Breast Cancer
The final item of business today is a members’ business debate on motion S4M-03421, in the name of Linda Fabiani, on October is breast cancer awareness month. The debate will be concluded without any question being put.
Motion debated,
That the Parliament recognises the important role of the Scottish Government’s Detect Cancer Early initiative; notes that the first cancer type to be targeted by this will be breast cancer; understands that 460 women in the NHS Lanarkshire area were diagnosed with the condition in 2010 and that the earlier cancer is detected, the better the chances of successful treatment; welcomes the role that Breast Cancer Awareness Month in October plays in promoting early detection and the work of all cancer charities in raising awareness, and acknowledges the work of Breakthrough Breast Cancer and its memorable breast awareness message, Touch Look Check, which promotes knowledge of the signs and symptoms of breast cancer and the importance of regular checking.
17:07
It is nice after the rambunctious debate that we have just had to know that we are going to speak about something on which there is consensus in the chamber.
I thank everyone who signed up to the motion and everyone who is here to take part in the debate, because October is breast cancer awareness month. We have to acknowledge the role that having a breast cancer awareness month plays in promoting the early detection of breast cancer and the work of all the cancer charities in raising that awareness. I thank Breakthrough Breast Cancer in particular for the help that it has given me for the debate and for its very memorable breast awareness message—touch, look, check—which promotes knowledge of the signs and symptoms of breast cancer and the importance of regular checking.
I know that many members want to speak, so I will just start by outlining a few facts about breast cancer in Scotland. It is the most common cancer among Scottish women, and nearly 4,500 women are diagnosed every year in Scotland—in 2010, 460 of those women were in the area covered by NHS Lanarkshire, where I live and work. Around 1,000 Scottish women die annually from the disease and Scottish women have a one in nine chance of developing breast cancer in their lifetime. I know that others will develop those particular themes, so I will concentrate on a few points.
I want to raise concern about breast awareness in the lower socioeconomic groups. Women in lower socioeconomic groups have poorer levels of breast cancer awareness compared with women in affluent groups. The 2011 survey that was carried out by Breakthrough Breast Cancer found that
“79% of women in group DE had knowledge of any sign/symptom of breast cancer compared to 93% of women”
in higher socioeconomic groups and
“only 47% of DE women checked their breasts once a month or more compared to 60% of women”
in socioeconomic group AB. That is an important point because, although breast cancer incidence is higher in affluent groups, women in more deprived groups have poorer outcomes and survival rates. Sometimes that is because they were diagnosed at a later stage; and sometimes it is because there can be an increased likelihood of there being other health problems. That means that it is important to improve levels of breast awareness. I know that Breakthrough Breast Cancer would like to see more focus on increasing breast awareness among those groups, combined with better public health messaging, so that people can improve their general health and improve their chances of a better outcome.
Another issue is older women. Over 80 per cent of breast cancers occur in women who are over 50. I know that there is a pilot going on in England on age extension from 47 to 63. I think, too, that the fact that age is the biggest risk factor for breast cancer makes it important that older women remain breast aware. Like Breakthrough Breast Cancer, I would like the national health service in Scotland to do more to focus on educating that age group about breast awareness.
That brings me to prevention. Some 80 per cent of breast cancers are not inherited. That figure surprised me very much. Although I had heard the other figures before, I realised, when I saw that one, that I suffered from what I believe to be a common misconception, which is that people are much more at risk if there is breast cancer in their family. Awareness must be raised about that figure of 80 per cent, which links into the breast awareness campaign.
Researchers estimate that around 40 per cent of all breast cancer cases could be prevented if women maintained a healthy weight, limited their alcohol intake and increased their level of physical activity. I am not going to say anything about anyone in here except me. I am not going to comment on my alcohol intake, but I certainly could increase my level of physical activity, and I do not think that my weight is particularly healthy. Again, that is a big issue.
If we can increase awareness of the fact that 80 per cent of breast cancers are not inherited and that 40 per cent could be prevented, that would be a worthwhile campaign. A 40 per cent reduction would be equivalent to around 1,800 fewer cases of the disease being diagnosed in Scotland each year, so we should try to make a big difference by changing behaviours around the risk factors that are modifiable.
