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Health: Cancer

Volume 727: debated on Tuesday 10 May 2011


Asked By

To ask Her Majesty’s Government what steps they are taking to improve outcomes for kidney cancer patients.

My Lords, our cancer strategy sets out a range of actions to improve outcomes for all cancer patients. It shows how we intend to tackle preventable cancer incidence, improve the quality and efficiency of cancer services and deliver improved outcomes. We are providing £450 million to achieve earlier diagnosis of cancer, and we are working with a number of rarer cancer charities to discuss current barriers to early diagnosis of rarer cancers and possible solutions.

My Lords, I thank the Minister for that Answer. Is he aware that each year more than 8,000 people in the United Kingdom learn that they have kidney cancer? That is approximately 22 people a day. Is he aware, too, that some of the treatment options contained in the UK guidelines for the systemic treatment of renal cell carcinoma have not been approved by NICE? Finally, will the Minister meet the James Whale Fund for Kidney Cancer and leading clinicians to explore methods and systems to improve the diagnosis of kidney cancer at the early stage?

My Lords, I pay tribute, first of all, to the James Whale Fund for Kidney Cancer, which is an organisation that I know quite well, as the noble Lord is aware. It is doing tremendous work, not least in the field of specialist cancer nursing but also as regards its care line, on which I congratulate it. The noble Lord asked whether I would agree to meet the fund. For my own part I would be very happy to do so, but it may be more appropriate for my colleague in the department, who deals with cancer services, to do so as well. We recognise that more needs to be done to raise awareness of the signs and symptoms of rarer cancers such as kidney cancer. Our strategy for cancer sets out our commitment to work with a number of cancer-focused charities. Officials have already met such charities and more meetings are planned over the summer.

My Lords, the noble Lord, Lord Davies, raised the question of National Institute for Health and Clinical Excellence approval of chemotherapeutic drugs. After a nephrectomy, not much else is available, because radiotherapy is generally not terribly helpful in renal cell carcinoma and other cancers of the kidney. The National Institute for Health and Clinical Excellence has to look, with these often quite expensive drugs, at how much benefit is being achieved for the cost of the drug. It is not an easy decision, which is why the noble Lord, Lord Davies, raised the question of some non-approved drugs. Is the Minister satisfied about the judgments being made by NICE about the benefit as against the cost? They are difficult judgments, but is he satisfied with the judgments being made?

I am grateful to my noble friend. He is absolutely right; these are very difficult decisions to make. NICE issues final guidance on the use of a drug only after very careful consideration of the evidence and wide consultation with stakeholders. The noble Lord, Lord Davies, and, I am sure, my noble friend will be aware that one particular drug has been refused or not recommended by NICE. However, we have established the cancer drugs fund, which will enable individual clinicians on a patient-by-patient basis to apply to access drugs even though they have not been recommended by NICE.

My Lords, will the Minister look at the problem of neuroblastoma, which is an aggressive type of child cancer? I have to declare an interest as I had a small cousin who had his kidney removed at five with a tumour. He had to go to America for treatment. Will the Minister ensure that the UK, which does not have a good survival rate for these children, looks with America at the research needed for them? There are only about 100 a year in the UK who have neuroblastoma.

The noble Baroness raises an important issue, because these conditions are devastating even though they affect only a comparatively small number. There is a good deal of research going on into cancer, some of it funded by my department. I do not have details of whether that condition is the focus of any such programme but I will take away her concern and write to her if I have further information.

My Lords, today the Cancer Campaigning Group, which represents dozens of cancer organisations including Kidney Cancer UK, has launched a survey of GPs in which 71 per cent agree or strongly agree that they will require specialist advice effectively to commission cancer services. Given that the cancer networks’ funding is not guaranteed beyond 2011-12, how will that commissioning support be provided? On an individual basis, how will support be provided to GPs when they have to tell a kidney cancer patient that they will not be able to afford to offer Afinitor? That is the drug the Minister referred to, which is not approved by NICE and which costs £200,000 per course of treatment.

My Lords, there are drugs which NICE has recommended for kidney cancer, so Afinitor is not the only drug on the menu. GPs have a crucial role to play if we are to achieve earlier diagnosis of cancer and meet our ambition of cancer outcomes that are among the best in the world. The National Cancer Director, Professor Sir Mike Richards, is working with pathfinder GP consortia to understand how we can support them in commissioning services that deliver the best outcomes. He is clear, as are we, that cancer networks will have a central role in the reformed NHS as a place where clinicians from different sectors come together to improve the quality of care across integrated pathways.

My Lords, has my noble friend made any assessment of the difficulties of treating cancer patients, when the trouble is with the kidneys, because of lack of spare parts?

I think I shall need to clarify with my noble friend what she means by spare parts in this context. I am aware that if we look at treatment options for kidney cancer, neither chemotherapy nor radiotherapy is generally appropriate. Usually, surgery is the preferred course of treatment. If my noble friend will allow, I will speak to her afterwards and investigate as appropriate.