Lobular Breast Cancer

Helen Grant Excerpts

Tuesday 10th December 2024 Westminster Hall

[Helen Hayes]

I thank my hon. Friend for bringing the story of her constituent to this debate. This is exactly the reason why we need to find better means of diagnosis and treatment for lobular breast cancer. I will come talk about some of those means shortly.

Currently, there are no treatments specific to lobular breast cancer. This must change. The issues have been well documented by Dr Susan Michaelis, founder of the Lobular Moon Shot Project. Susan was 50 when she noticed a small, pale, 1 mm mark on her left breast in 2012. She had no lump and both a mammogram and an ultrasound were reassuring. Six months later, the small mark had become redder and Susan had a biopsy that confirmed she had invasive lobular breast cancer. Susan’s cancer had spread to her neck, the back of her head, the eye area and her ribs. She is now on her sixth line of treatment.

Dr Michaelis is a qualified air accident investigator. She focuses on how accidents can be prevented by learning from past mistakes, and has used these skills to look at how treatments have failed her. In doing so, she has identified the need for a new approach.

[Helen Grant (Maidstone and Malling) (Con)]

I congratulate the hon. Lady on securing this really important debate. Does she agree that specific forms of cancer like lobular breast cancer require specific funding, research and treatment, and that a one-size-fits-all approach is going to fail millions of women? I declare an interest in asking this question in that last year I was diagnosed with lobular breast cancer. I am cancer-free now, thank God, as a result of the help of the Royal Marsden hospital. Tragically, that is not the case for many, many women in this country.

[Helen Hayes]

I thank the hon. Lady very much for that intervention and for sharing her personal story.

I pay tribute to Dr Michaelis for her research and campaigning on lobular cancer. I hope that all Members have received their Dr Susan Michaelis rose this week, named in her honour, and will plant it as a reminder of the urgency of her work.

There are so many other stories. Katie Swinburne was 47 when she was diagnosed with invasive lobular cancer in her left breast, leading to a double mastectomy, radiotherapy and 10 years of targeted chemotherapy. She writes:

“It is very hard to accept that none of my treatment is specific to lobular breast cancer and no one can tell me if it is working or has been effective…I find myself living in fear of recurrence. I deserved to have an early diagnosis. I did not get this. I deserve a specific treatment; I do not have this. I have three young children; they deserve to have a mum. I deserve effective follow up; I do not get this. I need you to change this for me, my husband, my family, all the women with a lobular diagnosis and all the women who will be diagnosed in the future.”

Emma Hunwick writes:

“I was a happy, healthy and relatively fit 49-year-old professional woman when I noticed a tiny pull in my right nipple. No lump, no other obvious external changes. An annual medical and referral just 12 days later resulted in a clear mammogram and a clear second 3D mammogram. An ultrasound then reported an area of 2 cm of concern. I rapidly went from ‘caught early’ to borderline stage 2 breast cancer. After my mastectomy I was informed that I was in fact stage 3c invasive lobular breast cancer…I am now at high risk with predicted survival outcomes at 10 and 15 years of approximately 45% and 30% respectively...I need to know that the vital scientific research into lobular breast cancer is being done now. Not next year or in 10 years but starting now, so that I might survive longer and continue to work with less worry about whether the standard monitoring tests that missed my first cancer, will miss a recurrence.”

Kirstin Spencer’s story is also typical. Diagnosed in 2018, she and had a double mastectomy, but was warned that, especially in the first two years afterwards, the disease could recur in areas such as the scar tissue, chest wall and surrounding skin. She was told that vigilance and well-managed medical follow-up were everything. Within a year of her diagnosis, she developed red-flag symptoms that were repeatedly dismissed by her breast specialist. She was refused follow-up treatment and sent for psychological counselling. By the time that a new GP listened to her concerns, substantial recurrence was confirmed, with extensive metastatic disease.