That brings me to diagnosis—I am aware that time is short, and I am glad that others will expand on these themes. There is a view that some health professionals are not as breast aware as they should be. The evidence is anecdotal, but we are told that some general practitioners are less breast aware than the women who present to them. There is a case for GPs receiving better education on the signs and symptoms of breast cancer, whether that is part of their medical training or part of engagement, in a continuing professional development capacity, with programmes such as the detect cancer early initiative. I know that many GPs are very involved with breast cancer charities, so I am not putting anyone down; I merely want to make it known that this issue is also important.
Some people believe that screening is not the best way to check for breast cancers. However, I believe that we should not allow that debate to put women off going for screening, as it is important. Further, we should ensure that women remain breast aware in between screenings.
I welcome the Breakthrough Breast Cancer initiative that has just produced a guide that contains the award-winning touch, look, check breast awareness message, which is available by texting “signs” to 84424. I should say that text users will be charged only their standard network rate and that no premium number charges apply. It is a very useful initiative. When the minister responds to some of my points and to those that others will make, I ask him to ensure that we maintain the detect cancer early campaign. It has been a big success and a great initiative, so we would like it to continue.
As a number of members wish to speak, I would be grateful for speeches of four minutes or less.
17:15
I congratulate Linda Fabiani on securing the debate. I note that she and I are both in purple today. We should have perhaps have co-ordinated and been in pink instead.
I also congratulate the many organisations, volunteers and supporters who have attended the Parliament this week and last on the issue. We have been privileged to celebrate the work of Breakthrough Breast Cancer and Walk the Walk, which organises Edinburgh’s moonwalk, when pink bras invade the city. Linda Fabiani and perhaps even the minister and the cabinet secretary might want to join Sarah Boyack, Drew Smith and me, who went on this year’s moonwalk, on the walk next year.
Malcolm Chisholm did it, too.
Forgive me, I almost forgot Malcolm Chisholm.
It would be a great signal for MSPs to walk the walk. Many of us, both male and female, have donned our pink feathered bras, hats and other more interesting items, some of which are, frankly, indescribable but all pink, in support of breast cancer awareness month. The stories that we heard were moving and dignified—from the initial shock of diagnosis, to the challenges of treatment and the positive stories of survival. We constantly need to remind ourselves of why this matters.
Yes, Scotland’s cancer record is continuing to improve and the fact that the survival rates of many cancers are increasing is to be celebrated. However, we should attribute part of that success to the increase in early diagnosis, to health education programmes aimed at encouraging earlier presentation and referral and to the raised awareness that is due to initiatives such as breast cancer awareness month.
We know that the earlier a cancer is recognised, the greater the chance of its being cured. That is why organisations such as Breakthrough Breast Cancer play such a key role. By sending out the simple message of TLC—touch, look and check—it is helping women themselves to identify problems earlier and ultimately helping to save lives across the country.
Cancer, though, is still a major issue that affects many of us in Scotland and breast cancer is a particular problem. It is the most common cancer among Scottish women: nearly 4,500 women are diagnosed every year, and around 1,000 die annually from the disease. I hope that we can do even more to ensure that more survive in the future. It is vital that we make every effort to reduce that number, and early detection programmes are simply the best way to do that.
Education is key. I found the statistics from Breakthrough Breast Cancer particularly appalling because they showed that only 3 per cent of women know that there are five or more different signs and symptoms of breast cancer. What is even more appalling is that 62 per cent of women do not check regularly, which is an easy thing to do. Scotland’s one-year survival rates are lower than those of other European countries, particularly Nordic countries. That is largely due to late presentation, because we do not check and we do not respond early enough.
In my view, breast-screening programmes are essential. Linda Fabiani referred to the debate about overdiagnosis and overtreatment, but that debate should be set clearly in the context of the impressive number of women who are diagnosed and treated successfully. Breast-screening programmes need to stay.
