What One Irish Roundtable Made Me Realize About Cancer Care Everywhere

When I started organizing the Irish advisory roundtable, I assumed we’d spend most of our time talking about intimacy after cancer.

We did, but not in the way I expected.

People certainly acknowledged sexuality, body image, relationships, communication, menopause, and all the changes that can follow treatment. Those conversations were important. What caught my attention, though, was how often we drifted into talking about the healthcare system itself.

Someone would describe a patient who finally mentioned that intimacy had become difficult. A few minutes later, the conversation had shifted to referral pathways (or lack thereof). Another person would mention body image, and suddenly we were discussing appointment lengths, role boundaries, and who was realistically in the best position to continue the conversation.

It happened often enough that it became apparent these are not separate topics.

One of the easiest assumptions to make is that improving intimacy support means creating something entirely new. For example: another specialist, another clinic, another program. Sometimes that’s appropriate, but I don’t think that’s where most organizations are starting or need to start.

What I heard instead was a collection of people who were already doing thoughtful work, in their own ways and realms, often without realizing that others around the table were wrestling with many of the same questions.

A nurse had developed language that helped patients feel comfortable raising concerns. A psychologist described supporting relationship changes that had never been labeled as “intimacy issues.” Community organizations had become places where conversations continued after patients left the hospital. Survivorship professionals were already addressing quality of life in ways that naturally opened the door to topics related to intimacy.

None of those examples looked identical, and I don’t think they should. Different organizations have different resources, different priorities, and different constraints.

What they shared was a recognition that patients don’t experience care as a series of departments. They experience the intensity of a life that has (suddenly and often drastically) changed, and they’re looking for someone who can help them make sense of it.

That has made me redefine what progress actually looks like.

Perhaps the first step isn’t asking whether an organization addresses intimacy. A more useful place to begin might be looking for where those conversations are already happening. Who has found language that feels natural? Which patients are finding support, and how are they getting there? Who are unidentified champions in an organization? Which referral pathways are there but just waiting to be formally identified?

Those questions don’t require a major strategic plan. They require looking closely.

One of the reasons I decided to share the report from the Irish roundtable is that I don’t think these observations belong only to Ireland. I suspect many organizations will recognize pieces of themselves in these conversations, even if the structure of their healthcare system looks completely different.

If you’re curious, you can download the full report here. My hope isn’t that people read it and agree with every conclusion. It’s that they begin noticing similar patterns in their own organizations, because that’s often where meaningful change starts.