Cancer Research

Part of Opposition Day – in the House of Commons at 10:12 pm on 9 February 1998.

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Photo of Ian Gibson Ian Gibson Labour, Norwich North 10:12, 9 February 1998

Cancer remains a major medical problem in the United Kingdom. One in three people suffer some form of cancer. One in four die of it. Given the demographic changes—the population's increasing age—it is estimated that one in two people will suffer some form of cancer by 2020. A wide range of cancers was targeted as a priority in last week's Government Green Paper, "Our Healthier Nation".

Cancer research is an integral part of cancer medicine. Progress in cancer treatment has been steady, but very slow. Significant advances have been made by both scientists and clinicians working together to develop new treatments and to refine the results of such treatments. There have been important success stories in relation to testicular cancers, lymphomas and tumours of childhood, but, with common cancers such as lung, colon and breast cancer, there has been less spectacular progress. Prostate cancer has emerged as a major threat to male lives, and will require a severe strategic and clinical approach to have some form of cure.

We are at a watershed in cancer treatment and entering a new age of entirely novel therapies, where we will be able to identify people who are genetically at risk—for example, women who are at risk from breast cancer. In the past decade, an understanding of the fundamental cell defects that cause cancer, the mutant genes, has allowed us to consider discarding conventional treatments with agents such as cytotoxic drugs, in favour of a range of new, specific and effective agents.

Those new treatments include the use of the mutant gene, the so-called oncogene, as a target, which is thus selective; preventing cancer from spreading; and selectively re-engineering cancer cells to make them normal.

Such specific treatments should, we hope, eliminate many of the present debilitating side effects. At the same time, we must consider research into the care of patients and the role of organisations such as BACUP—the British Association of Cancer United Patients—the Royal College of Nursing, and MacMillan Cancer Relief, which provide information, counselling, support and nursing research for individuals, families and patients, and are key players in this area of research.

Other important research has disclosed that social class V individuals suffer more cancer than social class I; the same is true where there are marked social inequalities. That shows that environment and diet are strong influences in the differentiation between the classes, and therefore need further investigation. After all, it was in Britain that the definitive research into the link between smoking and lung cancer was carried out. The Food Standards Agency will offer support with diet and its link on cancers.

Cancer medicine requires a rigorous, reductionist, analytical approach to the disease. A knowledge of genetics, cell biology and molecular biology is increasingly needed so that clinicians can think of the clinical problem of cancer in fundamental terms and understand the scientific rationale for new treatments. This essential core knowledge is included only at a very superficial level in the postgraduate training of cancer specialists.

In the past, research posts and research projects have been essential components of oncology training, but the opportunity to engage in such activities has been vitiated by the new strategies for national health service research and development introduced by the previous Government, which are heavily weighted in favour of operational and economic projects while providing very little support for clinicians wishing to pursue laboratory-based biomedical research.

Clinical research is the most widespread research activity in which clinicians participate. Clinical trials are the only way to evaluate and validate new treatments. It is vital that they are done, and done well. In the present state of knowledge, it is important that as many patients as possible with a malignant disease are offered the opportunity to participate in clinical trials. That is especially true of patients with the rarer malignancies. It is therefore important that there is support and encouragement for clinical trial participation at central and local level.

the last round of health service reforms by the previous Government unfortunately erected many obstacles in the path of clinical researchers. They have had the effect of severely restricting the scope for trial participation by non-academic departments. A recent article in the British Medical Journal by a senior consultant—sadly unsigned, even in this day and age, for fear of reprisals—illustrates the frustrations of trying to be both a clinician and a researcher. The lack of central support for and local commitment to clinical research activities, with NHS chief executives regarding clinical research with suspicion and as a potential drain on resources, is a major problem awaiting a solution.

Cancer research gets huge support from charities, and millions of pounds are donated each year by a generous British public. The Government can work with those private sources to underwrite long-term support. At the same time, the pharmaceutical industry—one of the success stories, we are told, in this country—seeks interaction with the wider scientific base in universities and research institutes.

I avidly await the views of Glaxo Wellcome and SmithKline Beecham on the effect of their proposed merger on these scientific issues—and, indeed, whether it will better the development of treatment for patients. The ground rules for applications to the National Lottery Charities Board need to be widened to support some of the initiatives that are needed.

We have a model—the National Cancer Institute in the United States. It supports cancer research and medicine throughout the USA. It supports a huge research and development operation in oncology, including laboratory science and clinical science at the highest level. It has pilot plant arrangements for the production of new compounds to be used in clinical studies.

Where there is co-development of new drugs with a pharmaceutical company, it has a degree of control over the pricing of the drug when it comes to market. That is extremely important for new drugs such as the Taxanes, which have been the subject of concern and rationing on ground of cost. Some women have been denied treatment for breast cancer because NHS trusts have run out of money. We need some control nationally over that process.

Moreover, the NCI is a comprehensive organisation for conducting and monitoring clinical trials. It makes comprehensive information resources available to clinicians and patients on the Internet—at www.nih.gov—and not only provides but maintains those information resources in the light of emerging data. In some cases, information is reviewed and re-edited monthly. The United Kingdom has no comparable resource.

The United Kingdom urgently needs a national cancer institute that could and should work in concert with its US counterpart. The idea has support from the director general of the Imperial Cancer Research team, in London, from many consultants, and locally, as demonstrated today in our newspaper. The local Norfolk and Norwich Big C charity each year collects some quarter of a million pounds from the good people of Norwich and Norfolk, and supports the initiative to establish a national organisation.

The Royal Marsden hospital is an obvious candidate centre, but the site of the new flagship hospital, in Norwich, which is so beloved by my hon. Friend the Minister, might also be a fine place to site such an institute.

There certainly needs to be a national research initiative with support rather than obstruction at central and local level. In the USA, Clinton has given a massive budget increase to the National Institute of Health and the National Cancer Institute to boost scientific and clinical research. Those organisations have strong links with the Imperial Cancer Research laboratories, in London, and many individual scientists and clinicians collaborate with each other on both sides of the big pond.

There is currently a great opportunity to forge links and engage in jointly funded projects—all it needs is central organisation and political momentum. The failure of Nixon's so-called war on cancer will be forgotten if our new knowledge of the causes and biological basis of cancer is accepted and applied, and a proper infrastructure is established to move discoveries from laboratory to clinic to bedside.