We had a debate earlier today, which was quite angry at points, about universal programmes versus targeting. However, we need to do both. We have a fine example of a universal screening programme, but we need to target disadvantaged areas more, because the risk of breast cancer is greater there. Women from deprived areas are less likely to be diagnosed early and have a lower survival rate than those in the most affluent areas. Therefore, we must do more to ensure that we reach those who live in disadvantaged communities.
I commend the Scottish Government for its current advertising campaign, which I think is fantastic. There is controversy about showing breasts on television and, dare I say it, even in newspapers. However, as Audrey Birt of Breakthrough Breast Cancer has said, “Get over it.” If it helps to save lives, people should indeed get over it and support the campaign.
17:20
I, too, congratulate Linda Fabiani on securing the debate on an issue of which many members will have personal experience—either themselves or through family members, neighbours or friends. I pay tribute to the women and men who are diagnosed with breast cancer and to the doctors, nurses, carers, families and friends who support them through often traumatic experiences.
The debate is all the more poignant for me because, as some members will know, my mum is currently undergoing treatment for breast cancer at Crosshouse hospital in Irvine. I thank members from across the chamber for their kind words of support over the past few months and I offer my encouragement to those who are here today who are similarly affected. My mum is doing fantastically well. I am certainly proud of her strength and courage and her determination to win her battle against cancer, as I did mine more than 20 years ago when I was 19. Had it not been for my mum’s support and that of the many doctors and nurses who got me through it at the Beatson cancer centre in Glasgow, I know that I would not be here today.
I am sure that many of us are aware of the debate surrounding the Scottish Government’s current detect cancer early scheme and the advert featuring Elaine C Smith, which has made headlines not just in Scotland, but across the United Kingdom. To be honest, it is great news that people are aware of the campaign. If just a handful more women check for the symptoms that are detailed in the advert and appreciate that lumps are not the only signs of breast cancer, it will have been worth it.
We can stand here and welcome the £30 million of funding for such programmes, but I believe that ensuring protection for our nation’s healthcare is more important than putting a monetary value on our national health service. Getting the right sort of educational message to people from a young age on how to check themselves and spot signs of breast cancer is vital to successful treatment. I believe that the Scottish Government is doing the right things in ensuring that waiting times for cancer patients are down and in highlighting how to detect cancer. We know that there is still more to do but, just a couple of weeks ago, we heard that, between April and June this year, 95.3 per cent of patients with suspected cancer started treatment within the target time of 62 days.
When cancer care nurses are asked what they think is the most effective form of detection, they do not hesitate in saying that breast-screening programmes have been invaluable. Last month’s injection of £12 million to upgrade breast-screening equipment to digital equipment will therefore be welcomed by the health professionals who deal daily with cancer patients.
It is not just the Government and NHS staff who contribute to cancer care. As Jackie Baillie said, many members will have dressed in our finest pink garments and donned interesting accessories for the Breast Cancer Campaign’s annual wear it pink day. Many members have hosted Macmillan Cancer Support’s big coffee mornings. Last week, I was delighted to have one in the office that I share with my colleague Joan McAlpine in Dumfries.
We are familiar with the charity Cancer Research UK and we are here today because of my colleague Linda Fabiani’s motion, which highlights Breakthrough Breast Cancer’s touch, look, check campaign. However, there are many smaller local cancer support networks throughout Scotland, many of which become a lifeline for cancer patients when they undergo treatment and during their recovery period, as I know only too well. I publicly acknowledge those organisations and thank them for all their efforts on behalf of our constituents whom they support.
This evening, we are offering words of gratitude, support and encouragement to breast cancer patients and to the people who assist them. However, that is not all we are doing: I like to think that we are, as parliamentarians, committing ourselves to ensuring that our NHS remains able to support all cancer patients, and that we are committing ourselves to an NHS that is free at the point of need and remains the mainstay of our public services, providing the best possible care and service.
I wish all breast cancer campaigns the best of success in the efforts to raise awareness, and have no doubt that members from all sides of the chamber give their full backing to those campaigns.
