Pancreatic Cancer

Stuart Andrew Excerpts

Monday 8th September 2014 Westminster Hall

[Stuart Andrew (Pudsey) (Con)]

It is a pleasure to serve under the chairmanship of my neighbour, Mr Davies. I begin by congratulating the hon. Member for Scunthorpe (Nic Dakin) on securing the debate. It has been my pleasure to work with him in the past on the campaign for the children’s heart unit in Leeds, and I know how dedicated he is to a cause once he gets the bit between his teeth.

I also pay tribute to my hon. Friend the Member for Lancaster and Fleetwood (Eric Ollerenshaw). I was interested to hear the hon. Member for Stalybridge and Hyde (Jonathan Reynolds) say that my hon. Friend’s mother lives in his constituency. Having heard a lot about my hon. Friend’s mother, I would love to see the canvass session when the hon. Member for Stalybridge and Hyde knocks on the door asking for support at the next election.

On the subject of the election, as someone in a marginal seat I have started to reflect a bit on my time here and wonder whether I will be re-elected. I have been remembering the things that have happened during those few years. I will take away many good memories, and I will be sincerely pleased also to take away my friendship with my hon. Friend the Member for Lancaster and Fleetwood. Thanks to his experience in politics over many years, he has given me good counselling and good advice.

On the subject of the debate in particular, my hon. Friend has often struggled with something that was very personal to him and very difficult, and he has often worried about his privacy and that of his partner. I want to put on the record how proud I am of him as a friend, and how proud I am of his campaign. I did not have the privilege of meeting his partner, but my hon. Friend has done that job exceedingly well.

I add my thanks and congratulations to the actress Julie Hesmondhalgh. She will not know this, but we met many years ago. Longer ago than I want to think about, I was at a Manchester Pride event dancing away on the set of Baker Street in Granada Studios, when bouncing along next to me came Hayley, as we all knew her then. She has clearly put her enthusiasm and her smile into the campaign. Having worked in the charity sector, I know that it is a great achievement to get someone with such magnetism behind a campaign. She has done a fantastic job in supporting the charities involved.

In 2012, I attended another debate on pancreatic cancer in Westminster Hall secured by my hon. Friend the Member for Lancaster and Fleetwood. I also attended his debate in March this year in the main Chamber, in which he rightly called for the drug Abraxane to be made available on the cancer drugs fund in England. I made the point that, given the short time that some patients face, if Abraxane gives someone only an extra couple of weeks, those are still an important couple of weeks for patients and their families to get their affairs in order. I was keen to take part in yet another debate on the subject, this time as a result of an e-petition. Many people have thanked Maggie Watts and her fellow campaigners. This is one of the occasions when Parliament actually works for people in this country.

I have been involved in a similar campaign for ovarian cancer. Through a debate like this one and by meeting Ministers, we managed to get an awareness campaign piloted in several areas in the country. I hope that that will be the start of improving diagnosis of that cancer.

During the debate in May 2012, my hon. Friend the Member for Lancaster and Fleetwood told us that 8,100 cases of pancreatic cancer were diagnosed each year. It is sad and terrible that that figure now stands at 8,800. It is even more tragic that 8,300 people died from pancreatic cancer last year—that is 23 people every single day. In simple terms, the mortality figures for pancreatic cancer are getting worse and the survival figures have remained largely unchanged. More people are being diagnosed with the disease and more people are dying of it. That is happening at the same time as mortality rates for most other cancers are falling and survival rates for most other cancers are rising. There is a huge inequality of outcomes compared with other cancers that needs to be addressed. There is still so much that needs to be done to improve the chances for pancreatic cancer patients, as well as for their families and loved ones, who are often overlooked in such situations.

I will now explore the inequality of outcomes in a little more detail and in a couple of different ways. The truth is that there is variation in pancreatic survival outcomes, both internationally and regionally within the United Kingdom. I will take the international outcomes first. The UK lags behind many G7 and G20 nations when it comes to pancreatic cancer survival rates. According to the Pancreatic Cancer Action charity’s website, the five-year survival rates in the US and Canada of 6% are nearly double the survival rates in the UK. Australia is also ahead of the UK on the same measure with 5.2%.

Our European neighbours also seem to perform better than us on pancreatic cancer. The EUROCARE-4 study of 2009 found that the UK’s relative one-year survival rate for pancreatic cancer, at 15.85%, was well behind the European average of 20.9% and behind countries such as Portugal, Spain, Poland and the Czech Republic. Belgium came out on top with 28.3%, nearly twice the UK’s figure.

I will now come closer to home. I know that the figures may come about because of the different ways in which data are recorded, but the trend seems to be clear. Will the Minister say whether any work is being undertaken to try to establish why other countries seem to be achieving much better patient outcomes? Is the Department of Health doing anything to try to learn from those other countries?

