Secondary Breast Cancer

Ashley Dalton Excerpts

Thursday 11th June 2026 Westminster Hall

[Ashley Dalton (West Lancashire) (Lab)]

As ever, it is an honour to serve under your chairmanship, Mr Betts.

I first acknowledge the campaigners from Make 2nds Count, METUP UK and Breast Cancer Now and the fellow MBC patients who are joining us in the Public Gallery. If you will indulge me, Mr Betts, I would like to take this opportunity to say a special thank you to my team at the Clatterbridge in Liverpool for the support they have given me through my treatment and diagnosis.

I am delighted to be able to speak in this debate on secondary breast cancer. Secondary, metastatic, advanced, stage 4, disseminated, which a new one for me, distant metastatic spread—lots of words that all mean the same thing: incurable breast cancer. For completeness, there is a relatively new term: oligometastatic, which means very small or very few metastases. There is a school of thought that suggests that that may be curable, but the jury is still out on that, so we will stick with the terms that we have. But there are some other words that describe secondary breast cancer: devastating, terrifying, overwhelming, horrifying, desperate, anger, resentment and fear—all of which I have certainly felt.

This debate calls it secondary breast cancer. It is really important that we get it right, because I have met many people who think that secondary breast cancer means having breast cancer for the second time. It does not. Let me be really clear about that. As we have heard, secondary breast cancer is breast cancer that has spread outside the breast tissue and is now incurable. It can be diagnosed after a primary diagnosis—primary breast cancer is potentially curable—or the first time that a person is diagnosed with breast cancer. That is called a de novo diagnosis. That is what secondary breast cancer is and, as we have heard, I have it, along with many, many other people.

I want to take the opportunity to talk about some of the myths around breast cancer. Colleagues have spoken really well about some of the issues and concerns, and the politics and policies involved, but I want to talk about the reality and some of the myths about secondary breast cancer. The big myth for many people is that it is curable. A number of people have, very well-meaningly, said to me, “How long will you be on treatment?” I will be on treatment until I die. “I hope you make a full recovery.” I am not going to be making a recovery. My favourite—I know people mean well—is: “If anyone can beat this, you can.” I know people mean well when they say that, but the truth is that I cannot beat it. I will always be in treatment, and I will not recover. It is absolutely terrifying, but we have to be honest about this. If we are not honest and do not grasp the nettle about this disease, we cannot truly tackle it.

There are some other myths about breast cancer. One is that when it spreads, it is a new cancer. If you have breast cancer and then you have cancer in your bones, that is not bone cancer; it is breast cancer in your bones. It looks like breast cancer and the cells are breast cancer; they behave like breast cancer and they will need to be treated like breast cancer. There is also a myth that the treatment for your primary cancer was somehow wrong or had failed if you get metastatic breast cancer. Again, that is absolute nonsense. Breast cancer can still spread, even after successful treatment for a primary cancer, and even with the best treatments in the world. Breast cancer in particular can lie dormant for years and years.

That leads me to the five-year myth. We often count survival after primary diagnosis and treatment at the five-year point. Sometimes, that creates the idea that if you get to five years and it has not come back, you are okay. Sadly, that is not true; it does not mean that it will never come back. Breast cancer in particular can come back up to 20 years, if not longer, after primary diagnosis. My breast cancer came back 10 years after my primary diagnosis. I do not say that to terrify people, but to say that it is absolutely imperative that they are aware of the signs and symptoms of secondary breast cancer in case they ever have them, no matter how long it has been since their primary diagnosis—or indeed, if they have ever had one. I put on record my commendation and thanks to Jo from METUPUK, who developed the infographic on secondary breast cancer symptoms, which has been extremely useful.

We have heard about lobular breast cancer, and there is an idea that secondary breast cancer is one disease. Obviously, it is not: there is ductal, lobular, metaplastic, inflammatory and other sub-groups such as hormone receptive, HER2-positive, HER2-negative and triple negative. The weird thing about cancer is that it is not a disease that infects us. It is not something from outside that we pick up, or that we get. It is us—it is our own cells that change and do this to us, so our cancer, invariably, is as unique as we are. There is also a myth that all treatments will work for everybody, and that if you have one kind of cancer, a certain treatment will work. Unfortunately—sadly—that is not the case, because we are all unique. A treatment that can be extremely effective for one person can have absolutely no impact on somebody else.

There is also the idea that the treatment for metastatic breast cancer is more aggressive than that for primary cancer; actually, it is often the opposite. I cannot be cured, so what is the point of making me so sick that I cannot get out of bed for six months? The point of treatment is to keep the cancer at bay—to hold it back to allow me to continue to do this work and live my life—not necessarily to cure me.

Then there is the myth that metastatic breast cancer means that you are going to die soon. I received some absolutely terrible comments when I went public with my disease. One particularly lovely person on Facebook said, “Oh, there’ll be a by-election soon then,” assuming that I was going to be dead—that was two years ago. It is not necessarily true. Metastatic breast cancer is treatable, but it is not curable. Our treatments are there to hold it at bay and treat pain and other side effects. Sometimes we might even get the holy grail of “no evidence of disease”, which is what everybody hopes for. That does not mean that you are necessarily cancer free, because we know that it lies dormant and we cannot necessarily see it.

We know what secondary breast cancer is, so what are we going to do about it? Some of these points have been raised already, but the national cancer plan, which I, as the Minister at the time, was delighted to lead on and launch earlier this year, is perhaps the first national cancer plan that does not have metastatic disease as a brief mention but has it at its heart. I am really pleased about that, because it has not been forgotten about—it is in the plan.

The No. 1 thing that I wanted to make sure was in the plan was that we count; this has already been touched on. We estimate that 61,000 people have metastatic breast cancer, but really we have not got a clue. We have some good data for de novo—where it is diagnosed initially—but for people like me who are diagnosed 10, 12 or 20 years later, we do not really know. Without that data, we cannot build the services or estimate demand. The fundamental truth is, if I am not counted, I do not count. We must start this. The cancer plan commits to counting metastatic disease properly, starting with breast cancer, so I ask the Minister what progress has been made, and will she set a deadline for trusts to report? It is literally just counting.

On research and lines of treatment, some treatments work and some of them do not. Basically, you try them, and if they work, you stay on them until they stop working or they make you so ill that you cannot carry on, and then you try another one. It is literally a process of trial and error, and you keep going until you run out of options, which means that without access to new drugs and without trials, we will run out of options sooner rather than later, and when we run out of options, we die.

The cancer plan committed to develop world-class cancer care through world-class research, so I ask the Minister what progress has been made, particularly to establish the cancer trials accelerator by 2027. When we do develop those drugs, we need to know that we are getting them. Changes to NICE criteria, namely the severity modifier, have been touched on, so I ask the Minister what developments have been made on them. Will she explore those? Access to drugs and research makes it possible for me and others like me to see our children grow, to meet our grandchildren and to bury our parents, not the other way round. Lives with metastatic breast cancer matter too.