17:25
I, too, thank Linda Fabiani for securing this timely debate. The motion emphasises the importance of early detection in all cancer cases, and recognises that the Scottish Government’s detect cancer early initiative will first target breast cancer.
I add to that of Aileen McLeod my praise for the staff who work with people who have been diagnosed with cancer, and who do such great work, not only at the time of diagnosis, but through treatment and often beyond.
We know about breast cancer statistics: some 4,500 women, and some men, are diagnosed each year, and 1,000 will die each year from the disease. Linda Fabiani’s motion says that, in 2010, 460 women in the NHS Lanarkshire area were diagnosed with the condition. When I read the motion, I immediately checked to see how many women in my area—Greater Glasgow and Clyde—had been so diagnosed, as I am sure many of my colleagues did for their areas.
Statistics are a valuable tool: they help to inform us as legislators, and they allow services to be shaped. However, every one of those statistics is a person who has been given a diagnosis that they feared and who now knows that they are likely to face months of treatment.
I have an admission to make: when I looked at the figures that were helpfully provided by Breakthrough Breast Cancer, my first thought was not to look at the latest figures, but to check how many women in Greater Glasgow at the time shared my experience of being diagnosed with breast cancer—I cannot remember precisely when, but I think it was four years ago in 2008, which seems such a long time ago—and the number was 940 women. The cancer that I had affects only 1 per cent of those who are diagnosed and, although surgery and reconstruction were required, I was exceptionally lucky because I did not need chemotherapy or radiotherapy and was back at work less than two months after surgery. I am not sure that was a benefit, but there we go.
My reason for mentioning my own case is simply to reinforce the message that although screening is important, being aware of changes to your breasts is essential, no matter one’s age. Members may find it hard to believe, but when I was diagnosed I was too young—just—to have been called for screening. I had noticed a change; it was not a lump—I will spare people the details—but let me just say that in my case size really did matter. My experience is why I think that the Scottish Government’s current adverts that remind women of the need to be aware of any change to their breasts are so important, and why the TLC campaign is vital.
I decided to mention my experience because I am worried about the number of women in constituencies like mine who do not attend screening. As with so many other health issues, women from poorer areas are least likely to attend and most likely to need radical surgery and treatment when they are eventually diagnosed. I ask the minister to consider targeting those communities in order to encourage more women to come forward.
If we return to the statistics, only about 70 per cent of women in Glasgow take up the opportunity to have screening. I suspect, too, that the statistics cannot tell us the number of women who continue to soldier on when they know they have a problem, either because they are afraid of what it may mean or because they are worried about who will look after their children if they have to go into hospital and whether their employer will be sympathetic when they need time off.
My message is clear: “If you are called for screening, go. If you spot something that’s just a little bit different from normal, go to your GP as soon as you can. Follow the TLC campaign, encourage your daughters, your friends and anyone you know to do so, too. In most cases, you won’t have cancer and, if you do, the earlier it’s caught, the simpler the treatment is likely to be and the greater your chances of making a full recovery.”
17:29
I was privileged a few weeks ago to attend the Breakthrough Breast Cancer workshop. It was at that workshop, led by Ashley Donaldson—a champion for Breakthrough Breast Cancer—that I realised the importance of TLC. TLC it is something that we can all accept and look towards, because it means different things to different people.
I applaud the courage and bravery of those who have shared their personal experiences this evening. Patricia Ferguson is absolutely right—statistics are people, and it is a shock to people when they are diagnosed. There is fear and anxiety. Breakthrough Breast Cancer encourages TLC at an early age for those who may not think that they will be affected by breast cancer and who are certainly outwith the age range for screening. If we can get young people to check regularly and do TLC in their teens, it will not be a problem for them when they are in their 40s, 50s, 60s and so on. It will be natural.
Breakthrough Breast Cancer encourages a routine. That is the way forward. It can be done when one has a shower or gets ready for bed. We are not asking for checks every day, but we are asking people to get into a routine and to be aware of changes. We are asking people to be more aware of their bodies.
