Oesophageal Cancer

Jim Shannon Excerpts

Monday 23rd February 2015 Commons Chamber

[Mike Weatherley (Hove) (Con)]

In November 2011, I had my dinner as normal, but what was not normal was that it did not settle well and I threw up. I dismissed it as probably a bug of some sort, but then it happened again a few days later. Clearly something was not right, but I did not relish the hassle of getting an appointment to see my doctor. I hate going to see my GP, not because I do not like her, but because the booking system is so frustrating. I put it off for another week or so, but by mid-December 2011, still throwing up occasionally, I decided to battle the booking system, and I went to see my wonderful GP. She referred me to the local NHS hospital, and five weeks later I got an appointment to see a gastroenterologist. The first diagnosis was excess stomach acid, so I was put on antacids and on the list for both an endoscopy and colonoscopy. Unfortunately, the painful probes were inconclusive, as was the follow-up CT scan—nothing was really found other than a severely restrictive oesophagus—but by now eating was becoming a major problem.

There are many people who influence and shape a life, but when someone saves a life—well, that is something very special. Professor Robert Mason is one of those exceptional people. He drew on all his experience, and despite no conclusive evidence, he insisted I came in immediately to have my oesophagus removed. Of course, I argued against this, asking for key-hole surgery or to defer the operation until the summer after more tests, but Professor Mason insisted until I changed my mind and a date was set for 18 April 2012. The full extent of just how serious this was had not fully registered with me. When I was in the pre-op room, I was asked what I had done to prepare in the morning, and I said I had gone to work, and indeed I had. I went into Parliament in the morning and drafted letters to constituents, and at the required time I popped across the river and slipped on the less-than-flattering gown.

It turns out that the surgery is equivalent to a triple heart bypass—the whole oesophagus is removed plus, in my case, a third of the stomach. May I pause here to thank all the doctors and nurses who looked after me at St Thomas’, and especially the nurses in the high dependency unit, who were simply fantastic and a tribute to the NHS? I must also mention a second person who was integral to saving my life—James Gossage, who carried out the surgery along with Professor Mason, and who carried out many post-operative follow-up surgical procedures. Mr Gossage is an exceptionally nice specialist who has a dedication to his profession that is inspirational.

Despite the ordeal, the worst moment was still to come. Until this point no cancer had been detected, but a week after the operation, Professor Mason came in and gave me the confirmation—the biopsy confirmed stage 3 cancer. There is nothing in this world that can prepare someone for the words, “You have cancer.” Sadly, oesophageal cancer is particularly aggressive, and more than half of oesophageal cancer patients die within a year. All sorts of things go through your mind when you hear stats like that, from severe regret about potentially not seeing your kids get married, to even more regret about not being treated earlier—every week really does matter—and many more dark thoughts. A sobering fact is that if Professor Mason had not insisted that the operation should be in April, and if he had agreed to wait until July as I wanted, it seems very likely that I would have been dead by Christmas 2012.

Step up the third person I owe my life to—Andy Gaya, who was in charge of my post-operative treatments. Intensive revolutionary radiotherapy and chemotherapy followed. There were days when I was so exhausted that I could not even reach out for the remote control to change TV channels. Andy Gaya made sure that I was going to be given the best chance of survival. We know that almost certainly some cancer cells were not removed during the surgery, and the treatments, while not pleasant, had to be intensive and push the boundaries in order to be sure that the cancer was treated.

Of course, there is a fourth member of the care team that I owe my life to, and that is my partner Niki. I cannot imagine how difficult it is for anyone going through this experience without someone holding their hand throughout. We throw around stats and theoretical outcomes, but the reality is that there is a whole army of real people behind every medical condition. In my case, there are four people who I can say directly saved my life, plus a huge number of attentive hospital staff, post-operative specialists, district care nurses, GPs and others. My dad often says that being born in the UK is like winning the lottery of life, and he is not wrong. We live in a great country. Having seen the NHS from the inside, I can of course see many areas where it is easy to say that this or that could be done better, and of course it is not perfect, but the reality is that it is an amazing institution that performs incredibly well. That is a result of the amazing people who work in that rightly cherished organisation.

