Nic Dakin: Much progress, but more work to do on cancer

What more can be done to improve cancer care?
What more can be done to improve cancer care?
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IN the debate about the country’s Cancer Strategy, and the current challenges, it is important to reflect on the positives, too. In the space of my lifetime, the progress on understanding, diagnosing and treating cancer has been remarkable.

In the 1950s there was limited knowledge of cancer and of the associated risk factors, the NHS had only recently emerged and there was no co-ordinated plan to treat cancer. We have come a very long way since those early days.

Cancer survival rates have doubled in the UK since the 1970s, which is a real credit to the countless health professionals, researchers, volunteers, charities and, of course, patients who have pioneered progress and who continue to do so every day. It is because of them that we are where we are today, where a person in the UK is more likely to survive cancer than to die from it.

However, massive challenges remain. My constituent Maggie Watts came to see me after losing her husband, Kevin, to pancreatic cancer in 2009. It is her fault that I have ended up as chair of the all-party Parliamentary group on pancreatic cancer – thank you, Maggie.

Kevin’s mother died of pancreatic cancer 40 years earlier, and the shocking thing is that Kevin’s chances of survival were no better than his mother’s. In most parts of life the world has moved on rapidly in 40 years, but it has not done so in that part.

In fact, at less than seven per cent in the UK, pancreatic cancer has the worst five-year survival rate of the 20 most common cancers, with the UK ranked 26th out of the 27 EU countries, according to the Association of the British Pharmaceutical Industry. Sadly, pancreatic cancer is on course to become the fourth-biggest cancer killer by 2026, so action is needed now.

We are now almost halfway into the five-year implementation plan of the Government’s Cancer Strategy for England. At this mid-point there are concerns about the rate of progress being made, and the workforce plan is not yet as effective as we would wish.

For example, as the Royal College of Pathologists has said, it can take up to 15 years to train a pathologist. Pathology services are unable to recruit to vacant ​posts today, and it is anticipated that a third of consultant histopathologists will retire in the next five years, which is just one example of the challenges we face.

The lack of workforce capacity must be addressed to change survival outcomes for pancreatic cancer patients. Fast access to quick and accurate diagnostic tests is also crucial. Many pancreatic cancer patients are diagnosed too late, when surgery — the only curative option — is no longer available.

The early-diagnosis inquiry by the all-party Parliamentary group on pancreatic cancer, Time to Change the Story, heard anecdotal evidence from a healthcare professional that a CT scan can be done quite quickly but that the report can sometimes take 10 weeks.

The diagnosis of not only pancreatic cancer but other cancers, such as blood cancer, can be complex because symptoms such as back pain or tiredness are often misunderstood or misdiagnosed. Delays in blood cancer diagnosis can have a major impact on a patient’s quality of life and overall outcome, and earlier diagnosis would make a difference for many, but not all, blood cancers.

To change this, recommendations for early diagnosis in the cancer strategy should be reviewed to ensure that all people with blood cancer are benefiting from early, accurate diagnosis. GPs could be encouraged to ask for a simple blood test for people displaying one or more symptoms.

The Cancer Strategy calls on Public Health England to continue to invest in Be Clear on Cancer campaigns to raise awareness of possible symptoms of cancer. Symptom awareness is a big challenge in terms of pancreatic cancer.

A ComRes poll carried out by Pancreatic Cancer UK in 2017 found that 35 per cent of adults in the UK would not be worried if they had a few of the potential symptoms of pancreatic cancer.

Last year, Public Health England launched an exciting regional pilot on vague abdominal symptoms, including persistent diarrhoea, bloating and discomfort. Although the results for the campaign were positive, it has not yet been rolled out nationally. I would be keen to know when Ministers plan a national roll-out of the vague abdominal symptoms Be Clear on Cancer campaign.

Much has been done but there is much more to do. Cancer alliances have a significant role to play in delivering effective change, and many are making a difference. Workforce planning, early diagnosis and greater symptom awareness are key areas where we need to up our game as we move into the second half of this five-year Cancer Strategy.

Nic Dakin is the Labour MP for Scunthorpe. He spoke in a Parliamentary debate on the Cancer Strategy – this is an edited version.