Very few men suffer from breast cancer. In fact, the number in Scotland is about 0.6 per cent. The symptoms for men are not so different from those for women. There could be a hardening around the breast area or changes around the nipple. Often, though, breast cancer is painless, and most men would probably disregard it. Scottish men in particular would probably disregard it because they are not particularly good at going to the doctor anyway, with any condition. Perhaps we need to get over those barriers. We need to encourage people to be aware of their body and changes in their body.
I support the work of Breakthrough Breast Cancer and encourage those who can to become champions for the charity throughout Scotland, to take forward the TLC initiative and to help and encourage people to become aware, because becoming aware saves lives.
As a large number of members still wish to speak in the debate, I am minded to accept a motion under rule 8.14.3 to extend the debate for up to 30 minutes.
Motion moved,
That, under Rule 8.14.3, the debate be extended for up to 30 minutes.—[Linda Fabiani.]
Motion agreed to.
17:33
I am pleased to take part in the debate and thank Linda Fabiani for securing it. She has given us the opportunity not only to discuss our experiences of breast cancer and highlight the challenges that people continue to face, but to thank the many people who work for breast cancer charities and organisations throughout Scotland.
There will be a person in our constituencies who, at this very moment, is worried about a lump or a change in their breast. They will be awash with anxiety but they will be reluctant to take that all-important step and make an appointment with their doctor. It is for that person that I welcome tonight’s debate. I understand that sense of trepidation, as I am sure we all do, but it is always better to know the truth than to live in fear and doubt, especially where one’s health is concerned. It is for that person, and for the many other people around the United Kingdom who are affected by breast cancer every day, that I welcome Breakthrough Breast Cancer’s touch, look, check campaign.
Like many others, I had the opportunity to attend a session with the Breakthrough team that recently visited the Parliament. I learned more about self-checking, particularly its importance in early diagnosis or simply as a means of alleviating doubt. The team does a fantastic job, and I hope that the crucial message that it promotes is beginning to reap rewards.
I was especially attentive to what the Breakthrough team said about self-checking, especially as I had thought that I had all the information that I needed. Since I was a teenage girl, I have been trained in what to look for and have carried out regular checks on myself. Only last Christmas, my sister and I received a self-examination glove and information DVD from our mum. That was not the gift that I had asked for, and members can imagine the look on my face when I opened the somewhat curious present, but I can honestly say that it is the most important present that I have ever received.
My mum was diagnosed with breast cancer at the age of 33. At the time, I was only 10 and did not realise how life-changing that diagnosis would be. I did not understand the magnitude of a double mastectomy, radiotherapy, chemotherapy or reconstructive surgery; what I did understand was that it was a frightening experience that caused a lot of physical and emotional pain, not only to my mum, but to the rest of our family. Although that pain reduces over time, it never goes away.
It is because of that that I believe that we need to offer more counselling to families and, in particular, children during such a traumatic time. I know that counselling services have moved on in the past 18 years, but there is always room for improvement.
I also believe that we should make a concerted effort to increase awareness of male breast cancer. The incidence of breast cancer is far lower among men—around 300 men are diagnosed with breast cancer each year in the UK and around 25 in Scotland—but, whatever the figure, more attention must be paid to the men who are potentially at risk. I have already alluded to my mum’s case and, as we have heard, many other members have had similar experiences, but I did not mention that her father—my grandfather—was also diagnosed with, and indeed died from, breast cancer. Therefore—believe me—when I say that we need to do more to increase awareness, I am talking from bitter experience.
My mother’s cancer is genetic, and although I realise that that is also rare, I know that my family is not alone. That is the message that we should be broadcasting to all those people who are affected by breast cancer: you are not alone. Help is always at hand. All you have to do is ask. That is the message of breast cancer awareness month, and it is why we must all keep supporting it.
17:37
I am pleased to speak in this debate at the start of breast cancer awareness month and I congratulate Linda Fabiani on her motion, which highlights the importance of early diagnosis of breast cancer. I would also like to endorse Jackie Baillie’s recently lodged motion on the same subject, because I think that it is important that we all unite in support of Breakthrough Breast Cancer and other cancer charities, which are working to get home to women the importance of looking out for any physical changes that might indicate cancer at an early stage, when it is likely to be easily and successfully treated. We have heard of many personal successes this evening.