However, I need to mention the opposite side of the spectrum. There are a lot of people out there in society who should hang their heads in shame. Around that time, as a result of my work in Parliament on various issues, I was getting death threats and other hate-filled correspondence, including from many people who simply tweeted with #getcancer. I wanted to reply saying, “Too late—already have it!”, but of course I refrained. The experience served as a stark contrast. One the one hand I was seeing the best of society in the care delivered by really caring people, but then there were the despicable members of society who contributed nothing positive. When I asked the Prime Minister to hold Russia to account for gay rights violations, I got one particularly nasty threat, which the police tracked down to a 24-year-old postgraduate from Manchester who said that she thought it would “be a laugh”. Anyone who supports that kind of hatred should spend a day in a hospital to see just how lucky they are and how great doing good is.

Moving back to cancer, let me take a moment to consider some statistics. The UK is facing an upcoming battle with cancer. It is projected that by 2020, more than half the European population will receive a cancer diagnosis sometime in their life. However, the rates of cancer survival in the UK rank among the worst in Europe. Reasons for that include, but are not limited to, late diagnosis and a lack of treatment options for cancer patients. In fact, a major study of more than 29 European countries found that the survival rates of almost all the most common cancers are worse in Britain than the European average. How will the NHS cope when, within five years, more than half a million people will be diagnosed?

As a cancer survivor—I say “survivor”, but all people who have had the disease know that it can come back at any time, so we are really just in remission—there are a few things that I have learned. Cancer support groups such as Macmillan Cancer Support and the Oesophageal Patients Association are key in providing aid and comfort to those with cancer. Beside providing emotional support to victims of cancer and their families, they often go the extra mile to provide information on matters such as treatment options, local support groups, holistic alternatives to surgery and chemotherapy, and cancer prevention. I was lucky—I had a great partner who helped me through it all, and I did not need to use the support services. I did have one moment in a restaurant when I could not eat and hit a terrible low, and I started reaching for the support line, but for the most part I did not have to fight it on my own. Sadly, many do, and such support groups are vital.

Specific to my cancer is the Oesophageal Patients Association, started by David Kirby back in 1985, which provides support and advice to patients with oesophageal cancer. It is involved in the campaign to increase awareness and in expanding our self-care groups across the UK. My thanks go also to Alan Moss, chairman of Action Against Heartburn, for his input into this speech.

More than 331,000 people are diagnosed with cancer each year in the UK. More than one in four deaths are caused by it, and 161,000 people died of it in 2012. Cancer is primarily a disease of old people—more than 50% of cases occur in those aged 75 or more—but, surprisingly, it is also the most common cause of death in children aged between eight and 14. In those aged between 25 and 49, cancer accounts for 18% of all deaths, and 41% of deaths among those aged between 50 and 74 are related to it.

[Jim Shannon (Strangford) (DUP)]

In Northern Ireland, the mortality rate among women with oesophageal cancer is rising, and the five-year survival rate among men is only 16%. That indicates a need for resources to be directed towards oesophageal cancer throughout the United Kingdom. Does the hon. Gentleman agree that it may be time for a UK-wide strategy to be applied to all four regions?

[Mike Weatherley]

I could not agree more. Early diagnosis is one of the key recommendations that I shall be making.

It is clear that cancer is one of the leading causes of death, but there are risks for survivors as well. It is estimated that 2.5 million people are living with and beyond cancer, and we know that at least one in four cancer survivors face poor health or disability after treatment. Cancer of the oesophagus is the eighth most common type of cancer in the UK among men. Only 40% of those who are diagnosed with it will live for at least one year after the diagnosis, and, tragically, 85% will die within five years. Let me put that into a personal perspective. According to the statistics, if I survive for another four years, I shall be part of a very small minority of just 15%. When people ask why I am leaving Parliament after one term, I reply that one of the reasons is that, given such a high probability, there is a chance that I will not see out another Parliament, and that does make one think about other options.