Cancer Priorities

Pauline Latham Excerpts

Thursday 13th February 2014 Commons Chamber

[Pauline Latham (Mid Derbyshire) (Con)]

I am delighted to be able to speak on this matter today and congratulate my hon. Friend the Member for Basildon and Billericay (Mr Baron) on securing the debate and the Backbench Business Committee on allowing it to happen. We would have had many more Members contributing to this debate if it were not on a Thursday afternoon immediately before a recess. Many Members also have problems getting home because of disrupted transport and, when they get there, they have to face flooding issues. It is disappointing that this debate was not scheduled for a much more popular time.

I also pay tribute to the hon. Member for Ashton-under-Lyne (David Heyes) for coming to talk about his personal experiences, which must have been very difficult. I am pleased to see that he is fit and well—or appears to be—and delighted that he is in the Chamber today. Like many Members, I have been affected by cancer, but not personally. A number of members of my family have unfortunately died at very young ages from various forms of the disease. I take a great interest in what happens to people who are either diagnosed with it or who have various issues with it.

One type of cancer that is particularly close to my heart is melanoma, having lost my brother to the disease 13 years ago. In 2011, more than 11,000 people were diagnosed with melanoma. It is a type of cancer that is relatively easily treatable if it is caught early. Simply removing the affected tissue can usually cure the disease. Given that it is easily treatable in its early stages, it is shocking that 11 % of those diagnosed die within the first five years. These figures would surely imply that there is a problem with awareness of the symptoms of the disease, and, as a consequence, with how long it takes patients to be diagnosed. Doctors need to get better at it. As the hon. Gentleman said, it often takes three visits to a GP before referral to a specialist. My brother went to his GP three times in a year before the GP suddenly said, “Well, there is nothing really wrong with you, but I will refer you,” By that time, it was far too late, and he died of a melanoma a few years later.

I note that the APPG’s excellent report recommends that the current advertising campaigns should continue and I am very pleased that an advertising campaign about melanoma will start in May 2014. Although preventing skin cancer is vital, the focus of the campaign should be on identifying its symptoms because, as lay people, most of us do not know what to look out for. I met one consultant who used to work in Australia, who told me that Australian school children go to school with rucksacks on their backs to take their books and kit to and from school and on each side are mesh holders, one for water and one for sun cream. We must encourage that practice in the UK, and teachers must not be frightened to help young people apply the cream in case they are labelled paedophiles. That is complete nonsense and they need to get over it and help young children who cannot apply the cream themselves.

Through my involvement with the charity Melanoma UK, I know that five-year survival rates are hampered by NICE guidelines on the treatment available to late-stage melanoma sufferers. The first line of treatment offered to patients is dacarbazine, which is generally accepted by clinicians as insufficient to treat late-stage melanoma. There is a call for NICE to recommend a second-line treatment, ipilimumab or Yervoy, in the first instance rather than dacarbazine and I believe that NICE is consulting on that.

One study that recommends ipilimumab as a first-line treatment concerns a man named Richard Jackson, who was told that he had only weeks to live when he was diagnosed. He was deciding which hymns to have at his funeral, but when he went to his doctor he decided to give him ipilimumab straight away. As a consequence of the early prescription of ipilimumab, Richard is still alive seven years after diagnosis. It does not make economic sense to use a first-line drug with such a low success rate only, in the majority of cases, to progress the patient on to ipilimumab when they are much weakened by the first drug. That gives them much less chance of doing well. Given the Government’s commitment to fighting cancer, I think it is important that pressure should be brought to bear on NICE to ensure that ipilimumab is available in the first instance. This debate is timely, because NICE is considering the issue right now.

One type of cancer that has been part of a successful national advertising campaign is, of course, bowel cancer. Perhaps Members will remember that when we had not been here for long after the 2010 election one Member wore a tie that contained a musical device that played a tune and it went off. That probably did more to raise awareness of bowel cancer than any other event. Although the Be Clear on Cancer campaign has no doubt been helpful in fighting bowel cancer, it remains to be seen whether its effects have been positive, as the results of the national cancer audit are due to be published later this year. In the interim, I welcome the APPG’s suggestion that the advertising campaign should be extended, as it will undoubtedly lead to more people being diagnosed with bowel cancer earlier.

People do not like talking about their bowels, but they should. They should not be nervous or embarrassed about it, because if they talk about things, they might realise that their symptoms are the very symptoms that are causing problems for so many people. I speak about this from personal experience because three members of my family have died of that cancer between the ages of 51 and 54, and one at 66. That is incredibly young these days. It is such a deadly disease unless, like others, it is caught early. Then, it is curable.

Although there is no mention of cancer drugs in the report, one element of cancer care that particularly concerns me is the legacy of the cancer drugs fund and what will happen to the provision of cancer drugs after its closure in 2016. The east midlands cancer drugs fund closed in 2013, and in every year of its existence it was left with lots of money to spare at the end of the financial year. One constituent of mine, Jill Bilbie, contacted me when she was funding her own treatment for cancer. It did not matter what I said or did, I could not persuade the cancer drugs fund to pay for the Avastin she so desperately needed even when it had the funding. All the fund said was that Avastin did not work, but she survived for three years on something that did not work. Sadly, she has now died, but during her illness, she paid more than £31,000 for the drugs, and people should not have to do that. It goes without saying that the cancer drugs fund and whatever replaces it in 2016 must be more flexible to the requirements of those making funding applications for drugs and must prevent the situation whereby desperate people exhaust their limited finances to fund their treatment.

Selective internal radiation therapy involving spheres is another cancer therapy that my constituents have had difficulty obtaining on the NHS. I was contacted by a constituent, Kate, who I had known for many years, who had been diagnosed with colorectal liver metastases and was trying to get that therapy to reduce the progress of the disease in her liver. As the cancer had metastasised from the primary tumour in her colon, she was refused. Once again, the guidelines for that particular treatment are insufficiently flexible and lead to premature mortality in otherwise treatable cancers. Another of my constituents managed to get the treatment not because the NHS funded it, but because she had private medical insurance. She is still alive today, which shows that the treatment works, so people should be able to get it. I am disappointed that, regarding the treatments that my constituents can get, the east midlands is a poor relation in comparison with other areas.

I generally agree with the report’s findings. A lot of effort went into the report, so I congratulate my hon. Friend the Member for Basildon and Billericay, who puts in a lot of work on the subject all the time, on bringing it forward. There must be an emphasis on the early detection of cancer, but I am worried that not enough is being done to ensure that cancer patients get the right treatment at the right time. I am pleased that the Government are aiming to reduce the number of cancer deaths every year by 5,000, but that aim is less likely to succeed if the Department of Health does not deal with early diagnosis.