It is important, too, to acknowledge the Government’s detect cancer early initiative, which has rightly selected breast cancer as the first cancer type to be targeted.
Given that breast cancer affects one in eight of the female population, I have no doubt that we have all been in contact with someone who has developed breast cancer. I had my first close contact with the condition more than 30 years ago, when I and three close friends from my medical school class all developed breast lumps. Mine was a cyst, and I still remember the palpable relief all around when the surgeon’s probe found fluid rather than solid tissue. One of my friends had a benign fibroadenoma, while the other two had cancer. Sadly, one of them died fairly soon after diagnosis from liver secondaries. If anyone has noticed the well-worn and very shabby purse that I always carry with me, the reason I will not replace it is because it was a 21st birthday present from that friend. The fourth member of our group lived with her cancer for around 15 years, until she eventually succumbed to very slow-growing lung secondaries. Therefore, I have been very much aware of breast cancer for many years. I would never miss a screening appointment, and I intend to submit to regular mammography after the age when screening is routinely on offer.
I was interested to hear Linda Fabiani mention older women, because the need to be aware of breast cancer into old age was brought home to me recently when a friend, who is also a constituent, contacted me to ask for breast cancer statistics in women over the age of 70. While she was in hospital for a lumpectomy, she had met two other patients in the same ward whose cancer had been diagnosed when they were in their 70s. That set me thinking about how many women, once they have reached the age when routine screening stops, might assume that their risk of developing breast cancer has fallen when, in fact, the risk increases with age.
With an ageing population, an increasing number of women will be at risk. I know that Breakthrough Breast Cancer and other organisations point out that the risk continues, but I wonder whether more emphasis should be put on that. I raised that point with the Cabinet Secretary for Health and Wellbeing during health questions last week.
Clearly, the importance of early diagnosis applies to all age groups. I hope that the publicity of breast cancer awareness month will remind all women of not only regular screening but regular self-examination and encourage them to pay attention to the touch, look, check message that is being promoted by Breakthrough Breast Cancer. Many people nowadays survive diagnosis of breast cancer for many years, and many more could do so if that diagnosis was made early.
I congratulate Linda Fabiani on doing her bit in Parliament to highlight the need to be aware of breast cancer, and I give all credit to those who work year in, year out to educate the general public on the importance of regular vigilance and self-examination, so that the condition can be diagnosed and treated as early as possible.
17:40
I add my thanks to Linda Fabiani for securing today’s debate.
Last week, I was one of thousands of people to join in the world’s biggest coffee morning in aid of Macmillan Cancer Support. I was delighted that the people of Erskine who attended helped to raise more than £160. I say a big thank you to everyone who came along on Friday.
Today’s debate is very sensitive, as breast cancer affects almost every family across Scotland and further afield. I speak as someone who has benefited from genetic testing. Because of a genetic breast cancer in my family, I know only too well how crucial the research into and advances in detection and treatment of cancer are.
This month, many charities and organisations are helping to raise awareness of breast cancer, from Macmillan Cancer Support and Breakthrough Breast Cancer in Scotland to the White House and the National Football League in the States. It is right that we have the chance to debate how we raise awareness in this chamber. Last month, the Scottish Government launched a new advert, fronted by Elaine C Smith, which has been mentioned by other members in this debate. Some people have referred to the advert as “shocking”. I would prefer that the likes of the BBC used adjectives such as “vital”, “necessary” or “crucial” to encourage women to look for early signs, not to scare them—suspecting that one has breast cancer is already a frightening experience.
I want to focus on tackling inequalities in screening. In NHS Greater Glasgow and Clyde, it was found that women with learning difficulties were less likely to take up screening than those in other NHS regions. Those women are more likely to wait longer before seeing a doctor or less likely to attend screenings. There needs to be more effort to encourage women with learning difficulties to have regular screening. How we target that group of vulnerable women is a serious issue that the Parliament must address—with regard to screenings not only for breast cancer, but for all cancers.
