Cancer Care: Young Adults

Debate between Sharon Hodgson and Julie Marson

Wednesday 8th June 2022 Westminster Hall

[Julie Marson]

I appreciate my right hon. and learned Friend’s intervention. I will come on to talk about some of the things he raised, because he puts his finger on some of the most important aspects of how GPs manage their diagnosis process. The diagnostic centres are fantastic, but they need to have patients referred to them, which goes back to what we are trying to achieve with Jess’s law.

Cancer charity CLIC Sargent found that around half of young people visited their GP at least three times before their cancer was diagnosed. Almost 10% of all new cancers are diagnosed in people aged between 25 and 49, with almost twice as many cases in females as in males in that group.

Simon and Andrea Brady created a petition in Jess’s name. My right hon. and learned Friend the Member for North East Hertfordshire and I joined them to hand it into Downing Street. Its plea was to increase the awareness of diagnosis of cancer in young adults. It currently has an incredible 240,000 signatures, and has highlighted the scale of the problem for young adults. The petition makes for heartbreaking reading. Countless people tell stories of their young family members who have had their lives curtailed by late or non-existent cancer diagnoses. The disproportionate occurrence of females is also deeply troubling.

Being told you are too young for cancer has been happening for years, and it is simply not acceptable. Young people have their symptoms explained away with other diagnoses. As I said, Jess was told she had long covid, despite never having tested positive. The explanations given to other patients for poor health are endless: irritable bowel syndrome, pulled muscles, fatigue, stress, migraine—the list goes on.

I welcome the significant roll-out of rapid diagnostic centre pathways across hospitals in England. I know we have just achieved one million tests and scans via our community diagnostic centres, which is a huge achievement and critical in tackling the covid backlog. Of course, patients still have to be referred by a GP, and that vital link is what we are focusing on here today, particularly the escalation of patients with undiagnosed symptoms within a GP’s surgery or to a specialist, as per Jess’s law.

There are other issues that relate to GPs, including having a dedicated GP lead for a patient. The general practitioners’ contract requires practices to provide a named accountable general practitioner to all registered patients. That GP must take the lead in ensuring that any primary medical services considered necessary to meet the needs of a patient, including appropriate referrals to specialist care and liaison with other health professionals involved in the patient’s care, are co-ordinated and delivered to that patient.

However, Jessica’s case demonstrates that that does not always happen. Jessica was not seen by just one GP at her surgery. In her case, four doctors spoke to her and prescribed medication. Although Jess was told on one occasion that she had been discussed at a practice meeting, it was obvious that there was no one person overseeing her case. She was never seen or contacted by her named GP. It is also vital that GPs are required to maintain their continuing professional development through up-to-date training and awareness of cancer, including in young people.

CLIC Sargent’s Young Lives vs Cancer is a charity dedicated to supporting children and young people with cancer, and ensuring that their voices are heard in the context of cancer care. It has identified several challenges faced by GPs that hamper early diagnosis. Those include limited training and awareness, and time pressures. Of course, the effect of the pandemic is exacerbating existing issues. One third of GPs reported inadequate opportunities to gain experience in the care of children and young people during their initial training as one of the top barriers to identifying cancer in children and young people.

The Health and Social Care Committee’s review into cancer services, published on 5 April, concluded:

“The single most effective way to improve overall survival rates will be to diagnose more cancers earlier. Diagnosing bowel cancer at stage 1 means that 90% of people will live for five years compared to just 10% of people diagnosed at stage 4.”

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

The hon Lady is making a powerful speech. I apologise for missing the start of it. My condolences to Jessica’s parents. That point on early diagnosis is absolutely key. I am chair of the all-party parliamentary group on ovarian cancer and vice chair of the APPG on breast cancer. I have done a lot of work in this area. The number of people—especially women with ovarian cancer —who are diagnosed only in A&E, when it is almost stage 4 or too late, really has to stop, and that all starts with symptom awareness. What is being called for in that petition, therefore, is so necessary. Sometimes people have been back and forward to the GP so many times. Does the hon. Lady agree that that is the one thing that would have made a massive difference in Jessica’s case?

[Julie Marson]

I very much welcome the hon. Lady’s intervention. She is absolutely right. Her work to raise awareness of ovarian and breast cancer is all part of that hugely important process. I lost a dear friend to ovarian cancer, and it is a very difficult and unspecific thing to diagnose, or even for someone to realise that they might have the relevant symptoms. Breast cancer we have made a lot of progress with, and we have to keep that up. There are different cancers, with different symptoms, and awareness of the range of symptoms and how those might impact on different people is key to early diagnosis, to self-diagnosis so that people say, “Let’s go to a GP now”, and to get that GP to take things forward to identify the real underlying issue. I thank the hon. Lady.

The pivotal role that general practice doctors play in diagnosing patients early cannot be overstated. People—our sons, daughters, mothers, fathers, family, friends and neighbours across the board, regardless of age, race, sex or any characteristic—are equally deserving of diagnostic testing and referral. Patients must be accorded the time, space and physical contact to voice their concerns when presenting with recurrent and progressively aggressive symptoms. Listening and acting are key.

I know that the Minister is listening. We have met and discussed the issue, and her own experience in the nursing profession gives her great empathy and insight. I look forward to hearing her response in a moment. I also take this opportunity to thank my right hon. Friend the Secretary of State for Health and Social Care, who is arranging to meet Mr and Mrs Brady to discuss Jessica’s experience, what we can learn from it and how we might be able to implement Jess’s law.

I am also grateful to all those who have contributed today, in particular my right hon. and learned Friend the Member for North East Hertfordshire, who stands shoulder to shoulder with the Brady family. Finally, but most importantly, I reiterate my thanks to and deepest sympathy for Simon and Andrea Brady and their family. We do not want to hear tragic stories such as Jess’s—not because we do not care, but precisely because we do.

To conclude, I will repeat a detail of Jess’s story that I think illustrates the high regard in which she was held. On the day of her funeral, a satellite that she helped to design was launched into space from Cape Canaveral. It was inscribed with the words, “Thank you, Jess!” In honour of Jessica Brady, let us implement Jess’s law, so that other young adults who face the trauma of cancer in future can also say, “Thank you, Jess.”