 Ymlight Xiao cyfronwch y ddreifon ryw wavell, mae'r defnyddio iawn ar bunsyn 1259 yn yny Clare Adamson. Mae continues ond pancreatic cancer awareness month 2021. Mae'r defnyddio iawn yn gweithio i fod ni cael ei gwasanaeth, ac mae'r defnyddio iawn ac hefyd colleagues yn ei gweithio i witnesses held y teisugau i fynd i gael gwellonau i ni o gwstiau dechrau o'i beth. Mae'n gweithio i fod i gael gweithiaid i fừadawsadau'r defnyddio iawn, diwrnod i gael, i gael gweithio i gael i gael gweithio i gael gweithio i'r defnyddio iawn, I start by paying tribute to the limitless dedication of the volunteers and campaigners that make pancratic cancer awareness month happen. Again, we are missing the sea of purple in our gallery but I know that they are with us tonight. 2017 was the first time that this debate was brought to the Parliament and as opposed to reflect on what has changed, I can say that I have more speakers from my own benches than we had in that whole debate in 2017 and that is testament to the efforts of everyone who works to get pancatic cancer in the political spotlight and I genuinely thank every one of my colleagues across the chamber tonight who will take part in the debate and I look forward to their contributions. Tonight I want to talk about optimism and that's not something we normally associate with this cancer but first let me outline some of the key statistics which show the need for action. Pancatic cancer is the least survivable common cancer in Scotland. Only one in four people diagnosed with pancatic cancer survive beyond a year. The five-year survival rate is only 5.6 per cent. Just compare that to the five-year rate of 69 per cent for other common types of cancer. Seven in ten people with pancatic cancer will never receive any treatment, they will move straight to palliative care and only one in ten will receive surgery. Each November, we emphasise the importance of early diagnosis and intervention. Yet in Scotland, recent surveys show that 55 per cent of people know almost nothing about the disease and 73 per cent can't name a single symptom. Let's work to correct that. Symptoms to look for are abdominal pain that can spread to the back, unexpained weight loss and loss of appetite, new diabetes without weight gain, a yellowing of the skin or the eyes and itchy and a change in bills habits, including indigestion that doesn't respond to treatment or smelly peel or floating stools. Figures around pancatic cancer have remained static for 50 years. I've said that in every debate that we've had since 2017, but do we really take what that means on board? I was recently reading about succession star and national treasure, Brian Cox, who I met in this Parliament at an event. His autobiography he talks about has been pushed into acting largely because of the trauma he had felt after his father Charlie passed away from pancatic cancer just three weeks after his diagnosis. When we think of the span of Brian Cox's life and career and that body of work, and then his experience devastating as it was is so redolent of the many patients and families experiencing the diagnosis of pancatic cancer and those who have shared it with me. Today, in Scotland, 50 years after his family experienced this, another family could be hearing the same devastating news and faceloving a loved one within a matter of weeks. That's why we're all here tonight. What about that case for optimism? Where can we look for change? We must remember that, with earlier diagnosis, pancatic cancer can be survived. For those diagnosed in time for potential life-saving surgery, a five-year survival increases to around 30 per cent. Early diagnosis, intervention and holistic care, people can live longer and enjoy a better quality of life. There are initiatives across the country working to raise awareness of this disease. In the summer, I was pleased to take back in the big step forward and wearing my medal today, organised by pancatic cancer. I had a walk-round staff by park, accompanied by Kim Rowne, who is a formidable campaigner on this area, donned from pancatic cancer, and Julius Tertuska, my assistant, and Mulack, the dog. I have to say, if you want to raise awareness of an issue, where all the t-shirts you want in the world, if you take a dog and a walk with you, you're going to get people asking what's happening. Thousands of people took part in this initiative. An amazing £248,786 was raised for world-leading research into pancatic cancer. I also attended the fabulous production of Islets of Silence, The Seaward, a play written and directed by Isabel Barrett. It was heartwarming, difficult but laced with purpose and hope. Most importantly, with the help of pancatic cancer action Scotland, the play is taking awareness right into our local communities. They are also hosting outside the Parliament the Pancan Van, which takes the message about pancatic cancer awareness into our communities, they go to events, they go into our town centres and explain to people about how to look out for the symptoms of this cancer. They are here tomorrow outside the Parliament. I encourage all my colleagues to visit the Pancan Van. I also mentioned the indomitable Linda Murray, whose advocacy for this cause cannot be overstated. The death of her father William Begley inspired us to campaign relentlessly for a patient pathway that will give people a chance that her father did not have. This summer, she led me out with the SHPBN, Hepatocellular Carcinoma and