Childhood Cancer Outcomes

Debate between Mike Wood and Maria Caulfield

Tuesday 26th April 2022 Commons Chamber

[Maria Caulfield]

I think the names that we have read out this afternoon show that, while cancer in children only accounts for 1% of cancer cases, if you are in that 1%, it does not feel very rare at all. I thank all hon. and right hon. Members for sharing the stories of their constituents.

That means, as has been pointed out, that GPs will only see one or two cases of childhood cancer over the course of their career. These can be difficult cancers to spot because some of the symptoms reflect other illnesses and other conditions. NICE guidelines are trying to support GPs. The NG12 guidelines underpin cancer referrals. They set out detailed guidelines for GPs on the symptoms of cancer in children and recommend very urgent referrals that mean an appointment within 48 hours for children presenting with a wide range of potential cancer symptoms, from unexplained lumps to bruising or bleeding. The guidance also recognises the knowledge and insight that parents have, as it sets out that GPs should consider referrals for children where their parents are thinking that their child is not well or there is just something not quite right with them. That referral should happen when parents are concerned, even if the symptoms are most likely to have a benign cause.

[Mike Wood (Dudley South) (Con)]

Will the Minister give way?

[Maria Caulfield]

I will not, if my hon. Friend does not mind, because we do not have a huge amount of time.

NICE regularly reviews and updates these guidelines on suspected cancers. It urges GPs to think of cancers sooner and lower the referral threshold for tests, and ultimately catch cancer sooner, which does not always save lives but can make a difference if a cancer is diagnosed earlier.

To help GPs to identify signs and symptoms of these childhood cancers, online education programmes such as Gateway C are available, but also face-to-face education sessions have now resumed, including seminars offered by providers such as Cancer Research UK, and primary networks are establishing cancer clinical lead groups to share latest research and good practice.

The rarity of cancers in children, as the hon. Member for North Antrim pointed out, means that it is harder to diagnose outside a specialist setting, and many of the symptoms can mimic other illnesses. For example, diagnosing brain cancer in children is particularly challenging because it often presents in a similar way to epilepsy, and sarcoma symptoms can often start with limb pain, which is often a common complaint in children. It is therefore crucial that children up and down the country have access to specialist services in cancer care, which are not necessarily provided in most hospitals, where traditionally cancer services are arranged by cancer type. Children’s cancer services need to be contained in a small number of specialist units, which we refer to as principal treatment centres, or PTCs. Each child with a suspected cancer should be referred directly to a PTC, which will make the diagnosis and direct provision of treatment. In England, we have 14 of these centres. They manage care through the multi-disciplinary teams and drive diagnosis, treatment and, crucially, as we have heard from many Members, research participation.

As well as diagnosing the condition, the centres are expert in offering psychosocial support, helping children to continue their education and helping, as Sophie campaigned for, to provide specialist play facilities seven days a week. Sophie’s complaint was that those were only provided for five days a week. It is important that we hear from children and young people who receive a cancer diagnosis. I personally thank charities such as Young Lives vs Cancer and the Teenage Cancer Trust, which last year put together guidance for young people in England, Scotland, Wales and Northern Ireland discussing having a visitor and a hand to hold when having cancer treatment. That is useful guidance, and it has been distributed by the NHS to all our cancer alliances in England.

I will touch on the issues that Sophie in particular was campaigning on. Food was a big bugbear of hers. I think she described it as “disgusting” in some of the reports I read. We know that food is important for all patients, but particularly for children, because nutritious food is a way of aiding patients’ recovery. It is difficult in hospital. I know from my experience as a nurse that we always serve food at 7, 12 and 6, and if someone is hungry in between, it is often very difficult to get any food at all. We are working extremely hard to improve hospital food following the publication of the independent review in October 2020. The review made a suite of recommendations across several areas, including nutrition and hydration. The three-year plan, “Great Food, Good Health”, led by NHS England, is under way to implement the recommendations from that review. I hope that Sophie and her family will be pleased we are making some progress with that, because I fully recognise the complaints she made from her experience.

I will touch on research, because it came up so often in hon. and right hon. Members’ contributions. It is important that we improve not only treatment, but its side effects. We have heard from many Members that childhood cancers can have a very successful outcome in terms of survival, but often the impact of those treatments can have a lifelong effect for those with cancer and their families.

I reassure Members that research is taking place. Since 2019, the NHS has been offering whole genome sequencing to all children with cancer to enable more comprehensive and precise diagnosis and access to more personalised treatments that will reduce the number of young people experiencing long-term symptoms from their treatment. There has been a lot of progress on the treatment of childhood cancers, with the majority of children now surviving, but for certain childhood conditions, such as rhabdomyosarcoma, that is not yet the case. Research is crucial to how we deal with it in the long term.

The NIHR, which funds research across the board in the NHS, is funding childhood cancer research across its whole remit, from early translational research right through to clinical research and social care research. I am concerned by the case raised by my hon. Friend the Member for Scunthorpe of researchers in her constituency finding it difficult to access those funds and go through the application process. I am happy to meet her and the researchers to see whether we can unlock some of those jams.

There is support for research into rhabdomyosarcoma at the Royal Marsden biomedical research centre—I declare an interest, as I still work as a nurse at the Royal Marsden—the Royal Marsden clinical research facility and the Great Ormond Street biomedical research centre. We are making some great inroads in funding research into not only cancer treatments, but the effects of treatments.

There is so much more I would like to say to answer Members’ questions, but due to time I simply reassure my hon. Friend the Member for Gosport that the 10-year cancer strategy that the Secretary of State has just announced will tackle many of the issues she has raised. The call for evidence recently closed, but it is a great opportunity to put forward the case for childhood cancers, and I am happy to meet her after the debate to see whether we can push her case forward.