Recently, the Equal Opportunities Committee launched its report into Gypsy Traveller communities’ access to healthcare, which included access to screenings by Gypsy Traveller women. Another report suggested that the best way to educate younger generations of Gypsy Traveller women is to go through the matriarch, who is normally the grandmother in the family. I look forward to working further with the committee and the new Cabinet Secretary for Health and Wellbeing on improving access to healthcare for Gypsy Traveller women, especially to improve the early detection of cancers, which can save the lives of many.
There appears to be a decline in the number of women who access screening when we look from the least-deprived areas to the most-deprived areas. As with women with learning difficulties, there is a lower uptake among women from the poorest areas of society. Although it is good practice for mobile breast-screening units to be parked near community centres and libraries, we must remember that those facilities are often the first to be closed as a result of budget cuts, especially in poor areas. That means that poor women will continue to have the lowest uptake of breast cancer screening.
In closing, I commend the work of Breakthrough Breast Cancer and its excellent touch, look, check campaign.
17:44
I congratulate Linda Fabiani on securing this important debate.
We can celebrate the improvements that there have been in breast cancer survival rates. Twenty years ago, just over 60 per cent of women survived five years beyond diagnosis; twenty years later the rate is upwards of 80 per cent. However, we must remember that more than 1,000 women a year die from breast cancer.
We must also remember that five-year survival is not always the end of the matter. Nanette Milne reminded us that slow-growing secondaries sometimes arise. Of course, the primary tumour can recur, as I was reminded at the moonwalk reception last night, when a marvellous woman from Glasgow, who is still young, told me that, sadly, her breast cancer, which was treated a little while ago, has recurred.
A problem that we have in Scotland is that more people die within a year of diagnosis than is the case in other countries. That is related to late presentation, which is why the Government’s detect cancer early initiative is so important. As other members did, I welcome the recent advertising campaign in that regard and I pay tribute to the work of Breakthrough Breast Cancer in its TLC campaign.
Breakthrough should be commended for a range of work that it has done during the past few years, such as the service pledge that it pioneered, its campaign on lymphoedema, a debate about which I was pleased to introduce two years ago, and its great work in the field of research. I acknowledge the great Breakthrough Breast Cancer research unit at the Western general hospital.
I also pay tribute to the amazing breast unit at the Western general. The main reason for our much better five-year survival rates than we had 20 years ago is the improved treatments and services at units such as the one at the Western general in Edinburgh and the Beatson in Glasgow, which Aileen McLeod mentioned.
I have talked about Breakthrough Breast Cancer, but it would be wrong to forget other charities that work in the area, which are mentioned in general terms in the motion. Breast Cancer Care provides invaluable services and three years ago developed standards for secondary breast cancer that were widely praised at the time. It would be interesting to know to what extent the standards have been taken up, if the minister has information about that.
Challenge Breast Cancer Scotland had a meeting in the Parliament last Tuesday—we have had three such receptions in the Parliament in a week. I have a particular attachment to that campaign, which started in 1994 and used to be called the Scottish Breast Cancer Campaign. I remember introducing a debate in the House of Commons a few months after the organisation started up, one of the purposes of which was to praise the campaign and the enormous lobby of Downing Street that took place in 1994 to demand more research and better services—two areas in which there has subsequently been great progress.
At the Challenge Breast Cancer Scotland meeting last week a general practitioner from Glasgow gave a talk that contained a very negative message about screening. I think that the majority of people in the breast cancer field would not agree with what she said, but I support Challenge Breast Cancer Scotland’s demand for an informed choice for women about screening decisions.
I think that we can all agree with that, but I also think that positive messages must be sent out about screening as well as checking and general awareness. Given that 1,000 women a year die from breast cancer, no one—not the health service, the Government or the charities—can rest until that number has drastically reduced.
17:48
I congratulate Linda Fabiani on securing time for this debate and I thank her for lodging a motion on an important issue that affects many women in Scotland—and has done for many years.
