Breast Cancer Diagnosis and Services: Covid-19

Steve Brine Excerpts

Thursday 12th November 2020 Westminster Hall

[Steve Brine (Winchester) (Con)]

Another debate about breast cancer. There have been many—too many. For my first five years in this place, I was proud to lead the all-party parliamentary group on breast cancer, and it is in good hands now with my hon. Friend the Member for North Warwickshire (Craig Tracey). For more than two years, it was the privilege of my life to serve as the cancer Minister and to be part of what I call team cancer. Heaven knows, I spent my fair share of time sitting in the Minister’s seat in Westminster Hall, as she—the current Public Health Minister—now knows.

For each of the 10 years that I have been an MP, we have lost around 11,500 women a year in the UK to this menace, as has been said. That number has come down thanks to advances that we have made and investments that all Governments have put in, but we have to do so much better. That is 115,000 mums, sisters, grans, aunties and friends over the decade that I have served in this place. I have never spoken before about which one of them it was for me, and I do not think I will go there today, but I will say this: I have fought and lost to breast cancer more than I have won.

And let us not forget the guys. I was glad that the previous speaker, the hon. Member for Dulwich and West Norwood (Helen Hayes), mentioned them. Yes, breast cancer is rare in men, but around 370 men a year are diagnosed in the UK. It still kills, so I welcome the Male Breast Cancer Study that was established to pinpoint some genetic and environmental lifetime causes in men.

Going back to the title of today’s debate, it is true that covid has not helped, but the breast cancer toll goes on regardless. That is as true today as it was pre-pandemic. Breast cancer remains a largely beatable and treatable cancer if it is detected early. Primary breast cancer can be fatal, but we know that almost all deaths are attributable to the development of metastatic, or secondary, breast cancer. As Breast Cancer Now puts it so well—this has been quoted before, but it is worth saying it again—coronavirus is the biggest crisis secondary breast cancer has faced in decades.

We know that some patients with breast cancer had their treatments changed or paused to protect their immune systems. We wait with nothing but fear for the impact of those periods on keeping the disease stable. Let us stop for a moment to consider the reality of those pauses. There is that sinking feeling in a person’s stomach every morning when they wake up and remember that they have breast cancer but they cannot take any action to beat back the disease, because of the pandemic. When they are busy doing something else—maybe enjoying a child or a grandchild being super-cute—it rushes back in, like a punch to the stomach, and they realise they cannot take any action to beat the disease, because of the pandemic. For the children of breast cancer patients who call up on Zoom because they cannot meet, things look and sound the same, but mum cannot take any action to beat back the disease.

Many of these covid delays have had a negative impact on the emotional wellbeing of patients and their families. Never before has the clinical nurse specialist role been more important. We have heard from research undertaken by Breast Cancer Now, an excellent charity, that patients feel they have had less contact with their CNS during the pandemic. When the Minister sums up, could she update us on that? I know she will.

The flip side to that emotional support is the third sector. Many charities, including Wessex Cancer Trust and the Winchester and Eastleigh Cancer Support Group in my area, have switched from physical to virtual, and I thank them for their work. However, there are other charities that have had to pull back just when we need them most, including Breast Cancer Haven, Wessex, which opened only a few years ago, and Breast Cancer Haven, West Midlands, in Solihull. They have closed permanently, and the charity is now operating only online services out of its London base.

Breast cancer incidence in my area, Wessex, is significantly higher than the England average. The rate is 184 per 10,000, compared with 168 across the country. Our mortality rate is spot on the average, but that still has us losing 118 people every year, almost all from secondary cancer.

I was alarmed that my trust had to cease the local breast screening programme in March, because of “did not attends” and cancelled appointments in the first lockdown. Three weeks later, the trust got formal guidance, and the service was suspended for 17 weeks. I fear that this is going to be one of the terrible legacies of lockdown.

The good news is that the restoration of the screening service is well under way, and I thank the team at Hampshire Hospitals for that. The tragedy for us is that, pre-covid, Winchester had a very high uptake of screening in the local population. We have to get back to that.

We have a battle royal on our hands with breast cancer; that was the case before the pandemic, and it is after. When I sat in the Minister’s seat, many hated me describing cancer and breast cancer as a fight, but they are just that. They always were. We needed to up our game pre-covid, and we certainly need to up our game post-covid, if we are not to be here in another 10 years having exactly the same conversations.