Pancreatic Cancer

Debate between Jim Shannon and Eric Ollerenshaw

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—

Pancreatic Cancer

Debate between Jim Shannon and Eric Ollerenshaw

Wednesday 23rd May 2012 Westminster Hall

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

Thank you, Mr Scott, for calling me to speak; it is a pleasure to serve under your chairmanship. I am pleased to have secured this debate, as it is on a subject of huge importance to thousands of families across the UK. It is also a subject that is close to my heart.

This debate was originally scheduled for the last week of the previous parliamentary Session. However, the cause of Prorogation it was cancelled, so I am particularly lucky to have been drawn again so quickly. Whether that was because of pure luck or the Speaker’s Panel taking pity on me, I do not know, but I am grateful none the less.

As it happens, the timing for this rescheduled debate could not have been better, because last week we established the all-party group on pancreatic cancer. It is chaired by Lord Patel, the Cross-Bench peer, who has huge experience of the medical profession, and it has a most fantastic treasurer in the hon. Member for Scunthorpe (Nic Dakin), who is here in Westminster Hall today. The all-party group aims to work with Pancreatic Cancer UK, Cancer Research UK and others to increase awareness of pancreatic cancer, and to help campaign for better care and treatments, which will lead to improved outcomes.

The simple fact is that we need better care and treatment. The number of people diagnosed with pancreatic cancer is rising. In 2008, around 8,100 cases were diagnosed—about 22 cases a day. Compared with other types of cancer, those numbers are quite low. However, there is a very poor prognosis in pancreatic cancer cases, with only 3% of patients surviving for five years or more. In my own particular case, my partner survived for only seven weeks after being diagnosed.

Despite advances in technology and improvements in survival rates for other forms of cancer, that figure of 3% has remained unchanged for 40 years, which is quite incredible. There are also wide regional variations in UK survival rates, the so-called and much cited problem of “the postcode lottery”. On a national level, that survival rate—only 3% of pancreatic cancer patients in the UK survive for five years or more—is the worst in the developed world. To put it into context, it is half the survival rate of the US, Australia or Canada. Those countries’ survival rates are obviously still low, but they are much better than the British survival rate.

There have also been reports from people with pancreatic cancer that the care provided in the UK has fallen below expectations. The 2010 NHS national cancer patient experience survey found that pancreatic cancer patients fared significantly worse than patients diagnosed with other cancers. That needs to change. Some things will be easier to rectify than others. For instance, improving the patient experience seems an obvious and relatively easy thing. However, we can and should work on improving awareness, diagnosis, treatment, care and—ultimately and most importantly—the survival rate across the board.

One can look at the impact of the advertising to increase awareness of bowel cancer, which is a difficult cancer to deal with. We are looking to achieve a similar impact in terms of increasing awareness of pancreatic cancer. Increasing awareness is vital, because too often pancreatic cancer is diagnosed at far too late a stage. Although symptoms may have manifested themselves for several months, many people do not visit their doctor until it is too late and the disease is quite advanced. In fact, 50% of pancreatic cancer patients are diagnosed only as a result of an emergency hospital admission and more than 80% of pancreatic cancer patients are diagnosed only once the tumour is inoperable. Those are startling, sobering and depressing statistics.

Let me refer again to my personal situation, in which the pancreatic cancer was diagnosed only after a series of what were just stomach aches, and tests were carried out only after those stomach aches and after a number of visits to the GP.

For the record, the symptoms of pancreatic cancer can be quite vague and varied. They can include weight loss and pain in the stomach, which both appeared in my particular experience of the disease, as well as back pain and jaundice. But if someone does not have any knowledge of the disease—neither I nor my partner had any such knowledge at the time—how would they realise that, because one is feeling tired every day there is something particularly wrong, until the stomach aches develop? Even then, in my personal experience the stomach aches were not significant in terms of pain. We had no awareness that that feeling of tiredness was anything to do with cancer.

We need to ensure that doctors are making the right diagnosis. Nearly 30% of pancreatic cancer patients will have visited their GP five times or more before being properly diagnosed; that was true in my situation. So we need to make sure that GPs are provided with the proper tools and training to recognise the symptoms of pancreatic cancer. Moreover, we need to ensure that GPs are able to refer their patients swiftly to hospitals for further tests when they suspect a case of pancreatic cancer.

As part of that process, Pancreatic Cancer UK is holding an early diagnosis workshop next month. Hopefully, that workshop will help to come up with more concrete actions that could be taken. I understand that the Minister’s colleague, the hon. Member for Sutton and Cheam (Paul Burstow), has agreed to support that workshop, which is an encouraging sign.

Put simply, late diagnosis means that the few treatments available might not be an option, so it is absolutely imperative that we improve awareness and diagnosis.

Let me turn to treatments. The uncomfortable fact is that few options for curative treatments exist. One of the reasons why survival rates for pancreatic cancer are so low, compared with those for other types of cancer, is that pancreatic tumours are relatively highly resistant to chemotherapy. Having said that, I note that Cancer Research UK has said that it believes there is some kind of breakthrough in terms of a new class of drugs, details of which it announced in April; that new class of drugs looks quite promising in terms of being able to improve treatment.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on securing this debate on a very important issue; every one of us will have constituents who will be affected by it. Does he share my concern—and, I suspect, the concern of many people—that pancreatic cancer is the fifth most deadly cancer in the whole of the UK and yet only about 1% of cancer research is on pancreatic cancer? Also, does he feel that it is now time for the Minister to work with all the regional bodies across the UK—the Scottish Parliament, the Welsh Assembly and the Northern Ireland Assembly—to introduce a UK-wide strategy to reduce deaths from pancreatic cancer?

[Eric Ollerenshaw]

The hon. Gentleman can obviously read minds, because that point about research is in my next paragraph. His other suggestion about a UK-wide strategy is a really interesting and positive one, because pancreatic cancer obviously does not respect any boundaries, or any devolved Government or national Government. So he makes an interesting point, which the all-party group can perhaps consider.

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 suffering, while always remembering that, with cancer, it is not only the patient who is affected but the people around them, including their family. Cancer affects not just one person; its effect spreads to other people. I had not entered the cancer world before my own personal experience—I call it a separate world, because it is like entering a separate universe that has never been experienced before. Patients’ loved ones also experience suffering.