Pancreatic Cancer

Jamie Reed Excerpts

Monday 8th September 2014 Westminster Hall

[Mr Jamie Reed (Copeland) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Davies.

I congratulate my hon. Friend the Member for Scunthorpe (Nic Dakin) on making a truly superb speech to open this debate, and the hon. Member for Lancaster and Fleetwood (Eric Ollerenshaw) on proving that inspiration is not simply found in one’s own party; his contribution to the debate was tremendous. Through their leadership of the all-party group on pancreatic cancer, I am aware of the importance of this debate and I thank them for their efforts to raise awareness of this vital issue. I also thank other hon. Members for their contributions to the debate, which are a testament to the strength of feeling across the House about this subject. Also, to find such an uncommonly well-attended debate while we face a looming constitutional crisis demonstrates how important this issue is to Members from all parties in the House.

We need only to consider the number of people—106,399—who signed the petition calling for the Government to look at pancreatic cancer to appreciate the strength of feeling right across the country. Like those who have preceded me, I must take this opportunity to pay tribute to Maggie Watts, who launched the petition to help push pancreatic cancer higher up the political agenda, raise its profile and encourage more funding for research into the disease. I say to her that hers is a job well done and she is indeed an example to others.

The story of Maggie’s husband, Kevin, shows why we here today. It has been said before, but it is shocking that when Kevin died in 2009, aged only 47, the survival rate for pancreatic cancer was no different from that when his mother died of the same disease in 1969; as many colleagues have said, not to have made any progress in 40 years is an appalling situation, and one that requires all of us to give this issue our urgent attention. It is shocking that only 20% of people diagnosed with pancreatic cancer survive a year, compared with the 68% average for all other cancer diagnoses, and it is appalling that only 5% of pancreatic cancer patients will survive for five years after diagnosis, compared with an average of 50% for patients with other cancers. So I am glad that Members have had this opportunity to highlight pancreatic cancer and examine in detail ways to improve the situation for future pancreatic cancer patients.

However, as we have heard today, we have much further to go to ensure that we raise awareness of pancreatic cancer and diagnose it earlier, refer people swiftly when pancreatic cancer is suspected, and treat the disease more effectively. In addition, we must not lose sight of the importance of working to prevent the disease from developing in the first place. I will consider each of these issues in turn.

On raising awareness and earlier diagnosis, we know that finding cancer early can make a real difference. When pancreatic cancer is diagnosed at an early stage, the treatment is often simpler and the outcome more likely to be positive. We also know that one in four people with cancer are diagnosed after an emergency admission, and for those with pancreatic cancer that figure almost doubles; almost half of pancreatic cancer diagnoses happen after an emergency admission. Tragically, a diagnosis at that stage means that on average patients are around twice as likely to die compared with those who have been referred by their GP.

The Government’s cancer strategy sets the welcome target that by 2014-15 some 5,000 additional lives will be saved each year and rightly states:

“It is mainly through earlier diagnosis where these lives will be saved.”

We all agree with that. I would welcome an update from the Minister on what steps the Government are taking to achieve that goal through improving earlier diagnosis. More must be done to raise awareness, so that people are able to spot the signs of cancer and visit their GP sooner rather than later. Efforts to promote public awareness, such as the Be Clear on Cancer campaigns, are very welcome and do great work, but we do not yet have a specific campaign for pancreatic cancer. Can the Minister say whether she has any plans to introduce such a campaign, so as to promote better awareness of the symptoms of pancreatic cancer?

Of course, I recognise that raising awareness of pancreatic cancer, the symptoms of which are not always clear, is more difficult than raising awareness of cancers that have more specific symptoms. However, the low levels of public and professional awareness about pancreatic cancer must be addressed. A 2012 survey of more than 250 GPs undertaken by Pancreatic Cancer UK found that although most GPs could list one or two possible symptoms, half of those surveyed said they were not confident that they could identify the signs and symptoms of possible pancreatic cancer. I am concerned about how frequently I hear of people going to see their GP with a concern or worry, returning a couple of times, only for them to be diagnosed with cancer a few weeks or months later. How many times have we all, as constituency MPs, heard of that? I am sure that all of us here today can recount tales of such episodes. Does the Minister have any plans to improve training for GPs to help them to spot the signs of pancreatic cancer?

