Cancer in Teenagers and Young Adults

Alex Norris Excerpts

Tuesday 1st December 2020 Westminster Hall

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank the hon. Member for Strangford (Jim Shannon) for securing this important debate. He works hard through the Backbench Business process to get important debates either on the Floor of the main Chamber or here in Westminster Hall. I think he has chosen very wisely in this one.

I know that all Members in the room have a personal commitment to this issue. My childhood experience of cancer was the death of my father just before my third birthday, and that stays with me and my family, 33 years on. I am here to speak up for my community, but also to fight on this issue so that across the country, there might be fewer families like mine. We are well served in that regard with the Minister, and her personal commitment to this issue is something that we all look to.

Similarly, when it comes to the Scottish National party, it always great to see the hon. Member for Glasgow East (David Linden) in his place. We always learn from his contributions, and also from those of his colleagues, such as the hon. Member for Central Ayrshire (Dr Whitford); with her enormous professional experience, she always adds to the debate. The hon. Gentleman mentioned his colleague and friend the hon Member for East Dunbartonshire (Amy Callaghan). I am sure she is watching, and I know the hon. Member for Glasgow East will pass our best wishes on to her. We can see that across this Chamber, there is a high level of commonality in our views about what must be done for young people. Between us, I am sure we can move forward on this important issue and make an impact.

I agree with so much of what the hon. Member for Strangford has said that throughout my speech, I will be reiterating the points that he made. Unlike him, I did not have a point to make on schooling, which is very important. Whatever challenges our children face in their lives—because of their socioeconomic background, their health, or whatever makes them different from their peers; everything makes a child different in some way—we must ensure that we are no less ambitious about their educational outcomes. We must meet their health needs in the short term, and then be ambitious about their futures so they can reach their potential. That is a cross-party theme; no one has ownership of it. It is important that we remain ambitious about the broader outcomes of children and young people who are suffering from cancer, so that—fingers crossed, and all that wonderful support willing—we can help them to resolve their health challenges and they can go on to live really full lives.

I refer to the poignant personal experiences described by the hon. Member for Wakefield (Imran Ahmad Khan). If he is still in touch with Daniel’s family, I hope that they can take comfort from the fact that Daniel’s story has been heard and his life recognised. The hon. Gentleman’s moving contribution will stand as a testament to Daniel in Hansard for centuries, and I hope that the family get to see it. I agree with what the hon. Gentleman said about early diagnosis, and I will refer to that theme shortly.

On covid-19, the hon. Gentleman said that the cure must not be worse than the disease. I understand that, but if we do not put restrictions in place and we do not control the virus to the degree to which we are able, our NHS will not be able to do anything else because it will be overwhelmed. I do not think that treating cancer and treating covid are in tension, and I hope we do not lose sight of that in the debate that we will have later today.

The hon. Member for North East Fife (Wendy Chamberlain) made points about cashlessness. We are all looking at how covid will change British life and our own lives. I was thinking about cashlessness only this morning as I beeped on to the tube. I have had the same £10 note in my wallet for months, and it is hard to think when we will use cash again. I have to say that such change makes me a little anxious—that might just be something in me—especially when I think about my constituents. For me, beeping in is great and doing stuff on apps on my phone while watching the telly is brilliant, but for lots of people in my community, cashlessness would be their worst nightmare. We tend to think about it in those terms, but the hon. Lady talked about how we might embrace the opportunity to get better outcomes, and how we might all take into these new times the spirit of putting money into charities’ collection boxes. Those points were well made. Importantly, I am sure that those whom she works with at Toby’s Magical Journey will have seen that their contributions and their wonderful work have been recognised today. I will come back shortly to the point about getting an early diagnosis.

I have spent eight months as shadow public health Minister, and it has has been a non-stop procession of virtual calls. The fact that it has been eight months may remind you that it feels simultaneously as though this pandemic has been going on forever, and as though it only started yesterday. The sense of time and space is strange. Sometimes, the virtual meetings can blend in together—I think I can say that without that sounding rude—but one really stood out, and that was when I was lucky enough to meet the Teenage Cancer Trust youth advisory group. I heard from four incredible people who had all experienced cancer at a young age, and they shared with me their unique and personal experience of this horrific disease. What they said was eye-opening and quite hard to hear at times. It was so inspiring that those four young people, who have fought or are fighting cancer, have chosen to use their experiences to fight the greater fight for others like them. That has had a great effect on me and informed my work.

