Secondary Breast Cancer

I beg to move, That this House has considered secondary breast cancer. It is a pleasure to serve under your chairship, Mr Betts. I declare an interest as a governor of the Royal Berkshire hospital; a family member also holds shares in a medical company. It is a privilege to speak in today’s debate on incurable secondary breast cancer, a debate that the hon. Member for City of Durham (Mary Kelly Foy) and I have brought to Westminster Hall. I thank the many healthcare professionals, charities and life science organisations that have provided valuable information ahead of the debate. I also thank the patients and the charities Breast Cancer Now, Make 2nds Count and METUP UK, who are represented today in the Public Gallery, for their work and support. I would like to recognise everyone involved in the Moments That Count campaign exhibition last November, particularly the brave testimonies from Claire, Laura, Jo, Lisa and Juliet. As I have mentioned many times in Parliament, I am a breast cancer survivor. That experience showed me the importance of early diagnosis and effective treatment, not only for survival but for the quality of life. My own diagnosis was delayed: I was initially sent away by the first GP I saw, and I waited several months before being diagnosed. During that time, the cancer spread to my lymph glands, which had to be removed. Eighteen years later, I still experience the consequences, most recently just a few weeks ago. Fortunately, my treatment was successful. For those living with secondary breast cancer, however, a cure is not an option. Secondary breast cancer occurs when the disease spreads to other parts of the body. Treatments can slow its progression and give people more time, but it cannot be cured. About 11,500 women and 90 men die from breast cancer every year, and most of those deaths are caused by secondary breast cancer. For those living with the disease, every extra month matters, yet too often their voices are not heard, their needs are not recognised and time runs out.

I am grateful to the hon. Member and to my hon. Friend the Member for City of Durham (Mary Kelly Foy) for securing this vital debate. I am pleased that it was rescheduled from earlier in the year and that we have the opportunity to be here today. In advance of this debate, I heard from many women in Newcastle-under-Lyme who have been impacted by breast cancer. I am here to add my voice to their calls for action, to place on the record my support for the More Time to Live campaign and to pay tribute to Breast Cancer Now for all it does. I am grateful to my two colleagues for giving me the opportunity to do so.

I thank the hon. Member for putting his support on the record. This debate is very important: it gives us the opportunity to highlight the experiences of people living with secondary breast cancer and the action needed to support them. One of the biggest challenges is the lack of reliable data. It is estimated that about 61,000 people in the UK are living with secondary breast cancer, but we do not know that for certain. The disease remains under-recognised, poorly tracked and inadequately recorded. People living with secondary breast cancer are still not consistently counted. Too often, they are invisible within the health system, making it harder to provide the tailored treatment, services and support that they need. Some 20 years ago, data collection on metastatic breast cancer was identified as a priority by Breast Cancer Now’s secondary breast cancer taskforce. Progress was made in 2013 when mandatory data collection was introduced, and subsequent strategies have promised further improvements, but we are still flying blind. The first two national audits of metastatic breast cancer were unable to provide a complete picture, because recurrence data remains insufficient, both in quality and in completeness. The audit has demonstrated just how important it is that the issue be addressed: without accurate data, the NHS cannot properly plan services, allocate resources or understand the scale of need. Better data could also help to address continuing gaps in access to clinical nurse specialists for people with metastatic breast cancer. Most importantly, people living with the disease are left feeling that they do not count, because the system cannot guarantee the support that they need. The reality is simple: if we do not know how many people have the disease, we cannot hope to support them effectively. This challenge is not unique to the UK; it is a global issue, and international collaboration can help us to learn from best practice elsewhere, but we should be leading the way. That is why the Government’s national cancer plan is so important. The plan commits to defining and counting recurrent cancers, starting with metastatic breast cancer in 2026. That commitment must now be delivered in full, and Parliament must hold the Government to account on achieving it. The ongoing work of the national disease registration service with NHS trusts to improve data collection is encouraging, but progress will require national leadership and accountability. I am delighted that the hon. Member for West Lancashire is here today. Ashley Dalton was the Minister who drove the national cancer plan through Parliament.

Order. Members must not refer to each other by name in the Chamber.