Regarding swift referrals, as vital as awareness-raising is, it will not be enough on its own if people are not referred quickly after pancreatic cancer is first suspected. Before Christmas, we heard that the Government are missing their target for 95% of people with suspected cancer to be seen by a specialist within two weeks in as many as half of all cases. Today’s report from Cancer Research UK adds to concern about that situation by highlighting that, after decades of progress, cancer patients are now waiting longer for tests and treatment, and that is particularly true for pancreatic cancer patients. The all-party group’s report on pancreatic cancer, which was published earlier this year, revealed that patients are experiencing delays in referral to specialist centres or completely missing out on the opportunity to receive specialist treatment. Can the Minister say what the Government are doing to ensure that suspected pancreatic cancer patients are referred for testing and treatment as soon as the cancer is suspected, and that after they are referred they do not wait longer than two weeks to see a specialist? The Cancer Research UK report shows that the number of cancer cases is going up as the UK population ages. If that is the case, how will the Government ensure that the NHS will be fit for the purpose of diagnosing more people, treating more people and helping more people to recover from pancreatic cancer in the coming decades?

On the issue of high-quality treatment, after being diagnosed with cancer, patients need to feel safe in the knowledge that they will receive the most effective treatment possible, yet the paucity of treatments for pancreatic cancer is shocking; surgery remains the only way to cure someone. However, less than 20% of those who are eligible for surgery go on to have curative procedures, because for most people by the time they are diagnosed the disease is far too advanced. Can the Minister say what action the Government are taking to support research into the development of a wider range of treatments for pancreatic cancer?

Pancreatic cancer patients do not just need treatment; they also need high-quality and patient-centred care. I, too, pay tribute to Macmillan Cancer Support; the briefing that it provided to all Members in advance of today’s debate is exceptionally. Also, the findings of the 2013 national cancer patient experience survey, run by NHS England, show that patients affected by upper gastrointestinal cancers, including pancreatic cancer, experience poorer levels of care than those affected by common cancers. Only a quarter of upper gastrointestinal cancer patients were offered a written assessment and care plan; a third reported not being definitely involved in decisions about their care and treatment; and a quarter indicated that test results were not completely explained to them. Moreover, a shocking 37% said that they had not been given written information about their type of cancer.

Those findings were echoed in the all-party group’s report. In its inquiry, it found that there are serious shortcomings in providing patients with consistent access to high-quality, patient-centred care, including the provision of support and information. Will the Minister set out how she is improving the experience of pancreatic cancer patients in our NHS?

On prevention, we all know that our battle against cancer cannot be won with better care and treatment alone. Around 37% of pancreatic cancers in the UK are, sadly, linked to lifestyle, and risk could be reduced through such measures as smoking cessation, promotion of a healthier diet, exercise and drinking alcohol in moderation. We all know this.

Tobacco smoking is one of the biggest risk factors in developing pancreatic cancer; almost a third of pancreatic cancers in the UK are linked to smoking. Under the previous Government, the number of smokers dropped by a quarter, which in my view is a significant achievement. Yet the proportion of our population who smoke today—20%—is still too high. Experts have warned that current decreases in smoking-related cancer incidence will eventually stop unless further progress can be achieved in reducing exposure to tobacco.

Earlier this year, Parliament voted in favour of introducing standardised packaging of tobacco and, together with Labour’s proposal to ban smoking in cars carrying children, this is a great step forward in protecting children and ultimately creating, we hope and believe, a shift in smokers’ behaviour. As the independent report from Sir Cyril Chantler concluded, it is

“highly likely that standardised packaging would serve to reduce the rate of children taking up smoking”.

We must maintain momentum and push ahead with the regulations and ensure that these two victories are not seen in isolation but are part of a much bigger, broader, more effective ambition. I would appreciate an update from the Minister on where we are with regard to the regulations.

As we have heard today, although we are making progress in our fight against cancer, this does not apply to all types of the disease, not least pancreatic cancer, for which survival rates have not improved in 40 years. As pancreatic cancer threatens to overtake breast cancer as the UK’s fourth biggest cause of cancer death by 2030, we need concerted action from the Government to improve diagnosis, speed up referral times and improve care and the development of treatment.

This is something we all care about, something that touches all of us and something that we all want to do something about. The all-party group report is right to say that it is time to change the story. I appreciate that the Minister has a slew of questions to answer, and I look forward to her considering them.