Pancreatic Cancer

Jane Ellison Excerpts

Thursday 15th January 2015 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

I return to the Dispatch Box very rapidly after the debate earlier this afternoon, and on an important topic; one of the most important in my portfolio. I congratulate once again the hon. Member for Scunthorpe (Nic Dakin) on securing the debate. As ever, he is ably assisted by my hon. Friend the Member for Lancaster and Fleetwood (Eric Ollerenshaw). They and their colleagues in the all-party group have achieved much in this Parliament in highlighting the needs associated with this dreadful disease and in raising awareness of it.

I have said many times before at the Dispatch Box that improving cancer outcomes is a major priority for the Government and as the annual report on our cancer outcomes strategy in December showed, we are on track to save an extra 12,000 lives by 2015. Sadly too few of them are those suffering from pancreatic cancer, so while we want to see the best possible results for all cancer patients, I appreciate—as we have discussed before—that outcomes are particularly poor for patients with pancreatic cancer. We need to do a lot better.

I was delighted that on Sunday 11 January NHS England announced a new independent cancer task force to develop a five-year action plan for cancer services that will build on the existing work to improve survival rates and save thousands more lives. The taskforce has been set up to produce a new cross-system, national cancer strategy to take us through the next five years to 2020, building on NHS England’s vision for improving outcomes as set out in the NHS five-year forward view. The taskforce will be set up in partnership with the cancer charities and the health system leaders, and chaired by Dr Harpal Kumar, the chief executive of Cancer Research UK. The all-party group might like to consider how it, too, can participate in, and contribute to, the taskforce.

The new strategy will set a clear direction covering the following areas: prevention; early and faster diagnosis; better treatment and care for all; recovery, re-ablement and living with and beyond cancer; research and innovation; end-of-life care; data and metrics; and work force. The taskforce will produce a statement of intent by March this year, with the new strategy published in the summer.

Tackling late diagnosis is, as we have often said, a very important element in achieving our ambition to improve all cancer outcomes. As the hon. Member for Scunthorpe said, however, there is currently no easy way of detecting pancreatic cancer and it can be particularly difficult for GPs to detect and diagnose, especially in its early stages. Symptoms can be complicated by the fact that they are shared with a wide range of benign conditions.

My ears pricked up when, as part of the taskforce announcement last weekend, NHS England launched a major early diagnosis programme, working with Cancer Research UK and Macmillan Cancer Support, to test new approaches to identifying cancer more quickly. These include offering patients the option to self-refer for diagnostic tests, as the hon. Gentleman said; lowering the threshold for GP referrals; creating a diagnostic pathway for vague symptoms like tiredness, which is particularly important for hard-to-spot cancers such as pancreatic cancer; and setting up multidisciplinary diagnostic centres so patients can have several tests done on the same day at the same place—not the ping-ponging around, which can be so debilitating for someone already feeling very poorly. NHS England’s aim is to evaluate these innovative initiatives across more than 60 centres around England, collecting evidence on approaches with a view to implementation from 2016-17.

Turning to the awareness campaign, we have debated the possibility of pancreatic cancer being part of the “Be Clear on Cancer” campaign set before. Since 2010-11, the Department has undertaken a series of local, regional and national campaigns. Public Health England now leads on this work with the Department, NHS England, charities and relevant stakeholder groups.

It has always been difficult to give a positive response with regard to pancreatic cancer to date, because the focus has so far been on those cancers with the largest number of avoidable deaths. As colleagues know, these campaigns are under constant review, and we work with the relevant experts to see what more can be done. All the time, there are small trials going on to see where we can tackle other cancers. Pancreatic is obviously one that experts will keep under review.

The group that makes decisions about the campaigns, the public awareness and primary care steering group, chaired by our national cancer director, Sean Duffy, has considered pancreatic cancer for a possible campaign. To date, it has been unable to recommend it owing to the problems we mentioned about symptoms, but members would be very happy to look at it again if there were new evidence. I sense from all the things going on—particularly some recent announcements—that that point might not be too far in the future.

[Nic Dakin]

I thank the Minister for everything she has said to date. On the issue of a public awareness campaign on pancreatic cancer, is there a way in which those with pancreatic cancers could engage with that body to see if there is a way forward?

[Jane Ellison]

If I recall my diary correctly, I have a meeting with Sean Duffy coming up, and I would be happy to raise that issue with him, along with any other points arising from this debate. It will certainly be on my agenda for discussions with him. I have touched on the matter briefly with him before, but I will pick it up again.

