Prostate Cancer

Mary Glindon Excerpts

Wednesday 6th February 2019 Commons Chamber

[Simon Hoare]

The hon. Gentleman is absolutely right, and I will turn to diagnosis in a moment.

Let me return to the point I made a moment or so ago about fear. We will all have had family and close friends experience being given a diagnosis of prostate cancer or, indeed, other cancers, and the first thing is always to face that in a very black mood and think that there is absolutely no cure. However, we know that there are scientists—clever men and women—striving every day to find such cures. Indeed, life expectancy post an early diagnosis is of course getting better and better. Rightly, we place huge emphasis on breast and cervical cancers, but I suggest to the Minister that, in the shape of male cancers, we need to up the game in communication and education as well.

Some statistics on prostate cancer, provided by Prostate Cancer UK, may be of help to the House. Prostate cancer is the most common male cancer in our country: 47,000 men are diagnosed each year. One in eight men will get prostate cancer, and every 45 minutes one man dies of it in our country. Men over 50—I turned 50 this year, so I do not know whether—[Hon. Members: “No.”] I know; it is almost impossible to believe. I am not sure whether I should therefore declare an interest, but men over 50 are more prone to it, particularly if they have a family history.

A statistic I have learned—I am yet to find any particular reason for it—is that black men are far more at risk of contracting prostate cancer: one in four will get it. Someone’s risk of prostate cancer is heightened—again, this was a new fact to me—if their mother or their sister has had breast cancer. I wonder how many people recognise that and see that, if a female in the family is diagnosed with breast cancer, that should act as a spur for them to go and have a test. In 2016, 11,631 men died of prostate cancer in the UK alone.

At our party conference last year, my right hon. Friend the Prime Minister said:

“The key to boosting your chance of surviving cancer is early diagnosis… Through our Cancer Strategy, we will increase the early detection rate… We will do it by…investing in the very latest scanners.”

[Mary Glindon (North Tyneside) (Lab)]

I congratulate the hon. Gentleman on securing this important Adjournment debate. As well as early diagnosis, this is about people’s awareness that they themselves may possibly have the symptoms. When my husband was diagnosed, he just thought he had a chill. Unfortunately, his is incurable, but he thought no more about it than that he had a chill. An even more important issue than having screening is that we should be aware of our bodies.

[Simon Hoare]

The hon. Lady makes an incredibly telling point, because unless people know what the full range of symptoms are, they do not really know what they should be thinking and whether one of those symptoms or a combination of them should actually trigger a visit to their doctor in the first instance. I think she is absolutely right that we need a better understanding.

This goes back to a point I made a moment or two ago. Because this is a below-the-waist issue and we men get frightfully embarrassed about those sorts of things, we are inclined to say that it might just be something else or that it will pass, and so on. However, for too many people, it is left too late to have any meaningful, beneficial outcome as and when they eventually go to see their GP and then trigger the referral process.

--- Later in debate ---

[Steve Brine]

We do not often use the term, “No decision about me, without me” any more, but I always remember the former Health Secretary—now Lord Lansley—using that a lot, and that is still very true. A patient over that age has every right to request a PSA test, and certainly even more so if they believe that they have symptoms. I would be very concerned about a GP refusing it—I think it would be extremely unlikely for one to do so in such instances—but any patient has the right of travel. Every patient has the right to change GP if they are not satisfied with the relationship that they have. If my hon. Friend did know of an instance of that, I would be very interested to hear about it—as, I suspect, would the Royal College of General Practitioners —but I would be very surprised.

I want to touch on screening, which we talk about a lot at the moment, and I will come on to why. Because of the limitations of the PSA test, there is currently no national screening programme for prostate cancer. In 2016, Prostate Cancer UK, which has been rightly lauded this afternoon, began work to help to develop tests that could form part of a national screening programme. This would potentially involve better blood tests, which are currently in development, combined with more advanced scanning. It is hoping to make that happen in the next five years—nothing happens quickly in this space unfortunately—and I am sure that we all welcome their efforts.

Members will be aware—I have spoken about this quite a lot in the House recently; we have had a number of cancer debates since Christmas—that Sir Mike Richards is leading a review for the Secretary of State of our current screening programmes. As part of that—I met Sir Mike last month—we will consider how we can make screening smarter, targeting those most at risk. We expect that Sir Mike’s work will have positive implications for future programmes. He is an incredibly experienced and respected figure in this space, and I hope that his work will enable us to roll screening out faster when the evidence base is there to support it. I am very hopeful and ambitious about that work, as I know Sir Mike is.

Let us talk about public awareness campaigns, which my hon. Friend mentioned in opening the debate. The Government have to do all that they can to raise awareness of prostate cancer and target high-risk groups, while recognising that there are limitations on how much the public will listen to public health messages from Ministers at the Dispatch Box—I know that it is hard to believe that people do not take this all to heart, but they do not, so we work with our partners.

In 2014, along with Public Health England, we worked on the phenomenally successful “Be Clear on Cancer” campaign, which has had a number of iterations, on prostate cancer in black men. The campaign messaging included:

“1 in 4 black men will get prostate cancer”,

which was one of its tag lines. It urged black men over 45 who were concerned about their risk of prostate cancer to visit their GPs. The campaign evaluation showed that it had stimulated new conversations about prostate cancer among families and the black community. Public Health England has made all the materials developed for the campaign available online, so that groups and other organisations can use them locally if they wish. They are very striking and powerful, and we believe that they were very successful.