My mother-in-law Cressida’s story is very different from Heather’s, and we are all so grateful to the doctors who treated her and for the subsequent 22 years of health that she has had and continues to enjoy. Cressida did not have any grandchildren when she was diagnosed, but a prompt diagnosis meant that she has been able to be closely involved in the lives of eight subsequent grandchildren, as a much-loved granny. But Cressida’s outcome was about luck rather than design, so much so that it was only very recently, when reviewing her medical notes, that she found out that the type of cancer she had was lobular.

Breast cancer survival rates are directly impacted by the stage of diagnosis. Late diagnosis, which is all too common for lobular breast cancer, leads to far worse outcomes. To improve this situation, we need much better awareness of the full range of breast cancer symptoms, including the very small skin changes that are typical of lobular cancer. Not all cancers cause lumps. A clear mammogram does not provide absolute reassurance, because lobular cancer typically does not show on a mammogram. We need lobular-specific research and treatments.

Staff at Manchester Breast Centre have stated that they are able to do the research to understand the complete pathology of lobular breast cancer—research that has never been done—to pave the way for bespoke treatments to be developed. This will take five years and cost £20 million—moonshot funding that will be recouped many times over in the tax revenue paid by women like Heather, who would be able to continue working, and in the NHS costs that will be saved.

Hundreds of MPs in the last Parliament and this one have listened to the stories of constituents affected by lobular breast cancer and pledged their support for the Lobular Moon Shot Project. Lobular cancer is the sixth most common cancer in women. It is more common than ovarian, brain, central nervous system, non-Hodgkin lymphoma, pancreatic and kidney cancers. I know that the Minister cares deeply about women’s health equality and I put it to her that lobular cancer is a women’s health equality issue.

Suicide and Mental Health of Young People: Tatton

Helen Grant Excerpts

Tuesday 26th November 2024 Westminster Hall

[The Minister for Care (Stephen Kinnock)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I am grateful to the right hon. Member for Tatton (Esther McVey) for securing this debate and raising many important issues. I also thank her for sharing the tragic story of Olivia. My heart goes out to Olivia’s family and loved ones; it is a truly heartbreaking situation and process that they have gone through.

The right hon. Lady made a number of important points about withdrawal from SSRI antidepressants. A number of those points are quite specific, and I do not have in specific responses my notes. With her leave, I would like to write to her with responses on those points. She made a point about the coroner’s advice, which contained a lot of useful counsel on how we might address and tackle the issues raised. I will certainly look at that in detail, and will happily take those matters forward with her. We have a shared interest in addressing the issue. If the system is not working and people who are on that antidepressant are not being supported with withdrawal, we need to look at that in detail. We need to tackle it—I share her views on that.

I will turn to some more general points about the Government’s position on mental health. We have made suicide prevention and mental health a priority, especially for young people. Many of the issues raised today are symptomatic of an NHS that is broken. Looking at the figures, the challenges that face the NHS are truly sobering.

About 50% of lifetime mental health conditions are established by the time an individual is 14 and 75% by the time they are 24. Evidence suggests that the prevalence of mental health conditions is rising among children and young people. In 2023, 20.3% of eight to 16-year-olds had a probable disorder, compared with 12.5% in 2017. Of course, the covid-19 pandemic exacerbated needs, with analysis showing that 1.5 million children and young people under the age of 18 could need new or increased mental health support following the pandemic.

According to the Darzi review, 343,000 referrals for children and young people under the age of 18 are waiting for mental health services, including 109,000 referrals waiting for more than a year. Under the NHS Cheshire and Merseyside integrated care board, as of the end of September 2024, 10% of children and young people still waiting for first contact with NHS-funded mental health services were waiting for more than 951 days, equating to 1,301 people. Half of those still waiting had been waiting for more than 300 days. There are 13,010 children and young people still waiting for first contact with NHS-funded mental health services.

Until recently, there had been an upward trend in suicide rates for children and young people. For women between the ages of 10 and 24, the rate has nearly doubled since 2012, rising from 1.6 per 100,000 to 3.1 per 100,000 in 2023.