The problems with late diagnosis have been explored before, and it is critical that we get people the most appropriate treatment early. We have discussed radiotherapy before. It can be a very helpful treatment for some patients. As part of its recent announcement, NHS England committed a further £15 million over three years to evaluate and treat patients with a modern, more precise type of radiotherapy— stereotactic ablative radiotherapy or SABR, as the hon. Gentleman mentioned. That evaluation programme will mean a significant increase in the number of cancer patients eligible to access this treatment by around 750 a year, and the programme will widen the number of cancers being treated by SABR, including cancer that has spread to another part of the body.

The new investment is in addition to NHS England’s pledge to provide up to £6 million over the next five years to cover NHS treatment costs of SABR clinical trials, most of which are being led by Cancer Research UK and one of which—as the hon. Gentleman knows from our debate last September—relates to pancreatic cancer. As for the hon. Gentleman’s suggestion regarding commissioning through evaluation, I shall raise it with NHS England. I am afraid that we do not yet know which centres or how many patients will take part in the trials to assess the effectiveness of SABR in comparison with conventional radiotherapy or surgery, but I understand that we are likely to have that information in the coming weeks. I will certainly make the decision-makers involved aware of the debate, and of the interest in the outcome of their deliberations.

NHS England’s chemotherapy clinical reference group has set out service specifications defining what NHS England expects to be in place to enable providers to offer evidence-based, safe and effective chemotherapy services. NICE has issued technology appraisal guidance which recommends Gemzar as an option for treating patients with advanced or metastatic adenocarcinoma of the pancreas who meet certain clinical criteria. NICE is also appraising a number of new drugs for pancreatic cancer. NHS commissioners are legally required to fund treatments recommended by NICE in its technology appraisal guidance.

Understandably, the cancer drugs fund has been mentioned this evening. The Government’s reasons for establishing the fund are well documented. At the end of August 2014 it received an additional £160 million, and I welcome the announcement on 12 January by NHS England, which is now responsible for the fund’s operational management, that it too would provide extra money. The CDF panel has decided that further consideration of Abraxane for the treatment of pancreatic cancer is needed, and it will remain on the national CDF list until that has been concluded. I am not yet sure about the timings, but I will undertake to update the all-party group, including the hon. Members for Scunthorpe and my hon. Friend the Member for Lancaster and Fleetwood, in due course.

Let me now say something about NICE appraisals. Representatives of the Department, NICE, 10 key cancer charities and the pharmaceutical industry met in December to discuss the future of cancer drugs commissioning. They committed themselves to establishing a working group to develop a robust process to support the sustainable, long-term commissioning of cancer drugs. The group will meet for the first time, opportunely, on Monday 19 January.

I am glad that the hon. Member for Scunthorpe found the letter about research useful. He and I, along with my hon. Friend the Member for Lancaster and Fleetwood, had a very good meeting with the chief medical officer, and we have followed that up with a response to the all-party group’s excellent report, which was published last October. At our meeting, the chief medical officer said that she would be happy to attend a meeting of the all-party group. I will remind her of that, but I suggest that the hon. Gentleman and my hon. Friend get in touch with her. We would respond positively to that.

The Government are investing a record £800 million over the five years to 2017 in a series of biomedical research centres and units, including £6.5 million of funding for the Liverpool pancreas biomedical research unit. The unit is working in partnership with industry and leading research institutions to develop new treatments and diagnostic strategies for pancreatic cancer. The National Cancer Research Institute brings together clinicians, scientists, statisticians and lay representatives. Its upper gastro-intestinal cancer clinical studies group has a pancreas sub-group, which plays a vital role in the development of trials.

Late in 2012, the Prime Minister launched the 100,000 genomes project, which will sequence 100,000 whole genomes from NHS patients by 2017. It focuses on patients with rare diseases and their families, as well as on patients with some types of cancer. We believe that the six cancers that will be covered will give us knowledge and understanding that can be applied to all cancers. Although pancreatic cancer is not one of the six, we expect the project to make a useful contribution in that regard.

I thank both Members who have spoken this evening, I thank the all-party group, and I thank all those who campaign tirelessly for progress on pancreatic cancer. We know that achieving improved outcomes for people with the disease is a huge challenge, but I believe that the change that we all desperately want to see will come. I welcome the new cancer taskforce, which will be leading the way, and I undertake to write to its independent chairman, drawing his attention to this evening’s important debate and the work of the all-party group.

Question put and agreed to.