I did mention the hon. Member’s constituency first, but I take your guidance, Mr Betts—my apologies for that. I recently joined a meeting with the hon. Member and with charities including Breast Cancer Now, Breast Cancer Network Australia and Rethink Breast Cancer. Together those charities are working across the UK, Australia and Canada to improve metastatic breast cancer data and ensure that patients’ voices are heard. The message is clear: if we do not count people, we cannot support them. Collecting and publishing this data is essential, because people with metastatic breast cancer count. Alongside better data, timely access to new treatments is critical. Secondary breast cancer may be incurable, but advances in medicine have transformed outcomes for many patients, giving them more time with the people they love. However, too many patients still struggle to access life-extending treatments on the NHS. One example is Enhertu, a treatment for people with HER2-low metastatic breast cancer. It has the potential to extend and improve lives, yet it was rejected for routine NHS use in England in 2024 on cost grounds. As a result, many patients have been unable to access the treatment that they need. Meanwhile, Enhertu is already available in 26 European countries, including Scotland. England is falling behind. Recent changes to the National Institute for Health and Care Excellence’s cost-effectiveness threshold provide an important opportunity to revisit that decision. I urge Daiichi Sankyo, AstraZeneca, NICE and NHS England to work together to reach an agreement so that patients can access and benefit from Enhertu. More broadly, concerns remain about how NICE assesses medicines and about the impact on innovation and access to treatments, particularly following the introduction of the severity modifier in 2022. Even after recent changes, the threshold for approving some medicines for metastatic cancer remains lower than before 2022. NICE has estimated that the revisions may result in only three to five additional medicines being approved each year. It is the patients who pay the price. Life-extending treatments exist, but they are not always available to those who need them most. That cannot be right. The commitments in the national cancer plan to streamline medicine approvals and accelerate clinical trials are welcome. The recent UK-US pharmaceutical agreements, including commitments to strengthen support for the life sciences sector, are likewise welcome, but without meaningful investment in innovative medicines for severe conditions, access will remain limited and patients will continue to miss opportunities for longer and better lives. Support services also remain inadequate. Clinical nurse specialists play a vital role in guiding patients through complex treatment pathways and providing emotional support, yet many people with secondary breast cancer still do not have access to a clinical nurse specialist. Even among those who do, a quarter have not seen their specialist since diagnosis, and only 65% feel that their specialist has enough time for them. The reason is simple: caseloads are too high. We must recognise the profound emotional impact of secondary breast cancer. More than a quarter of patients say that they did not receive enough mental health support. Many need greater support for their family as well. The NHS long-term plan promised every cancer patient access to a clinical nurse specialist or support worker. That commitment must now be delivered for people with secondary breast cancer who need specialist expertise to navigate this complex disease. People living with metastatic breast cancer do not have time to wait. They need to be counted. They need access to the support they deserve. They need rapid access to treatments that can give them more precious time with the people they love. I ask the Minister for two clear commitments. First, will she set out a timeline for delivering the national cancer plan’s commitment to define and count recurrent cancers, starting with metastatic breast cancer in 2026, and will she outline any plans to make the data that is currently held by the national disease registration service publicly available? Secondly, what are the Government doing to support metastatic breast cancer patients who may miss out on life-extending medicines because of pricing and access barriers?

Order. I will call Mary Kelly Foy next, as the co-sponsor of the debate. After her speech, I will give hon. Members an indication of how long they may have to speak, to try to get us to the end of the debate in a reasonable fashion.

It is a pleasure to serve under your chairmanship, Mr Betts. I am grateful to have had the opportunity to work with the hon. Member for Wokingham (Clive Jones) to secure this important debate. I thank the campaigners who work to ensure that people living with secondary breast cancer are seen, heard and supported. I am thrilled that my hon. Friend the Member for West Lancashire (Ashley Dalton), who has spoken so openly about her diagnosis, is here today: I am sure that her remarks will be invaluable. I speak not only as a Member of Parliament, but as someone who has been through breast cancer. I was fortunate: my cancer was picked up through screening and caught early. I received timely treatment and am now cancer-free, but I am forever grateful to the teams at the QE hospital in Gateshead, the Maggie’s centre and Future Dreams for their support. Whenever I can, I encourage people to attend screening appointments and to check themselves. In fact, on 14 July I will be hosting an event alongside leading breast cancer advocates and sporting ambassadors, focusing on raising awareness of the importance of women prioritising their breast health. I would love the Minister to join us.