[Helen Grant (Maidstone and Malling) (Con)]

Over the past 10 years in England and Wales, one student has died every four days as a result of suicide. Despite that forlorn tragedy, the law remains unclear about the duties and responsibilities universities have towards their often very vulnerable young students. Will the Minister meet me and members of the LEARN Network and ForThe100 to discuss the introduction of a statutory duty of care for all higher education providers?

[Stephen Kinnock]

I thank the hon. Lady for that important intervention. I am happy to meet her and the LEARN Network. The Government cannot do all this alone; we need to work in partnership with all sorts of different stakeholders, including universities and the higher education sector. We would support any partnership working that we can do.

Until recently, there had been an upward trend in suicide rates for children and young people. For women between the ages of 10 and 24, the rate has almost doubled, but the trend for children and young people has flattened in the past year, despite overall increases in suicide. Although those rates are low compared with those for other age groups, children and young people are a priority group in our mission to tackle suicide. The Department is commissioning research via the National Institute for Health and Care Research to advance our understanding of why rates of suicide have been increasing in certain age groups.

We are committed to reforming the NHS to ensure that we give mental health the same attention and focus as physical health. It is unacceptable that too many children, young people and adults are not receiving the mental health care that they need. We know that waits for mental health services are far too long. We are determined to change that. That is why we will recruit 8,500 additional mental health workers across children’s and adult mental health services. We will also introduce a specialist mental health professional in every school and roll out young futures hubs to provide timely mental health support to our children and young people.

We are working with our colleagues at NHS England and the Department for Education as we plan delivery of those commitments. Furthermore, the Government are also committed to tackling suicide as one of the biggest killers in our country. The suicide prevention strategy proposes targeted support for priority groups such as children and young people. The Department for Education is reviewing the statutory guidance on relationships, sex and health education, and the Secretary of State for Education is clear that children’s wellbeing should be at the heart of it.

Some 79 voluntary, community or social enterprise organisations up and down the country have been allocated funding through the Department of Health and Social Care’s £10 million suicide prevention grant fund over the two years to March 2025. These organisations—from local and community-led through to national—deliver a broad and diverse range of activity that will prevent suicides and save lives.

Early intervention on mental health issues is vital if we want to stop young people reaching crisis point. Schools and colleges play an important role in that early support, which is why we have committed to providing a mental health professional at every school. Mental health support teams help to meet the needs of children and young people in education settings; such teams, which are made up of mental health practitioners and education mental health specialists, are available in schools in Tatton.

However, it is not enough to provide access to a mental health professional when young people are struggling. We want the education system to set young people up to thrive, and we know that schools and colleges can have a profound impact in promoting good mental health and wellbeing. Doing this well takes a holistic approach, drawing in many aspects of the school or college’s provision. Many schools are already doing that, and my Department is working alongside the Department for Education to understand how we can support such good practice across the sector, and across the length and breadth of our country.

The opportunity mission will break the link between people’s background and their success. The mission will build opportunity for all by giving every child the best start in life: high-quality early education, early child health, home learning environments and family support. The mission will also support children to achieve and thrive, ensuring high school standards with a broad curriculum, excellent teachers and targeted interventions, an inclusive approach to special educational needs and disabilities, mental health support, access to arts, culture and sport, and youth services and provision.

In our manifesto, the Government committed to rolling out young futures hubs. This national network is expected to bring together local services, deliver support for teenagers at risk of being drawn into crime or facing mental health challenges, and, where appropriate, deliver universal youth provision. The hubs will provide open-access mental health support for children and young people in every community.

We are concerned about the widespread availability of harmful material online, promoting content on eating disorders, suicide and self-harm, that can easily be accessed by people who may be young and/or vulnerable. We have been clear that the Government’s priority is the effective implementation of the Online Safety Act 2023, so that those who use social media—especially children—can benefit from its wide-ranging protections as soon in their lives as possible. Earlier this year, Ofcom concluded its consultations on the draft illegal content and child safety codes of practice. We expect the illegal content codes to be in effect by spring 2025, with the child safety codes following in the summer.