Breast cancer awareness month presents an important opportunity for us not just to reflect on what has happened over the years and the campaign for more effective treatment and support for women who are diagnosed with breast cancer, but to ensure that we consider the future and the opportunities that will arise as a result of advances in medical science. Alongside that, we need to keep focused on a cancer that continues to affect so many people in Scotland.
I thank in particular the range of charities that do a tremendous amount of work not only to raise awareness among women and the general public, but to support women and their families as they undergo treatment after their diagnosis. Although that bit can often be forgotten, it should not be underestimated.
For most of us, being diagnosed with cancer is probably the worst scenario that we can imagine. Our response might well be informed by past experience of seeing a friend or loved one with the disease. Although I am not sure that we will ever be able to eradicate that fear, it is worth bearing in mind that the outcomes from a cancer diagnosis are, for many cancers, radically different from what they were 20 or 30 years ago.
In the debate, a number of members have mentioned how breast cancer has touched their lives and has resulted, perhaps, in the loss of a friend. However, many of us who might not have lost a friend through breast cancer are likely to know someone who has survived it. After all, the number of women who survive the illness is increasing, largely as a result of the good progress that has been made in treatment over the past two decades. Moreover, breast cancer screening has helped to ensure that women are diagnosed earlier, which means that treatment can be given earlier and less aggressive treatments used. Another piece of good news is that nine out of 10 women diagnosed with stage 1 breast cancer now survive beyond five years.
That said, we need to recognise that Scotland’s cancer survival rates continue to lag behind those in other European countries. Given that and our ageing population, we expect the incidence of cancer to increase. Clearly we have to do more in this area.
We know that breast cancer is common, with one in nine Scottish women being diagnosed with it in their lifetime, but by detecting it earlier we can treat people while they are in better health and with, as I said, less aggressive treatments. However, if we are to continue to turn the tables in our fight against cancer, we have to get better at detecting it even earlier, and that is exactly the aim of the detect cancer early programme to which a number of members have referred. It is all about changing people’s mindset about cancer and its signs and ensuring that not only individuals but our clinicians and other healthcare support staff are more vigilant.
Part of the programme is a social marketing strategy that seeks to ensure that health professionals have more of an understanding. We have also started a new programme of work with Healthcare Improvement Scotland to review the Scottish referral guidelines for breast, colorectal and lung cancer and find out whether they can be improved. We are also examining the capacity issues that are likely to arise in screening and diagnostic services as a result of the changing demographic situation in Scotland.
As far as breast cancer is concerned, we have launched the breast cancer social marketing campaign. Of course, each year many MSPs get involved in some form of social marketing themselves when they don pink hats, pink rosettes or whatever pink thing they choose to put on, but it is all part of the social marketing campaign that we carry out with third sector organisations in order to raise awareness.
Jackie Baillie made the important point that some of the research shows that women are not necessarily as aware of the common signs of breast cancer as they should be, nor are they aware of the changing survival rates or of a variety of changes that can take place within a breast. That is why we produced the breast cancer campaign. It would be fair to say that it has generated a considerable amount of interest and discussion, which is good, because that is exactly what it was meant to do. It was meant to encourage people to talk about such matters much more openly. As Audrey Birt says, people will just have to get over it and start to discuss these things much more openly, because that is the healthy way in which to address this challenge.
Several members referred to the screening programme. We are putting further investment into that programme over the next three years to upgrade the system to a digital one, which is much more effective.
I am conscious that we need to make more progress, particularly for women from more deprived communities who might not take up the opportunity of screening. Mary Fee made a point about the health inequalities that exist for individuals who have learning disabilities. There are clearly grounds for us to consider more closely how to cover that.
I give members my commitment that, where we can take further measures to encourage more women from deprived communities to take up the opportunity of screening, we will do so in a way that recognises that some of them may require support. If they have learning disabilities, we will make the system as accessible to them as possible and ensure that we encourage them to make use of screening in Scotland.
Meeting closed at 17:56.