Improving Cancer Outcomes

Sharon Hodgson Excerpts

Thursday 5th February 2015 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I am pleased to speak in this important debate. I thank the Backbench Business Committee for granting such an important debate and the hon. Member for Basildon and Billericay (Mr Baron) for applying for it. His excellent speech showed his knowledge on and passion for this subject. I commend him for all the work that he has done over the years.

I would also like to acknowledge the dedicated work of three amazing women who sadly lost their lives to ovarian cancer: Eilish Hoole, who sadly lost her battle in July last year; Chris Shagouri, who worked tirelessly with her MP, the hon. Member for Pudsey (Stuart Andrew); and Jenny Bogle, who, thanks to her MP, my hon. Friend the Member for Islington South and Finsbury (Emily Thornberry), was the only patient to give evidence to the Health and Social Care Public Bill Committee in 2011. They were fearless campaigners who regularly attended events in this House to lobby us all for greater awareness of this terrible disease, and they will be sorely missed.

It is estimated that by 2020, roughly half the population of this country can expect to be diagnosed with a form of cancer in their lifetime, so improving outcomes has never been more important. One major way to do that is to push for ever-greater awareness of the many different forms of the disease, from causes and symptoms through to treatments. With that in mind, I will focus on ovarian cancer—a subject that I know well as chair of the all-party parliamentary group on ovarian cancer.

Ovarian cancer is the fourth most deadly cancer for women in this country, with more than 4,000 women a year dying of the disease. That is 12 mothers, sisters or daughters dying every single day. One of the biggest reasons why it is so deadly is that the vast majority of women are diagnosed too late, meaning that their chances of survival are extremely poor. That contrasts hugely with those who are diagnosed early, up to 90% of whom survive. Put simply, if all cases were caught early enough, thousands more women would survive this terrible disease each year.

The biggest barrier to that happening is a profound lack of awareness of ovarian cancer and its symptoms. If I were to ask women up and down the country to name the key symptoms of early-stage ovarian cancer, such as persistent bloating, difficulty eating, feeling full quickly and persistent abdominal pain, the vast majority would not be able to do so.

A study by Target Ovarian Cancer last year found that only 3% of women surveyed were really confident about spotting any of the symptoms of the disease, and another study found that nearly half of women believed incorrectly that cervical screening is able to detect ovarian cancer, making them much less likely to be on the lookout for symptoms themselves—even if they knew what those symptoms were. It is also believed that GPs have a harder time spotting symptoms of ovarian cancer than many other types of cancer, as it is classed as a rarer cancer and, according to the NHS “Five Year Forward View”, it is estimated that the average GP will see a rare cancer only once in their entire career.

Disappointingly, that was one of the few mentions of cancer in that report. In fact, the only section on the disease features in the last two pages. It appears to have been a late addition, as it does not even feature in the contents page. However brief the mention, it does make a couple of good points. It says that we need an NHS that

“works proactively with other partners to maintain and improve health”.

It also recommends that, because of the rarity of some forms of cancer, we need to give GPs support to

“spot suspicious combinations of symptoms”.

It also says that

“as well as supporting clinicians to spot cancers earlier, we need to support people to visit their GP at the first sign of something suspicious”.

It predicts that achieving that would mean 8,000 more patients living longer than five years post-diagnosis.

After reading that commendable statement, I was disappointed to hear from the NHS’s national clinical director for cancer, Sean Duffy, at our last all-party group meeting on ovarian cancer, that ovarian cancer may not be included in the Be Clear on Cancer campaign. That seems to me to be contrary to what the NHS report recommends. Perhaps the Minister will be able to tell the House whether any such decision has been taken and, if not, that she will work with me to ensure that ovarian cancer is included.

I would also like to know from the Minister whether the lack of focus on cancer more generally is a result of the Health and Social Care Act 2012. As co-chair of the all-party group on breast cancer, I have spoken to several leading breast cancer charities, which have told me that the Government’s reorganisation has ended up reducing the capacity of the NHS to deal with cancer services, not least through the dissolution of the cancer policy team in the Department of Health and the dedicated cancer networks locally. At a time when more people than ever are getting cancer, it is worrying to see changes to our NHS that have significantly reduced our ability to deal effectively with this awful disease.