I will turn to other aspects of our plans to improve mental health services. The Mental Health Bill, which was announced in the King’s Speech, will deliver the Government’s manifesto commitment to modernise the Mental Health Act 1983 by giving patients greater choice and autonomy and enhanced rights and support, and aims to ensure that everyone is treated with dignity and respect throughout their treatment. It is important to get the balance right to ensure people get the support and treatment they need when necessary for their protection and for that of others.

I am pleased to say that the Bill has been introduced in the Lords and will be coming to the Commons in the new year. The Bill will make the Mental Health Act fit for the 21st century, redressing the balance of power from the system to the patient and ensuring that people with the most severe mental health conditions get better, more personalised care. It will limit the scope to detain people with a learning disability and autistic people under the Act unless they have a co-occurring mental health disorder that needs hospital treatment.

I conclude by once again commending the right hon. Member for Tatton for securing the debate and colleagues from across the House, including the hon. Members for Maidstone and Malling (Helen Grant) and for Strangford (Jim Shannon), for sharing their insight on the vital issue of suicide prevention and mental health care for children and young people. I am committed to working with the right hon. Member for Tatton and her hon. Friend, the hon. Member for Maidstone and Malling, to take forward these issues, and I hope that we can, together—across the House—address this vital issue.

Question put and agreed to.

Breast Cancer: Younger Women

Helen Grant Excerpts

Tuesday 12th November 2024 Westminster Hall

[Wera Hobhouse (Bath) (LD)]

I beg to move,

That this House has considered breast cancer in younger women.

It is a pleasure to serve with you in the Chair, Mr Vickers. I thank the Minister for being here to respond.

Every woman deserves a fair chance against breast cancer, no matter her age. It is the most common type of cancer in the UK. Most women who are diagnosed are over 50, and it is therefore a disease often associated with older women, but young women are at risk, too. Breast cancer in younger women is often caught later when it is more advanced. That is because there is no routine screening and too often symptoms get dismissed as something less serious. That must change. Awareness and early detection are crucial, no matter your age.

The issue arose for me during a constituency surgery when my Bath constituent Lucy shared her story, which resonated with me because my nephew’s mother died many years ago of breast cancer aged 35. In 2021 Lucy, who was 38, had two young children and was diagnosed with primary breast cancer. She underwent a mastectomy, chemotherapy and radiotherapy before being given the all-clear. In 2024, when she was 41, a self-initiated MRI scan tragically came back showing that her cancer had returned, leading to a diagnosis of secondary breast cancer, which is currently incurable. In both cases she found it a struggle to be diagnosed.

The first time, despite her mother having had breast cancer and Lucy presenting with a lump, at least three different doctors told her that it was likely to be hormones and nothing to worry about. It was not until she requested the biopsy, which ultimately came back showing it was cancer, that the diagnosis was made. The second time she repeatedly voiced concerns about a symptom that she was experiencing, but she was repeatedly assured that it was just a side effect of the treatment. Still concerned, she approached the GP, who did some initial tests but ultimately suggested that her worries were anxiety-driven. After that appointment she came out and sobbed in her car.

Searching for peace of mind, Lucy then paid privately for a breast MRI, which tragically revealed that the cancer had returned, but by then it was too late. In both cases—first by requesting the biopsy and secondly by initiating an MRI—it was up to Lucy to fight for a diagnosis.

[Helen Grant (Maidstone and Malling) (Con)]

I congratulate the hon. Lady on securing this important debate. Because of the age restrictions in accessing NHS mammograms and the importance of early diagnosis, which she highlights, does she agree that self-awareness and self-examination in young women is critical in the battle to beat breast cancer?

[Wera Hobhouse]

The hon. Lady is absolutely right that we need to continue to raise awareness, but I am pointing out that even when young women are aware and go to a doctor, the doctor says, “Don’t worry about it.” However, I agree that we need to continue to make sure that women examine their breasts and are aware of the risks of breast cancer, even when they are young.

