Pancreatic Cancer

Lord Stunell Excerpts

Monday 8th September 2014 Westminster Hall

[Eric Ollerenshaw]

My hon. Friend makes an important point. It is difficult for Ministers and boards to make decisions about what is or is not fashionable. Nothing we are trying to do, in getting pancreatic cancer higher up the agenda, is aimed at taking away from the advances being made for other cancers. We all welcome those. We simply want fairer funding ourselves, and some recognition of the impact of this particular cancer. We are not asking to take away from anything else, but unfortunately we are asking the Minister for something extra.

I come now to the Recalcitrant Cancer Research Act, which my hon. Friend the Member for Peterborough (Mr Jackson) mentioned. It was passed in 2012 in the United States, and requires the director of the US National Cancer Institute to prepare a special strategy for recalcitrant cancers in the US. A recalcitrant cancer is defined as a cancer type with a five-year survival rate of less than 20% that kills more than 30,000 US citizens a year.

The result of the Act has been more focus on pancreatic and lung cancer research in the US, as well as a welcome increased focus on and awareness of those cancer types more generally. I would like the Minister to consider whether the British Government need to produce their own recalcitrant cancer research strategy, commissioned and produced either by the Department of Health or the National Institute for Health Research. Such a strategy should focus not just on pancreatic cancer but on other cancers of unmet need—those with low survival rates.

If a British strategy were to use the US definition of “recalcitrant”, it would cover pancreatic cancer, which has a survival rate of just under 4%; lung cancer, for which it is 10%; oesophageal cancer, for which it is 15%; brain tumours, for which it is 19%; and stomach cancer, for which it is 19%. That would help to give a focus.

[Sir Andrew Stunell (Hazel Grove) (LD)]

I apologise to my hon. Friend for arriving late—I was at a Statutory Instrument Committee. My brother-in-law died of pancreatic cancer in July in the United States. I draw my hon. Friend’s attention to the fact that research has then to go on to produce outcomes, and we are still a long way from that. I hope he will agree that it will be a long-term project.

[Eric Ollerenshaw]

I thank the hon. Gentleman for that. I think everybody here—all the people who signed the e-petition and the hon. Members who are here to support the debate—realises that it will be a fairly long journey. We are trying to say that we want a quicker start to that journey, please, given what has happened.

I will not detain hon. Members for too much longer, but I want to finish by mentioning a hobby-horse that I have mentioned in previous debates: the need for more and more effective treatments for pancreatic cancer to be made available on the NHS. The treatments do not need to be discovered; they already exist. Last week, I spoke in the House about the need for the National Institute for Health and Care Excellence to reform if it is ever to be fit for purpose, at least when it comes to ensuring that patients have access to cancer drugs. That is evidenced by the fact that in 2011-12, NICE, as it is called, rejected 60% of the cancer medicines it assessed—an increase since 2010. Simply put, that means that drugs licensed for use in the UK are not being made routinely available on the NHS to all who need them.

The cancer drugs fund for England was introduced in 2010 to clear up the mess—we welcome the fund—and because of it 55,000 patients have been able to access drugs they would not otherwise have managed to access. Those drugs have extended patients’ lives, giving them more time to spend with their loved ones. Unfortunately, the CDF is funded only until 2016. Doctors have to apply for drugs from the fund, which are not routinely available, and any drug on the list could in theory be removed by the CDF panel at any time.

The drug Abraxane, for metastatic pancreatic cancer patients, was added to the CDF list in March this year, following a public campaign and a debate held in the main Chamber. Sadly, however, things have moved on. The Health Secretary recently announced that the CDF will get more money, but the accompanying announcement said that the CDF will be reformed. The precise wording was that it would be more closely “aligned with NICE” and that a new cost-benefit analysis will be introduced when new drugs are considered. Imagine the alarm, Mr Chope, when Sir Andrew Dillon, the chief executive of NICE, said to the Health Committee last week:

“We would like to move away from a situation where…the Cancer Drugs Fund then says yes to the treatments we have said no to…I don’t think that makes any sense. It’s not a criticism of the decision to allocate more money to cancer. It’s about an alignment of processes and methodologies that we need to get sorted out…There is no reason at all why we can’t provide the basis for NHS England’s decisions on cancer treatments just as we do for all other treatments.”

I say to Sir Andrew that there is a reason why: as I have already said, NICE does not work for cancer patients. To treat cancer as if it were like other diseases when it causes so many deaths and when the population is ageing—we know the likelihood of cancer increases with age—is to take a step backwards.

I would be grateful if the Minister commented on the cancer drugs fund. We are worried at the moment. Abraxane has been considered by the fund. We are grateful that it has received ministerial sign-off in Wales. The cancer drugs fund agreed to list it, but now that is with NICE. I hope I am wrong on this, but I suspect that in the near future it will be rejected by NICE for routine use in the NHS in England. It is the first advance in some kind of pancreatic cancer treatment for 40 years, and it looks likely that NICE will reject it. That is a disgrace.

I have held up the Committee for too long, but I do not mind because of the importance of the issue. Just to finish, next year 8,800 people will be diagnosed with pancreatic cancer, of whom 80% to 90% will probably not survive beyond six months. Thousands of relatives and friends will then enter a parallel world: the cancer world.