We also welcome the work that Prostate Cancer UK is doing with the Football Association to raise awareness through their “relegate prostate cancer” campaign. It is fronted by high-profile celebrity football figures, including the England football manager, Gareth Southgate, and includes the slogan:

“One man dies every 45 minutes of prostate cancer”.

Anyone who can stay awake for “Match of the Day” on a Saturday night—thank goodness for the repeat on a Sunday morning—will see very many people, including the pundits and the managers interviewed afterwards, wearing the badge that I am wearing today. Members will be very familiar with that badge, which demonstrates the widespread support that Prostate Cancer UK has in continuing to raise awareness of this disease.

Let me turn to research, as I come to a conclusion. Research has played a crucial part in the advances that we have made in cancer survival over the past four decades. More than 15 years ago, the Department identified the need for further research into prostate cancer, and we have since worked closely with Cancer Research UK—it was here this morning; I was pleased to pop into its drop-in—Prostate Cancer UK, the Medical Research Council and others, through the National Cancer Research Institute, which is a strategic partnership of the major UK funders of cancer research. NCRI spend specifically on prostate cancer research increased from £17.1 million in 2011-12 to £26.5 million in 2015-16.

[Mary Glindon]

On research, does the Minister think that those who are diagnosed with cancer should be encouraged to take part in clinical trials that aid research and help us to find ways to halt or even cure these horrendous diseases? I think this is underplayed and that we should encourage as many people as possible to help with research by themselves getting involved in trials.

[Steve Brine]

I am happy to agree with the hon. Lady. In her work on brain cancer, the late Baroness Jowell made the point about stimulating new research projects, and that work has been incredibly successful, including subsequent to her death. She also spoke a lot about clinical trials. Anybody diagnosed with a cancer for which there is no significant treatment would want to load the gun with the trial bullet, but there are challenges there. There is only so much that one can do, and there is a toxicity issue with moving from trial to trial that patients do not always fully appreciate, but in consultation with one’s oncologist and physician absolutely it has a critical role to play. Without trials, we would not have any of the treatments we have today, so I thank the hon. Lady for raising that point.

My hon. Friend the Member for North Dorset said that women’s cancers, such as breast cancer and the gynaecological cancers, perhaps get more Government attention. I have to disagree. Last April, the Prime Minister pledged £75 million towards clinical trials for prostate cancer, which will focus on improving early diagnosis and survival rates as well as exploring options for different treatments for men affected by the disease. We expect 40,000 men to be recruited to new research projects with this cash boost. I hope this demonstrates our ongoing commitment to male cancers as well as female cancers.

I am the first guy to hold the post of Public Health Minister in a long time, possibly ever, and it is true that there is a lot of focus on female cancers, but I am determined to raise the bar for men’s health generally, but for male cancers in particular, which is why I was pleased to mention the all-party group earlier.

Alongside the £75 million for research, in 2016-17 the NIHR clinical research network recruited patients to over 90 trials—the hon. Member for North Tyneside (Mary Glindon) raised the point about trials—and other studies on prostate cancer, so there are a lot of trials in this area. The NIHR biomedical research centre at The Royal Marsden here in London and the Institute of Cancer Research also have a five-year £3.1 million prostate cancer research theme.

I started by saying that we do not know everything about prostate cancer. We hope to see these projects deliver more personalised diagnosis, treatment and care of men with prostate cancer through better understanding of the molecular and genetic pathways that determine the non-uniform nature of prostate cancer. The prostate testing for cancer and treatment—ProtecT—trial was the largest publicly funded clinical trial ever to take place in the UK. NIHR funding to date is £40million, which is quite a significant sum.

I agree with what my hon. Friend said about the workforce. The NHS is nothing without the 1.3 million staff on whom patients depend day and night, and for no group is that more true than for cancer patients. We will not achieve our cancer ambitions without an increased cancer workforce, which is why the Secretary of State has commissioned Baroness Dido Harding, working closely with Sir David Behan, who used to lead the Care Quality Commission, to lead a number of programmes to engage with key NHS stakeholders to develop a detailed workforce implementation plan. Baroness Harding and Sir David will present initial recommendations to the Department in March, and these will consider detailed proposals for growing the workforce rapidly alongside the implementation of the NHS long-term plan, including that early diagnosis of cancer target I mentioned.

In connection with that, my hon. Friend mentioned cancer nurse specialists. Health Education England is working to expand the number of cancer nurse specialists and to develop their competencies and routes into training. This will mean every cancer patient having access to a CNS or other support worker by 2021, which I think he will agree is a very good thing.

I have covered today just some of the many initiatives the Government are undertaking in our significant efforts to tackle prostate cancer for many of our constituents, including my friend. I hope I have given the House some information today and a promise of some more. The Government remain totally committed to maintaining and improving cancer survival rates. Prostate cancer is the second-biggest cancer killer among men and is right at the top of our list of priorities.

Finally, I could not close without paying tribute to Prostate Cancer UK, led by Angela Culhane, and the work it does on research and early diagnosis and in supporting men with prostate cancer and reassuring them that they are not alone and that there is often a way out. As cancer Minister, I have been told many times by cancer patients that the cliff edge of an all clear is every bit as bad as the original diagnosis. Owing to our successes, people are living much longer and perfectly normal and full lives after cancer, but we need to support them better, so I pay tribute to the work of Prostate Cancer UK. Its work is invaluable, as is that of all those members of staff who make the NHS what it is. I thank everybody for taking part in today’s debate.

Question put and agreed to.