Secondary Breast Cancer Debate

18 Nov 2008
Ms Diane Abbott (Hackney, North and Stoke Newington) (Lab): I congratulate my hon. Friend the Member for Halifax (Mrs. Riordan) on securing this important debate.

I confirm what my hon. Friend the Member for Keighley (Mrs. Cryer) said about ethnic minorities often presenting quite late with breast cancer and other forms of cancer. That is partly to do with a diffidence about English and about interacting with authority, but it is often also to do with a sense of stigma. In many ethnic minority communities, there is still a strong sense of stigma about cancer. I remember that when my own mother was dying of stomach cancer she was most insistent that nobody knew, because she felt that there was something shameful about it. In those circumstances, members of ethnic minorities often present late. I think that the Government have done an enormous amount on breast cancer and cancer in general since 1997, but in framing a strategy we should be looking at the very specific needs and issues in ethnic minority communities.

8.44 pm

The Parliamentary Under-Secretary of State for Health (Ann Keen): I congratulate my hon. Friend the Member for Halifax (Mrs. Riordan) on securing the debate on the national health service for secondary breast cancer patients. I am aware of her interest in breast cancer, and I realise that today’s debate has been prompted by the recent work of Breast Cancer Care’s secondary breast cancer taskforce on metastatic—advanced—breast cancer.

I was able to attend a meeting with Breast Cancer Care in May, and, in the past couple of weeks, a meeting of the all-party group on breast cancer. We welcome the work by Breast Cancer Care and the secondary breast cancer taskforce to raise the profile of secondary breast cancer.

We are aware that patients with secondary breast cancer have different needs from those with primary breast cancer. My hon. Friend the Member for Keighley (Mrs. Cryer), who spoke in her usual positive and passionate way, made important points about cultural differences and the work that remains to be done. My hon. Friend the Member for Stroud (Mr. Drew) raised the important issue of the hospice movement, and my hon. Friend the Member for Hackney, North and Stoke Newington (Ms Abbott) mentioned a certain stigma that persists among some older women in the community. I can relate to all those points because, as a nurse for many years, I experienced them with patients and their families. Many of us now represent constituencies that include groups of people who need the confidence and reassurance that the NHS can give women.

The National Institute for Health and Clinical Excellence’s guidance, “Improving Outcomes in Breast Cancer”, recommends how breast cancer services should be organised, and covers recurrent and metastatic breast cancer. It recommends that a patient with breast cancer,

    “should receive information relevant to her case about the disease, diagnostic procedures, treatment options and effectiveness”.

Of course, that includes information on the probability of recurrence.

Let me explain how the information is given. NICE is currently developing clinical guidelines for the diagnosis and treatment of secondary breast cancer, which we
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expect to publish in February 2009. At the all-party group meeting, I heard the very different experiences of women in respect of the way in which information is presented to them, and especially the burden that giving information only to the patient, who has to go away and explain it time and again to friends and family, creates. It cannot be acceptable for that burden to fall on the patient alone, especially of an unexpected secondary diagnosis. I emphasise that NICE is currently developing clinical guidelines for the diagnosis and treatment of secondary breast cancer.



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