Pancreatic Cancer

Eric Ollerenshaw Excerpts

Tuesday 4th March 2014 Commons Chamber

[Eric Ollerenshaw (Lancaster and Fleetwood) (Con)]

Thank you, Mr Deputy Speaker. As one Lancastrian to another, let me say that I am pleased to introduce this debate on access to new treatments for pancreatic cancer. It will become apparent why we are so pleased to get this debate at this time.

I want to start by reiterating some points I made about this dreadful disease in a debate in Westminster Hall last May that might help to set the context for this further debate today. Before I do, may I put on record my thanks to Pancreatic Cancer UK, Pancreatic Action, the all-party group on pancreatic cancer and others who have highlighted the impact of this disease? These include that great Lancastrian actress Julie Hesmondhalgh, who recently gave the disease some publicity in “Coronation Street”. More sadly there is the example of Kerry Harvey, who died at the age of 24 on 22 February and did so much in her last months to highlight the impact of this disease with the assistance of Pancreatic Action.

Pancreatic cancer is the fifth most common cause of cancer death in the UK. Approximately 8,500 people will be newly diagnosed with pancreatic cancer this year with around 7,900 people dying from the disease annually. Pancreatic cancer has the lowest survival rate of the 21 most common cancers. Five-year survival rates are less than 4%; a figure that has barely changed in nearly 40 years. Pancreatic cancer five-year survival rates lag behind many other EU countries and are almost half of what they are in the US, Canada and Australia. Only 1% of the National Cancer Research Institute Partners' total research spend is directed towards pancreatic cancer. By way of comparison, £3,613 per death per year is spent on breast cancer research compared to £553 per death per year on pancreatic cancer.

Some 50% of pancreatic cancer patients are diagnosed as a result of emergency admission—nearly twice that of all other cancers combined. Patients diagnosed as a result of emergency admission, compared to other routes to diagnosis such as routine GP referral, have significantly lower rates of survival. Pancreatic cancer patients have one of the least satisfactory NHS experiences of all cancer patients, evidenced by National Cancer Patient experience surveys.

If it is not too presumptuous, I would like to quote myself from the debate on 23 May 2012:

“Effective cures for pancreatic cancer remain stubbornly elusive, but we need to try to find ways to prolong patients' lives and to ease their pain and sufferings while always remembering that, with cancer, it is not only the patient who is affected but the people around them, including their family.”—[Official Report, 23 May 2012; Vol. 545, c. 93WH.]

The all-party group then found out that a new drug, Abraxane, in combination with standard chemotherapy was licensed for use in patients in the UK and Ireland with metastatic pancreatic cancer. Abraxane has been described as the biggest advance in pancreatic cancer treatment in almost two decades—for a disease, as I have already said, where survival rates have barely changed in 40 years.

As the drug has not yet been approved by the National Institute for Health and Clinical Excellence, it is not yet available on the NHS as a standard treatment. Pancreatic Cancer UK is very keen to ensure that patients are able to access Abraxane through the cancer drugs fund. The House will now see the importance of the debate tonight: the decision will be taken on Thursday 6 March—that is this week. Along with others in the Chamber, I would like to see the drug approved by the CDF this week and then eventually by NICE so that access to it is more readily available. We know that Abraxane is due to be reviewed by NICE very soon but this process takes a great deal of time, and it is time that pancreatic cancer patients do not always have.

One of my fears is based on my understanding of the way these new drugs are measured. This is based partly on what is called quality-adjusted life years which, so far as I understand it, is a measurement of the state of health and how long life is prolonged running from optimum health to death.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for giving way and for bringing this important matter to the House’s attention. It is surprising how many of us know people, both personally and from our constituencies, who have been affected by pancreatic cancer. I have some figures from Northern Ireland that might help his argument. Only 14.2% of males and 10.3% of females live longer than a year after diagnosis. When we get to five years, those figures drop to 2.8% and 2.9% respectively. Early diagnosis is key, along with new treatments. That would increase the survival rate by 30%. Does he agree that a strategy covering all the regions of the United Kingdom of Great Britain and Northern Ireland would be better for addressing the issue?

[Eric Ollerenshaw]

The hon. Gentleman hits the nail on the head. It is of course a UK issue, and one of the concerns is the regional variation in performance on early diagnosis and the impact that is having. We want to get rid of that.

I want to talk today about the new drug Abraxane. The vast majority of pancreatic cancer patients are diagnosed so late that the benefit of any new drug can be measured only in months, rather than years. Our worry is that, compared with other cancers, that benefit might be deemed insufficient simply because it is measured in months and might not register highly on the quality-adjusted life years measurement scale.

