High levels of mental stress were also identified, with 90% of patients in the North and 86% in the Republic suffering this.
“These common challenges highlight the universal need for robust mental health and financial support systems for patients with MBC (metastatic breast cancer) in both regions,” the study recommended.
Patients in the North face fewer direct costs. They can get free parking for treatment appointments and travel expenses for those on benefits. In contrast, patients in the Republic often face high travel costs and car park fees of up to €300 a month.
Co-author and Cork University Hospital oncologist Professor Seamus O’Reilly said: “We need to look at financial supports for patients with cancer in the Republic.
“Patients are spending more time with their care in the Republic, so can we look at accelerating the movement of care out into the community?
“Can we do more in the community for patients and make it less hospital-based?”
The HSE plans to move more cancer care into the community, including for Cork.
“The trend in oncology is to move things into the community. I think they are doing a lot of that in Limerick but maybe this survey could be a catalyst for emphasising the benefits of that for patients,” he said. “But it would need to be resourced in terms of a location to do it in and staffing.”
The survey showed patients in the Republic have more visits to hospital day wards and spend more time in hospital compared to those in the North. They were also more likely to have family with them during diagnosis, at 60% compared to just 43% in the North.
Women in the Republic were more likely to seek medical advice for changes in their sex life after treatment, at 26% compared to 9% in the North.
“Embarrassment was more commonly cited by Northern Ireland patients as a reason for not seeking medical advice,” the study said.
Co-author and patient advocate Siobhan Gaynor said while it is known that the HSE and HSCNI (Health and Social Care in Northern Ireland) systems are different, this is the first time the impact on patients has been measured.
She focused on the issue of access to medical records, which was less than 40% in both regions.
“In the North in the last year, all oncology patients have got access to an app where they have all their appointments, medications. They report side effects and we are still light-years away from that,” she said.
Ms Gaynor would like to see more of an all-island approach to cancer, saying: “The problems for patients are the same. We could learn from each other as well.”
The study — ‘Regional differences in experiences of patients with metastatic breast cancer in the Republic of Ireland and Northern Ireland: a comparative analysis’ — is published in the journal BMJ Open Quality.