Cancer is life-threatening, but in many cases ignorance can be the biggest killer. In 2013, the all-party group on breast cancer published an excellent report that highlighted the fact that older women are lagging behind in early diagnosis of breast cancer, partly through a lack of awareness of the symptoms, and we laid out a clear set of recommendations to help deal with the problem. If that is the case for a cancer as common and as well understood as breast cancer, it is even more difficult for the rarer cancers such as ovarian cancer to be understood, spotted, diagnosed and treated in good time. That is why raising awareness among the general public is more critical now than ever. Unlike with breast cancer, there is no workable national screening programme for ovarian cancer, so it is even more important to get the message out about it. We have the tools at our disposal to do so almost straight away.

The Government’s Be Clear on Cancer campaign ran a pilot study in 2013, in which areas of the country were the subject of ovarian cancer awareness campaigns. I commend the former Minister, the right hon. Member for Sutton and Cheam (Paul Burstow), on his excellent work in this area. He met members of the all-party group to discuss the awareness campaign, which ultimately led to the pilots. The results from the campaign were extremely positive. More women remembered seeing the awareness campaign materials, there were higher levels of women going to see their GPs about possible symptoms and, crucially, more women than ever recognised key symptoms and demonstrated greater overall knowledge of ovarian cancer than women from other parts of the country who were not part of the campaign.

Last year, another pilot was launched in the north-west region. Sean Duffy reported back to the all-party group on ovarian cancer that the pilot may not lead to the desired roll-out, so perhaps the Minister will be able to let the House know when the full results of that study will be released and whether they differ significantly from the previous report, which pointed to greater awareness having been generated by the campaign. By making sure that ovarian cancer features in the national Be Clear on Cancer campaign, we can make sure that everyone is better informed. We can get women to see their GPs earlier and, ultimately, we can save lives. To that end, I have continually pressed hard for the full inclusion of ovarian cancer in the national campaign. I ask the Government to look at the evidence and the potential life-saving outcomes that could come from its inclusion, and commit to making sure it forms part of the national strategy. Most paths to reducing cancer deaths are time-consuming, costly and hard to achieve, but this decision could be taken quickly and easily, and it will save lives.

Cancer treatment is not just about survival rates; it is also about post-treatment care and quality of life. No matter what kind of cancer people are living with, we must ensure that the NHS and the Government are committed to helping them at all stages. This is only possible, however, once we raise enough awareness of all forms of the disease. We will then be able to make the improvement in cancer outcomes that every patient needs and deserves.

Finally, on the broader point of awareness, I was shocked recently to discover, after a meeting with Orin Lewis of the National BME Cancer Alliance, the huge disparities that exist in cancer awareness, diagnosis and treatment between white patients and those of a black and minority ethnic background. Incident rates of myeloma in African and African-Caribbean people are twice as high as for white people. Similarly, rates of mouth cancer among Asian women are 50% higher than for white women. Before the great work of Orin, there were a shockingly low number of BME bone marrow donors on the national register. I pay tribute to his work on this: it has led to a substantial improvement, although it still remains disproportionately low.

BME patients routinely rate their care experiences less positively than white patients. Even things as simple as having racially sensitive prosthetics or wigs when going through already traumatic experiences and cancer treatments are not properly taken into consideration. The list of discrepancies throughout every stage of the cancer journey for BME patients is long, shocking and deeply alarming. Alongside promoting greater awareness of cancer in general, it is critical that the Government and the NHS work with BME communities to make sure that national campaigns are designed to be absorbed by as many different people as possible, each with their own distinct cultures, religious practices and biological differences.

Improving cancer outcomes means improving cancer outcomes for everyone. I will continue to work on this specific issue to address the clear and present problems in the current system. I urge the Government and the NHS to give this real thought. If the Minister would like more information on any of the issues I have raised today, I am more than happy to meet her to discuss them further. I know we both share the same goal: to improve cancer outcomes for all.