Sepsis Awareness

Helen Grant Excerpts

Wednesday 9th October 2024 Westminster Hall

[Lee Anderson (Ashfield) (Reform)]

I beg to move,

That this House has considered sepsis awareness.

It is a pleasure to serve under your chairmanship, Sir Christopher. Sepsis is one of the least well known medical conditions and the No. 1 cause of preventable death in the world. Eleven million people die each year in the world from sepsis, and that represents one in five of all deaths in the world. Sepsis can be very difficult to detect and hard to distinguish from other illnesses. Sepsis claims more lives than lung cancer, bowel cancer, breast cancer and prostate cancer put together. That is truly astonishing. Across the UK alone, 48,500 people a year die from sepsis. The Academy of Medical Royal Colleges suggests that the figure is much higher—about 68,000 a year. That is incredible.

Given that there are approximately 200,000 cases of sepsis each year in the UK, it costs the NHS between £1.5 billion and £2 billion every single year and the wider economy at least £11 billion a year—some people think the figure is closer to £15 billion. The direct cost of sepsis to the NHS is 1% of its budget.

One reason why I requested this debate today is that I have many constituents who have been unfortunate enough to suffer from sepsis. I have a very brave young lady in the hall today. That is Abbi; she is sitting at the back. I am incredibly proud of the strength and determination she has shown to overcome this illness—she is a survivor. I will tell Abbi’s story. On 28 November 2022, she had been to her doctor’s for some antibiotics for her tonsils, because she was a long-time sufferer of tonsillitis and thought it was tonsillitis again. She had suffered with that all her life, so that was understandable. At 6 pm on that day, she was blue-lighted to King’s Mill Hospital in Ashfield, to the accident and emergency department, because she was fighting for breath and literally dying in front of her husband, Steve, who was sat there. She was given numerous injections of adrenaline while travelling to the hospital, because it was thought that she was having an anaphylactic fit and it was a reaction to the antibiotics that she had had that morning. When she arrived at A&E, she was put on 10 litres of oxygen by the staff, but it was evident that that was not enough; it was not doing the job. But they did not, unfortunately, administer any antibiotics or put her on IVs at that time; no blood tests were taken. Her husband, Steve, was constantly asking the staff, “Is there something else we can do for Abbi?” Only now, looking back a few years later, is it clear that sepsis was never thought of at the time.

Abbi very quickly deteriorated, so she was transferred to the intensive care unit at King’s Mill Hospital, where she was placed in an induced coma. She was fighting for her life, and all her organs began to shut down at a very rapid rate. Only when the ICU did some tests, when the results started to come through, did staff realise how ill she was and that she had actually got pneumonia, strep B and sepsis.

However, that was just the start of Abbi’s journey. When the ICU team realised that the situation was far more complicated than they could deal with at King’s Mill, they contacted Glenfield general hospital in Leicester. She was transferred there to be placed on an ECMO machine, which takes the place of the heart and lungs—I suppose it is a life support machine. She was lucky to have fitted the criteria to go on that machine. She stayed on it for the next three weeks, in a coma and fighting to stay alive. Without it, she would not be here today. There are only five of those machines in the UK, and it costs the NHS £20,000 per day, per patient. While she was on the ECMO machine, it was visible to Abbi’s family that she would lose both hands and both legs beneath the knee, because sepsis had taken over her body and given her gangrene.

On 17 December, Abbi was transferred back to the ICU at King’s Mill hospital because she no longer had to be on the ECMO machine at Leicester, but she still needed round-the-clock intensive care treatment. On 9 February, she was transferred to the burns and plastics ward at Nottingham city hospital, where she would wait for her amputations. Imagine that—having to wait in hospital knowing that they were going to take her arms and legs away, after everything she had been through. On 4 May, she was discharged after spending six months in hospital, coming out as a quadruple amputee. She told me just before the debate began—she sometimes forgets—she also lost the sight in her left eye. Incredibly sad. Incredible, brave lady. That is Abbi’s story, and I thank her for sharing it with me.

