Health, Social Services

and Public Safety

Northern Ireland

Department of Health and Children

Ireland

NIH Publication No. 03-5416

July 2003

Ireland-Northern Ireland-National Cancer

Institute Cancer Consortium 

Help Desk E-mail:

consortium@cancer.gov

Telephone:

(from Ireland/Northern Ireland):

001-301-496-5534

Web site:

www.allirelandnci.org

National Institutes of Health

Department of Health and Human Services

United States

The 2001-2002 Annual Report was prepared by the Directors of the Ireland-Northern Ireland-National Cancer Institute Cancer Consortium.