Pancreatic Cancer Patient Pathways Improvement Project. I wish me luck with this, I will have to say that again. The Scottish Hepatocell Pancreato Billiary Network aims to ensure equity and care for patients throughout Scotland with cancer of liver, pancreas, gallbladder and biliary trees. The Scottish Government has awarded funding of £653,000 to this new SHPBN project to help to streamline and shorten the staging phase and simultaneously enhance patient care and support through communication. I thank all of the clinicians involved in this and pay particular mention to Ross Carter and Anja Adair for their work. Despite the grim statistics that we encounter, there is a well of innovation around pancreatic cancer. I know that we are really busy tonight. I could go on about the precision pancreas areas, but I know from the people who are in the chamber this evening that those areas will be covered by my colleagues. The final ask to the minister this evening is to look at the stereotactic ablative radiotherapy SABR for treating locally advanced pancreatic care that is being piloted in England at the moment and ask that the Government have a look with interest to the success of that project as another way of fighting this cancer. Continued investment, training, research and cultural shifts to domestic care are vital to overcome pancreatic cancer. I hope that one day this annual debate will not need to take place and that people and families who are affected by pancreatic cancer can look back to this as a time of change. Thank you very much, Ms Adamson. I know what you mean about taking the dog for a walk. I've got one of those. He doesn't want to come back home with me all of the time. Anyway, we'll move on to the open debate. I'll call First Jenny Mintill to be followed by Sue Webber, Ms Mintill, around four minutes, please. Thank you, Presiding Officer. The pancreatic cancer ribbon is purple. It represents the love of one daughter for her mother. Rose Schneider died after battling pancreatic cancer. Her daughter founded the pancreatic cancer network to support those affected. Purple was Rose's favourite colour. Tomorrow evening, as part of World Pancreatic Cancer Day, Dunun landmarks will be bathed in purple light, reflecting the love of a family and a community for one of their own. Local firefighter David Cahoon. David was diagnosed with pancreatic cancer in September this year. I would like to thank my colleague Claire Adamson on behalf of David and his family for ensuring that the Scottish Parliament plays its important role in raising people's awareness of pancreatic cancer. His sister-in-law Jacqueline Kennedy said to me yesterday, all cancers need to be up there. We need people to talk about them. As Claire has said, pancreatic cancer is the deadliest common cancer in Scotland. The five-year annual survival rate is only 5.6 per cent. Awareness levels in Scotland are low, 55 per cent of people know almost nothing about the disease. Jacqueline is right, we need to talk about it. David is Dunun through and through. He has his own roofing business, as is employed as a firefighter at Dunun Fire and Rescue Service. In August this year, David was one of the heroic firefighters who risked his own life during the horrific fire in Argyll Street. David has given so much to his community. Tomorrow, his community will be showing their support for him and helping to raise awareness of the key symptoms of pancreatic cancer. The family wanted to use what they were experiencing to improve the prospects of others by bringing their voices, commitment and energy. They are helping to change the pancreatic story across Cowell. David's daughter and her friends organised a sponsor where Purple Day at Dunun Grammar School. Friends and family have taken on individual walking challenges, all raising funds for pancreatic cancer action Scotland and pancreatic cancer UK. Tomorrow evening, there will be a walk through the town, visiting all the purple lit landmarks from Dunun Fire Station to Dunun Castlehouse Museum. This has been an incredibly tough couple of months, as David, his wife, his children, immediate family and friends come to terms with the diagnosis, but the support that they have received from NHS Scotland as well as Sheila, their amazing Macmillan cancer support nurse, have been a huge help. Both pancreatic cancer UK and pancreatic action have also been great. Both charities work tirelessly for people living with and affected by pancreatic cancer, supporting innovative research to find breakthroughs that will help how pancreatic cancer is understood, diagnosed and treated. One example of that is PERT, pancreatic enzyme replacement therapy, a tablet that replaces the digestive enzymes that people with pancreatic cancer can no longer produce. Only one in three people with pancreatic cancer in Scotland are being prescribed PERT, but, fortunately, Scotland is acting on this issue and leading the way in transforming PERT prescription rates. I will finish with the simple and honest words from Jacqueline, which ring true for any illness, but even more so for pancreatic cancer, as it does not present in an obvious way. Jacqueline said to me, keep listening to your body and keep going to the doctor. Thank you, Deputy Presiding Officer. November is pancreatic cancer awareness month, and tomorrow is pancreatic cancer awareness day. I really welcome the opportunity to speak in this debate to show my support. It is a fantastic chance