Other constituents have contacted me about sepsis, including Karen from Ashfield. Her elderly mother contracted sepsis and had an awful time at the hospital. Her diagnosis was slow. It was not picked up properly, and, just a few months later, she sadly collapsed and passed away. Neil from Ashfield was much luckier. It was picked very quickly. They got the antibiotics into his body and he made a full recovery. With Pam from Ashfield, it was lucky for her husband that she was a former nurse. She recognised the symptoms and insisted that the hospital put the IV antibiotics into his body very quickly. There is a window of about 12 hours to get the antibiotics in. The point of today’s debate is to get the awareness out there, not just in the wider community but in hospitals, because it is very unfortunate that sepsis is being missed. Maybe if they had picked it up quicker in Abbi’s case, we would not be sat here—I do not know. Shirley from Ashfield had a better experience. The hospital picked it up very quickly and she made a full recovery, so there are people making full recoveries.

We all know about the sad story of our colleague, Craig Mackinlay—Lord Mackinlay now. I have had conversations with him over the past few weeks about this debate, although he could not be here today. He had a torrid time. His wife was told he was going to die, but he fought back. I think she put pictures of his family on the ceiling of his room at the hospital. He is a fighter, is Craig. It nearly took his life and it has taken him several months to get over it. We did not know where he was; we thought he was just on holiday somewhere at first. We did not see him for months and then we heard what condition he was in. He came back to Parliament a few months back. I will be honest: there was not a dry eye in the House when he walked in as the bionic man. It was so emotional. He is living proof that we can fight back from this disease and have a reasonable quality of life, given the right support and a good hospital.

As I have said, 48,500 people a year die from sepsis. Other organisations put that figure much higher. That is almost 1,000 people a week dying from sepsis in this country, but if somebody was stopped in the street and asked what it was, they would probably struggle to say. The symptoms are a very high or low temperature, uncontrolled shivering, confusion, passing less urine than normal, and blotchy or cold arms and legs. I know that because a few years back, my wife had those symptoms. My wife has cystic fibrosis and she is post double lung transplant, so she has all sorts of medical problems as well, and we thought that it was maybe a rejection of the lungs or pneumonia. We managed to get her to the hospital, and it was sepsis. They told us at the hospital that if we had left it any longer, she would have died—simple as that—because of other complications and she has no immune system. Last year, when she had it again, we knew straightaway what it was. She had the same symptoms, so we got her there pretty sharpish.

I also learned today from Abbi that, on her road to recovery she got her prosthetic limbs but she is also—I do not know if the Minister is aware of this—on a list at Leeds hospital to have a hand transplant. She has a prosthetic for her right arm, but she is on the list for a hand transplant—it is absolutely amazing that we are doing that now. It offers people a lot of hope—Abbi does not stop smiling. We have a campaign in this country for strokes and we all know the symptoms now. We have all seen the stroke campaign on TV about the facial symptoms or someone not being able to talk or keep their arms up. We know all that now. I would like to see a campaign for sepsis so that families and, more importantly, our hospitals are fully aware. What does it cost to give somebody some antibiotics as a precaution if they are shaking, are cold, are blotchy and have a fever? For goodness’ sake, what does it cost to put an IV on them and get some antibiotics pumped into them while they do the other checks?

[Helen Grant (Maidstone and Malling) (Con)]

I congratulate the hon. Gentleman on securing this important debate. Does he agree that sharing the stories of all those we know who are affected by sepsis, as he has done so sensitively today about his Abbi, helps to highlight the importance of early recognition of this dreadful disease and the importance of early diagnosis?

[Lee Anderson]

The hon. Member is absolutely right, if I am honest, and that is what this debate is about. It is about sharing stories. As I said earlier, we could probably ask 100 people on the street what sepsis is and the vast majority would struggle to tell us what it is and what the symptoms are. What we need, and it is quite right, is a campaign for awareness, whether that is through schools or on social media or the TV. I would really like to see a campaign on sepsis so that everybody knows the symptoms. I am going to wrap up now—I have spoken for 13 minutes. I know there are lots of colleagues present who want to speak as well and I am conscious that we have only an hour.