That is why Pancreatic Cancer UK launched its Two More Months campaign, which highlights what patients would have been able to do with two more months, which is the average additional survival time provided by Abraxane. I have a few quotes from relatives of those who have died from pancreatic cancer:

“Two more months would have been a significant amount of time for Nicola, only 25 years old herself, to spend with her four year old daughter”.

That was from Chris, Nicola’s brother.

“Two more months would have meant my daughter Gemma might have got to wear her wedding dress and walk down the aisle with Adam”.

That was from Debbie, Gemma’s mum.

“Two more months would have seen my wife Jill finish her Open University Modern Languages degree and attend an international social work conference in Buenos Aires, both of which she would have been very proud of”.

That was from Dave, Jill’s husband.

“Two more months would have seen Andy and I celebrate our second wedding anniversary, and given us more time to prepare for what was to come”.

That was from Lynne.

For me, two more months would have meant one last Christmas with my partner—

[Stuart Andrew (Pudsey) (Con)]

May I pay tribute to my hon. Friend, who has done tremendous work on this issue and been a great advocate for all those affected by pancreatic cancer? I know from my experience of working in the hospice movement that time is the thing that all patients want. If that drug can provide just a little more time, surely it is something that all those families should be given.

[Eric Ollerenshaw]

rose—

[Guy Opperman (Hexham) (Con)]

I congratulate my hon. Friend on securing the debate and endorse what he says entirely. Does he agree that perhaps we should also consider going commando this Friday to raise male cancer awareness and show our general support for all cancers that people are struggling with today?

[Eric Ollerenshaw]

I am grateful for those well-timed interventions from my colleagues across the frontier.

What I am trying to get on the record is the fact that those two more months are critical in this particular cancer. Our worry is that two more months might not look good enough when the judgment is made, but for pancreatic cancer it is a massive improvement.

I also want to put on the record two other emerging possibilities. A useful and emerging new technology is NanoKnife. It carries out a process called irreversible electroporation, which destroys parts of the tumour while avoiding damage to vital tissue nearby, such as blood vessels. The process shrinks the tumour to a more manageable size, which might then allow more permanent surgical solutions. NanoKnife is currently available only through the private sector at one hospital in London.

A company called Novartis, has a treatment for neuroendocrine pancreatic cancer that is currently funded via the CDF in England. Although it is welcome that patients can access treatment via that route, we continue to argue for a long-term solution. In that context, we are worried about Andrew Dillon’s statement that, under the new system of value assessments that NICE is due to introduce in the autumn, only six out of 20 treatments assessed by NICE in the past year would be approved. A 30% approval rate is clearly not the long-term solution expected from the original concept of value-based pricing. In 2013, I understand, not one new cancer drug was approved by NICE. That issue, perhaps, is for a wider debate, but I hope the Minister understands that those arguing on behalf of pancreatic cancer patients are extremely worried about ever getting the new drugs on to the system and available for wider use across, hopefully, the whole United Kingdom.

Minister, this debate has been an unashamed appeal for support—from the charities concerned, the all-party group, the survivors and all those who have been affected by pancreatic cancer through the loved ones they have lost. We do not want others to go through our tragic experiences.

[Tessa Munt (Wells) (LD)]

I congratulate the hon. Gentleman on securing this debate. I should like to pick up on what he said about NanoKnife—there is also CyberKnife and Gamma Knife. Those are all modern, stereotactic treatments for cancer. I hope that he agrees that we need to concentrate not just on the drugs but on those particular types of radiosurgery, which can make sure that people live longer if they are given the trials that they need.

[Eric Ollerenshaw]

The hon. Lady makes an important point. Our point is that because of the poor pancreatic cancer survival rates and its late diagnosis, which is the key, it always seems that the pancreatic cancer patient is last in the queue. The quality of life assessments do not look long enough to justify a new drug or new radiotherapy, as has been pointed out.

Again, I pay tribute to Pancreatic Cancer Action, which got a great deal of press from an advert, not used at the time, saying, “I wish I had breast cancer”. That was effective in raising publicity about the impact of pancreatic cancer.

I am trying to put whatever pressure the Chamber is capable of exerting on the cancer drugs fund when it makes its decision on Thursday and on NICE for what it does to follow. Providing Abraxane and an extra two months could help ease this year’s 8,500 tragedies and start the process of making up for 40 years of lost hope.