Health: Cancer

Lord Beecham Excerpts

Thursday 11th November 2010 Lords Chamber

[Lord Beecham]

My Lords, I come to this debate two years after my wife was diagnosed with inoperable bowel cancer and with secondaries in her liver and lungs. I therefore hope that your Lordships will bear with me if I speak in a more personal vein than is perhaps usual in debates in your Lordships’ House. My wife was diagnosed after some months of suffering from constipation. Her GP did not refer her to a cancer department—despite there being something of a family history—although in all fairness, as it turns out, it was probably too late in any event. But it is quite significant that constipation is not always recognised, even by some bowel cancer charities, as a significant symptom. It is to be hoped that that matter can be addressed in alerting the public in future to the need to seek advice.

I join most of the speakers who preceded me in paying tribute to the noble Baroness, Lady Finlay, for securing this debate and in particular for her emphasis on the quality of life. My wife was very realistic about her prospects. She did not chase after alternative treatments. She did not seek second opinions. She was determined to make the most of what time was left to her. Within a couple of months of being diagnosed, she made an acclaimed documentary for BBC North East and Cumbria about her condition and about the need for people to seek advice. She even wheeled on a footballer who had previously captained Newcastle United and Scotland to participate in that programme. Indeed, only last week I was approached by somebody quite unknown to me while shopping who had seen that programme and who had, as a result, sought advice and undergone a colonoscopy.

Not only that, my wife subsequently underwent a caecostomy in 2009, which made her a stoma patient. Of course, stoma patients have suffered from a variety of conditions, not just cancer, but together with other stoma patients she went on to make a DVD called “Have Bag, Will Travel”. It was trying to explain to both patients and their friends and, indeed, to practitioners about how to cope with stoma. That is also now being much used. It is available on YouTube and is being used and disseminated in hospitals, universities, medical schools and the like. She had undergone chemotherapy; at first, it seemed to be successful but the tumours began to grow again. She then had a second course of chemotherapy, which did not work; finally, she was treated with cetuximab. She passed the gene test, probably marginally, but alas the treatment did not work. However, NICE did its job. It was an approved treatment and, with some more luck, she might have been able to benefit from that.

However, she went on in her efforts to promote information. As a life coach and counsellor, she then organised a group counselling course for a number of other women who were cancer patients. That has been written up in a booklet called Moving Forward, published by Coping With Cancer. The aim of the booklet is,

“to provide tools to help people who have experienced cancer to reassess their present situation and move forward with their lives”.

That also is now being quite widely disseminated.

In the mean time, she received excellent treatment and support from the new cancer unit at the Freeman Hospital in Newcastle, from her district nurses and from Macmillan nurses. These were all very helpful. In her last weeks, a series of aids and adaptations were installed extremely rapidly. She did not in fact live long enough to gain the benefit from them, but close collaboration between the adult services department of the local authority and the PCT led to those being installed. There are considerable advantages to the close collaboration of those two organisations. Finally, she went to a hospice and received excellent treatment there. As she wished, she was sedated so that her last two or three days were spent without pain.

A number of policy issues arise from this and, of course, from many other similar histories. The first is to promote a better understanding of symptoms, not only among patients but among practitioners. The second is to welcome the improved screening; I am now speaking particularly about bowel cancer. The previous Government instituted tests by faecal smears. The present Government have promoted flexible sigmoidoscopies, although it should be pointed out that my wife had a sigmoidoscopy but it was not able to detect the tumours; the process does not go far enough, as it were, whereas colonoscopies do. I understand it to be the case, certainly in America and maybe in other places too, that more regular colonoscopies are available and are almost treated as routine. That could have a significant effect on detecting cancer early. Although I would not of course expect the Minister to make any kind of commitment, perhaps he would like to comment on the possibility of going beyond the further use of sigmoidoscopies. I would also like the Minister to comment on the provision of stoma nurses because it was apparent, certainly in our area, that there was a limited number of stoma nurses in the community. It would be helpful to have more of them.

A further issue is psychological support, which is the subject of the booklet that I have just mentioned and which again perhaps needs further emphasis. There again, GPs really must be encouraged to have closer contact with cancer patients.

There is also the question of support for the charities that the noble Lord, Lord Howard, so eloquently referred to: Macmillan, Marie Curie and the hospice movement. It is of course wonderful that so many people devote time to, and raise funds for, those hospices, but surely it is time to recognise that perhaps a greater degree of government funding and support is necessary.

Many patients, and my wife was one of them, would like to die at home. It was not possible in her case and perhaps not appropriate, but for many others it would be. I endorse the views of noble Lords who have called for further efforts to ensure that that is available to more patients.