The truth is that there are large variations in survival rates across the UK, too. Five-year survival rates in England, based on the 2012 data, were 5%, whereas the survival rates for Scotland were just 3.2%, Wales 3.4% and Northern Ireland 4.7%. One-year survival rates saw the same fluctuation: England on 19.6% and Scotland again behind on 15.7%. There are even massive variations between the regions of England. Using a regional comparison of five-year survival data put together by the charity Pancreatic Cancer UK, based on the old English cancer network boundaries, the best-performing part of the UK was north-west London on 8%. That rate was four times greater than the rate in the Greater Midlands cancer network area. My own area of Yorkshire fared about average on 3.6%.

Again, those variations could be down to the way the data are collected, public health issues or any number of things, frankly. We need some research to get the answers because, on the face of it, if we can bring the worst performing parts of the UK up to the very best, we will go from being the laggard in world performance to being the world leader. What is the Department doing to try to work out why there are such variations in outcomes across the UK? What can we learn from north-west London and export to other parts of the UK? How can we start to end the existing postcode lottery? I am asking for research into why such differences exist.

In addition to more procedural and systems-oriented research, we need more scientific, medical and clinical research into pancreatic cancer. The National Cancer Research Institute report on spending across all cancer types between 2002 and 2011 concluded that spending on pancreatic cancer research is still relatively low. As we heave heard, £5.2 million a year is put into site-specific pancreatic cancer research, compared with well over £40 million for breast cancer. It seems fair to draw a link between those levels of research funding and the relative change in breast and pancreatic cancer survival rates over the same period. Breast cancer survival has soared, whereas pancreatic cancer survival has remained largely the same.

The Minister and her colleagues in the Department of Health have given a number of answers to written questions on this subject over the past year or so. All those answers point to large sums being spent at different institutes, including the Liverpool pancreas biomedical research unit, where £6.5 million is being spent on researching gastrointestinal disease. Although some of that money is likely to be spent on pancreatic cancer research, it will be only a small portion of the overall sum.

The fact remains that, although funding for general cancer research is welcome, and some of that work will undoubtedly benefit advances in pancreatic cancer care, there is still not enough site-specific research. Given that pancreatic cancer is such a difficult cancer to diagnose and treat, more support from major funders is needed if we are to see the advances that we need. Does the Minister have any plans to work with the NCRI, the Medical Research Council, the National Institute for Health Research and others to seek increased funding for pancreatic cancer research in coming years?

As we have heard, pancreatic cancer has some of the worst survival rates of any cancer tumour. Attention must rightly be focused on improving diagnosis and patient care, but support following a terminal diagnosis is also crucial. I have bored hon. Members many times about my background in the hospice movement, but in that movement I have seen the excellent work being done by so many organisations. I am pleased that we are seeing more palliative care in the community, but it is important that we get it right. There is a saying that nothing is certain in life other than death and taxes. In politics we seem to talk an awful lot about taxes, but we do not talk a lot about death.

I have seen so many people who were not able to die in the place they wanted. Recent studies show that 79% of people want the opportunity to die at home, and slightly fewer would prefer to die in a hospice, but just 23% of people get to die at home. The reason is that it takes planning, and the problem with pancreatic cancer is that time is often against the patient. There is not an opportunity for patients to go in and get the excellent care that hospices provide. Families I have spoken to have wanted to get their relative out of hospital but, as my hon. Friend the Member for Lancaster and Fleetwood said, they had entered the cancer world and suddenly all the decisions that had to be made became so difficult. Before the family knows it, the patient has sadly lost their life.

I pay tribute to the work of hospices, and I hope that we can do more work so that they are able to get to these patients quicker and provide a better environment as patients come to the end of their life. I hope we can expand palliative care in the community, and I pay tribute to nurses such as the Macmillan nurses, who offer excellent home support.

There are a couple of things that would help to get palliative care right. Access to emergency medicine packs is important. It is vital that they are stored in the homes of palliative patients who have chosen to spend their last days at home. The packs contain strong medication that can be administered by a registered nurse or doctor. Pancreatic Cancer UK’s support line, however, has received calls where that has simply not happened. In one case, the family had to wait for the Macmillan nurse to arrive and there was no emergency medicine pack. The nurse had to obtain a prescription from a GP and collect it from a pharmacist, which took four extra hours. That was incredibly upsetting for the patient and for the family, who had to watch their loved one suffer. I would like us to look more broadly at developing further packages of 24-hour, seven-day-a-week community care so that we can help more people die in the place of their choice.

We have heard some excellent, varied points today. There is a danger in such debates that we all make the same points, but it has been incredible that today’s speeches have all touched on different things. I also praise David Park for the work he has given us, and, finally, I pay a special tribute to my hon. Friend the Member for Lancaster and Fleetwood. I will break a parliamentary rule by saying that, Eric, you have done a fantastic job.