Those young people talked about the scale of the problem that we are dealing with. We know that every year, 2,200 15 to 24-year-olds will be diagnosed with cancer. Lymphoma will be the most common—about a third—the next most common will be carcinoma of the thyroid, cervix, ovary, bowel or breast, at a little bit less than that. Survival rates are improving. That is something we should recognise, and we should be pleased and optimistic about it. We know that 82% to 85% of teens or young adults diagnosed with cancer will now survive for at least five years, but that is still in the context of the fact that nearly once a day a young person will pass away from cancer. That is the level of seriousness of this debate. Cancer in young people is rare, thankfully, but it is the biggest killer by disease, and the 2,200 15 to 24-year-olds diagnosed each year face mammoth challenges. We in this place cannot make that go away, although we wish that we could, but we have a responsibility to make sure that the best services are in place to meet their health needs directly and to provide support. I know that we are all committed to that.

The hon. Member for Strangford talked about the wide variety of challenges our young people face; everyone goes through them, even if they do not have to deal with this disease. I am just about young enough to remember some of them, whether social, emotional or physical. The idea of combining them with the physical and mental burdens of dealing with cancer is quite unimaginable. As we know, the normal challenges faced by young people are not sidelined in that situation; dealing with cancer just adds to and compounds them.

The experience that the TCT youth advisory group shared with me highlighted one of the biggest issues that young people with cancer face, and that is diagnosis. As multiple hon. Members have said, that is something that those young people face before they even know they have cancer. Cancer is often not the first, second or even third suggestion for what their healthcare challenges might be, and we know that young people are the most likely age group to present three or more times before they are diagnosed. That is backed up by studies that show that rarity can lead to doctors being unfamiliar with some of the symptoms that are presenting. A compounding factor is that, as the hon. Member for Strangford said, this age group is the least likely to take to a doctor concerns about their bodies. That can often go on for more than a year. Although the challenges that we face are understandable, we should not accept them. Rarity is not an excuse for us to not be really focused on the issue, and to want to do something about it.

I know the Minister will want to do that, and I look forward to hearing her contribution. I hope she can address a couple of issues. I am particularly keen to understand what steps the Government can take differently to increase awareness of cancer, not just among young people, but also among healthcare professionals, doctors and the wider healthcare system. We know those people are doing their best, so what can we do better to make sure they have the right information and awareness to recognise it more quickly? The hon. Member for North East Fife mentioned Childhood Cancer Awareness Month, and I think we could all do more during that month.

I am keen to hear the response to the question asked by the hon. Member for Strangford about what can be done to get waiting time statistics broken down by age, and I will explain in a second why that is particularly personal. The current situation masks the true extend of the problem and restricts our ability to understand it.

That leads on to my point about the impact of the coronavirus. I have raised this at three of the last four Health questions. Dealing with the cancer bubble of delayed diagnosis and delayed care is critical to improving our health services and making sure we do not add to the terrible loss of life from covid a series of other lives lost to cancer. Young people are particularly at risk in that regard.

In the short term, I cannot even imagine how scary it must be to deal with cancer at a young age during this period of time, because all the support systems that would normally be there are more difficult to access, and they must be accessed virtually rather than person to person. That is really challenging. The long-term issue is around waiting times. In the first lockdown, referrals dropped dramatically, as people stayed home to protect themselves and others. That means that lots of undiagnosed cases of cancer are out there, many of which will be among young people, who were already less likely to seek medical attention or be diagnosed quickly. That is a potential added factor that may make outcomes for young people worse. As cancer services are restored, we really need a sense of what we are doing differently to deal with the bubble for young people in relation to those extra factors.

[Jim Shannon]

The hon. Gentleman is making some important points. There is a build-up of young people, children and young adults who have not had a diagnosis or the chance to get treatment because of covid-19. Does he think that in the Government’s policy and strategy decisions, resources must to be set aside to address the long list of people who need diagnosis and treatment, and that resources must be in place for staffing as well?

[Alex Norris]

I agree with the hon. Gentleman. We will have to do something differently to catch up. When we talk about restoring cancer services, that does not mean restoring them to how they were in January. I know there will be a debate tomorrow morning on ways in which we can make those treatment pathways better. I think the wise thing to do is to focus on those groups on whom the impact is worse, and young people are one of those groups. Before I finish, I ask the Minister for her assessment of what the second lockdown has done to referrals and waiting times. When that was discussed at Health questions the week before last she was relatively optimistic about it, but I would be keen to know more. Particularly, we had a period between lockdowns where services will have been getting back to normal. Do the Government feel that we have learned any lessons from that about restoration of services, particularly for young people?

I want to conclude by saying, as have all Members who have taken part: if any young person, or indeed anyone at all, who is watching this is worried about possible symptoms, such as hacking cough, blood in the stool, or a lump or bump that they do not recognise—whatever it is—they should please not think that we are distracted by fighting the coronavirus and that they should therefore not present in the normal way to the health services. Do it—ideally this morning, or, if not, this afternoon or tomorrow morning. Whatever the earliest opportunity is, please do it, because the services will be there for you.