Pancreatic Cancer

Debate between Emma Lewell-Buck and Nicholas Dakin

Tuesday 2nd April 2019 Westminster Hall

[Nic Dakin]

I pay tribute to the work that the hon. Gentleman has done on blood cancers in particular, and other cancer awareness issues such as this. He is right that we must learn the lessons from elsewhere, and hopefully I can demonstrate that there are things we can do to help us to catch up, once the diagnosis is in place, and get faster treatment.

One of the things that frustrates campaigners such as Maggie is the danger of accepting that little can be done after a diagnosis of pancreatic cancer. There is a sense of nihilism about this disease. Maggie’s optimistic initiative in response to her situation is called “Hope is Contagious”, and it should energise us all to redouble our efforts. No one should be written off.

Paul Kenny is a pancreatic cancer sufferer who has contacted me on Twitter, saying he has a “slim chance” of seeing his next birthday, but adding:

“Hopefully future generations of sufferers will be prevented or given better prognoses.”

Paul is right—we can do so much better, and we must.

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

My hon. Friend is making a powerful speech that will resonate with many people, including my own family. My lovely mother-in-law, Jean Buck, had stomach pains and was misdiagnosed with pancreatitis. She was sent home from hospital on a diet of bread and water. When back in hospital, she suffered a heart attack and slipped into a coma. Only then did the hospital suspect pancreatic cancer, but it was too late to operate, because she needed to breathe unaided and sadly she could not. That left my father-in-law, Maurice, my husband and his brother and sister with the heartbreaking decision of whether to end her life support—a decision that will haunt their grief forever. Does my hon. Friend agree that earlier diagnosis is key not only for those who are suffering, but for those left behind?

[Nic Dakin]

I thank my hon. Friend: in sharing that personal story, she makes a powerful argument about the need for better early diagnosis. Sadly, the story that she tells is the familiar one of undiagnosed general symptoms eventually, in an emergency, being diagnosed as pancreatic cancer. Very often, it is then too late to take action to address the illness. However, I want to focus on the fact that when we do diagnose early, we need to act early to cure people, because that is an area where we can certainly up our game.

At the moment, only one in 10 pancreatic cancer patients receives potentially curative surgery and only two in 10 receive chemotherapy, meaning that a massive seven in 10 people receive no treatment at all. That has to change. Last month, I delivered to the House a petition signed by an incredible 100,600 people supporting Pancreatic Cancer UK’s campaign to “Demand Faster Treatment”. They are asking for pancreatic cancer to be recognised as a cancer emergency and for people to be able to access treatment within 20 days of diagnosis in order to have the best chance of survival.

That ask is based on the latest evidence and best practice from existing fast-track models for operable and inoperable patients. Those models show that treating people with pancreatic cancer within 20 days increases the number accessing surgery by 20% and the number accessing chemotherapy by 25%. Those are significant improvements. Fast-track surgery will allow more people to access life-saving treatment, and we know that the survival rate is 10 times higher for those receiving surgery. The 100,600 people who signed the petition believe that those models should be the basis of a national optimal pathway for the diagnosis and treatment of pancreatic cancer to ensure that people with the disease can be treated within 20 days.

I want to be clear that I am not talking here about early diagnosis, important though that is—hon. Members’ interventions have underlined that—and I welcome the focus of the Government and NHS England on early diagnosis of all cancers. That can only be a good thing and it will help. However, there are currently many people with pancreatic cancer who have been diagnosed early enough to receive treatment but, unacceptably, do not receive it. That is the issue that I am focusing on today.

For example, more than half of people with stage 1 and stage 2 pancreatic cancer die within a year, and almost half of them, 42%, do not receive any active treatment at all—neither surgery nor chemotherapy. The data suggests that those patients are not prioritised and have not been treated as an emergency. Unfortunately, all the evidence shows that the Government’s current and proposed waiting times are not fast enough for people with pancreatic cancer. A one-size-fits-all approach is not improving, and will not improve, survival rates for pancreatic cancer.

It was disappointing that the recently published interim report of the clinically-led review of NHS access standards did not take the opportunity to propose a differentiated target for pancreatic cancer. If we really want to transform outcomes, it is high time that we had differentiated targets, including a 20-day treatment target for pancreatic cancer.

Behind the statistics are real people. We have heard about some of them today, and their stories help us truly understand the missed opportunities and devastating consequences of the current system. No one did more to mobilise people to sign the petition and help make the case for faster treatment than Erika Vincent. In February 2018, Erika was diagnosed with stage 4 pancreatic cancer, yet despite its advanced nature, she was made to wait two months for treatment—something that she described as psychological torture for her and her family. While she waited, her cancer spread, bringing her more pain and complicating the care that she would eventually receive. Erika believed that the delays to her treatment reduced the time she had left with her family. She chose to spend much of that time championing the need to treat pancreatic cancer as an emergency, believing, as I do, that pancreatic cancer patients cannot afford to wait. Sadly, Erika passed away just weeks before the petition calling for faster treatment—a petition that she had done so much to assemble and put together as part of a campaign—was presented to the House.

Erika’s story stands in stark contrast to that of Liz Oakley. When Liz was diagnosed with pancreatic cancer in January last year, it took just 12 days for her to be scheduled for surgery—the only cure for pancreatic cancer. Liz had already survived breast cancer twice. She is both a testimony to the remarkable progress that has been made in the treatment of other cancers and living proof of what is possible for patients with pancreatic cancer.

There is a compelling case for treating pancreatic cancer as a cancer emergency and for creating optimal fast-track pathways. Far too many people have been lost to this disease too early. For far too long, pancreatic cancer has been forgotten, neglected, written off. The Government can commit today to changing that. Will the Government look at developing optimal pancreatic cancer pathways? Will they evaluate rolling out fast-track surgery models across England? Will they commit to the ambition of allowing people with pancreatic cancer to access treatment within 20 days of diagnosis by 2024?

Thankfully, we have seen huge changes for other cancers. Lung cancer is a good example. Back in 2005, the national lung cancer audit showed that patients with operable lung cancer were not referred for surgery, and it was shown that the surgery rate could be tripled in a cancer network within one year. Between 1985 and 2005, there were just 3,000 operations a year; that increased to 7,250 in 2016. That is inspirational. It shows what we can do. It shows what we can achieve when a cancer is treated as a cancer emergency, as pancreatic cancer must be now. Hope is contagious. Let us make it happen.