Pancreatic Cancer

Debate between Lord Jackson of Peterborough and Eric Ollerenshaw

Monday 8th September 2014 Westminster Hall

[Eric Ollerenshaw]

The hon. Lady makes an extremely important point, which the all-party group was trying to weigh up. The hon. Member for Scunthorpe made an important point about CT scans and made the important suggestion that there should be pilots. Also, interestingly, he mentioned that the going backwards and forwards between the GP and the specialists delayed diagnosis. There are certainly things that we could learn from other countries.

One of the basic needs that came up from our research was the need for investment in the basic science and biology of tumours, as well as access to better infrastructure that would allow that, such as access to tissue samples. On the latter point, the Pancreatic Cancer Research Fund told the APPG that it was working in conjunction with Barts on creating a specific pancreatic cancer tissue bank, which would help. That is a massive investment for a small charity and it should be applauded.

As Members know, there is a massive shift throughout all cancer research towards personalised medicine. Pancreatic cancer patients could benefit particularly from such an approach, given the nature of the disease and the fact that so many different tumour types are involved. New treatments need to be developed to attack and destroy the cancer cells. That does not mean new drugs alone, but perfecting the use of advanced radiotherapy techniques, such as NanoKnife or CyberKnife, for the benefit of patients and to the satisfaction of the National Institute for Health and Care Excellence, so that they can be provided on the NHS.

All in all, a lot of research needs funding. A key statistic for this debate, as mentioned in Maggie’s e-petition, is that pancreatic cancer receives only 1% of the National Cancer Research Institute’s site-specific spend of £5.2 million a year. That is despite the fact that pancreatic cancer is the fifth biggest cancer killer in the UK, and predicted to become the fourth biggest by 2030. It is responsible for 5.2% of all cancer deaths in the UK. The National Cancer Research Institute itself acknowledges that research into pancreatic cancer and other cancers deemed to have unmet need, such as brain and oesophageal cancers—forgive me if I do not pronounce that correctly—remains “relatively low”.

By “relatively low”, however, the institute means “low”. I contend that £5.2 million a year from the NCRI partner funders is simply not enough to tackle the extreme intransigence of a disease as tough as pancreatic cancer, a disease that has seen—as has been mentioned before and should be mentioned again and again—little change in survival rates over the past 40 years or by comparison with other countries, as the hon. Member for Belfast East (Naomi Long) said.

Why does funding matter? Is money the be-all and end-all? No—other things need to be done as well if research into pancreatic cancer is to become more effective. However, if we look at other cancer types, we see that sharp increases in survival rates from breast, prostate and bowel cancer, for example, have mirrored sharp increases in research spending into those diseases. As Professor Peter O’Hare, chair of Pancreatic Cancer UK’s scientific advisory board—now there’s a powerful job—told the APPG inquiry:

“I think if you simply looked at the history of science, I don’t think you can, as a scientist, start to make guarantees about research. It’s not like a sausage grinder; you don’t put research in and it comes out and you solve the problem. It just doesn’t work that way”—

we totally understand and agree with that—

“there are convoluted pathways and you can’t make guarantees.

However, I think there is a guarantee you can make: if you don’t carry out research, you are not going to move; nothing is going to happen. That’s the guarantee that you could make.”

Some evidence suggests a critical mass, a level at which research needs to be funded, if advances are to start to gather pace. Pancreatic Cancer UK produced a report in 2012, “A Study for Survival”, which demonstrated a level—around £10 million to £12 million minimum—at which the amount of research starts to become sustainable and from which new research proposals and ideas are generated. Those new ideas in turn lead to more funding coming in, and we get a virtuous circle.

We are some way off that level of funding at the moment. National Cancer Research Institute funding partners contribute just £5.2 million at present. Incidentally, we learned during the all-party parliamentary group’s research inquiry that the Department of Health’s contribution to that sum is just £700,000 a year. Although they are growing, charities for pancreatic cancer are still small and supply probably less than £2 million a year between them for research. Where, then, can that extra funding come from? What needs to be done?

In its new research strategy, published in April this year, Cancer Research UK made a welcome move in the right direction, with a promise to increase funding into pancreatic and other cancers of unmet need—brain, lung and oesophageal—twofold or threefold over the next few years. That is great news.

[Mr Stewart Jackson (Peterborough) (Con)]

My hon. Friend is making a customarily powerful and passionate speech. He is aware that the five-year survival rate in the United States is 6%, as against 3.3% in the UK. Is he also aware that, under the Recalcitrant Cancer Research Act of 2012, the US Congress has given a legal imperative for the director of the US National Cancer Institute to produce a strategy to tackle such cancers? We should do the same in the UK.

[Eric Ollerenshaw]

I am grateful for that intervention, particularly as I will go on to mention the Recalcitrant Cancer Research Act—as usual, my hon. Friend has got in before me. He is on exactly the right lines in terms of what we are all thinking.

I have talked about good news and extra money. However, I am not sure whether that goes quite far enough. There is still no ring-fencing per se of money for research into pancreatic cancer, brain tumours and so on. Instead, applications will still have to be made for funding. They will be peer-reviewed and selected from similar applications for research into other cancer types.

The issue is that the reason given by Cancer Research UK for not awarding more funding for pancreatic cancer in the past has been that not enough quality applications have been received, so the doubling or trebling of funding set out in the strategy will happen only if more applications are made. For that to happen, we need more researchers in the field, whether established and respected researchers coming over from abroad, such as Professor Andrew Biankin from Australia, who has recently relocated to Glasgow—as usual, Scotland sets the trend—to carry on his pioneering work there, or new, young researchers starting out in their careers.

We are currently in a Catch-22 situation, however: new researchers do not generally want to enter the field, partly because it is deemed difficult to make advances in it—that puts them off as they fear it will hold back their careers, as the Department of Health’s written response to the e-petition mentioned—and partly because the funding is not there. But the funding is not there because not enough research applications are being made.

I firmly believe that we need to break that vicious circle and to pump-prime research into pancreatic cancer, making sure that we hit the minimum funding level required to gain critical mass. I also firmly believe that the Government can and should play a role in that.