for the pancreatic cancer community to come together to raise awareness, funds and to remember loved ones who have sadly died of this disease. Raising awareness is key because two thirds of people in the UK cannot name a single symptom of pancreatic cancer. Even more worrying is that around half of pancreatic cancer patients will visit their GP with their symptoms three times before being referred to a hospital. Pancreatic cancer is the deadliest common cancer in Scotland, and only one in four people diagnosed survive beyond a year. 10,000 people across the UK are diagnosed each year, yet pancreatic cancer receives only 2 per cent of the national cancer research funding, despite being the fifth highest-killing cancer. Scotland is leading the way, as we have heard, in many pancreatic cancer innovations. For example, the PrecisionPank is a major research programme that is being developed and run out of Glasgow at the Beatson. It collaborates with world leaders from the University of Glasgow, the Cancer Research UK Beatson Institute, Cancer Research UK Cambridge, Manchester and the Institute of Cancer Research in London, the University of Oxford and the NHS. My life before this chamber allowed me unparalleled access to the surgical treatment of this deadly cancer. Working alongside upper GI consultants across the country, Ross Carter, as you have already mentioned, I know first hand of the complex nature of the surgery needed to treat this pancreatic cancer. Those are very much specialist surgeons that are dedicated and committed to adopting innovations to reduce surgical operative time even by the slightest margins and to seeking new ways to reduce surgical risk and post-operative complications. They work collaboratively across the NHS to do all that they can to ultimately increase the survival of their patients. However, the outcomes following this potentially life-saving surgery are still a long way from being acceptable. If diagnosed in time for surgery, the five-year survival increases to 30 per cent. In short, we need to diagnose people far earlier. If people can be diagnosed earlier, they will live longer and experience a far better quality of life. If you face a diagnosis of pancreatic cancer, as my friend's mother has, life stops, albeit briefly, and your family and friends must respond quickly, Mike had to come all the way back from Australia, and the only saving grace is that he was able to return to see his mum, because one year ago he would not have been able to do that. Such a diagnosis of pancreatic cancer can affect every aspect of life, bringing emotional, financial and practical problems that can last long after treatment ends. So if you are in this position and are listening to this debate today, can I take this chance to direct you to the practical, emotional and financial support that is offered by Macmillan Cancer? As a first step, they have a telephone helpline and it is 0808 808 000 or please go to their website for help. Finally, I want to turn to Clare Adamson for bringing this debate before Parliament to the debate and thanking her for helping to raise the awareness of pancreatic cancer. Thank you very much indeed, Ms River. I now call Marie McNair, who will be followed by Carole Mocken. Four minutes, please, Ms McNair. Can I begin my contribution by congratulating Clare Adamson for securing this debate? I know that she has a long-standing interest in this issue. I commended her initiative and her opening speech. It was a contribution made with compassion and real understanding of the issues. It is really important that we take this opportunity to not only recognise pancreatic cancer awareness month but that we strive to improve the response to this dreadful disease. For me, I have also used this debate to ensure that the voices of my constituents impacted by pancreatic cancer are heard in this chamber. As we know, this is the 10th anniversary of pancreatic cancer awareness month, with Thursday being marked as World Pancreatic Cancer Day. Over 9,000 people die of this disease annually across the UK, and that is often tragically within weeks of diagnosis. We need to raise awareness to save lives. We know that the public awareness levels are really low. 52 per cent of the public know almost nothing about the disease, and 73 per cent cannot name a single symptom. It is the lowest survival rate of all the cancers, mainly due to late diagnosis. My constituent, Kelly Martin, contacted me asking about raising awareness of pancreatic cancer. It is an honour to do so on her behalf in this chamber today. Kelly lost her mum, Helen Carson, in December 2020 to this disease, only three months after diagnosis. Helen worked at the STC for 40 years, a job that she enjoyed very much. She was also a very proud bankie born and bred. Kelly is pushing for better treatment nearer to people's homes and increased awareness of the disease. She feels that the general public and health practitioners alike need to be more aware of the signs and symptoms of pancreatic cancer to enable a quicker diagnosis. Also, her experiences have convinced her of the need for enhanced end-of-life care and support. Bethau communication and streamlined services are essential to help those impacted to enable them to use the time that they have left to greater effect. Helen attended the Victoria hospital in the Glasgow royal infirmary for further investigations, which left her exhausted and fatigued. As Helen's disease was found to be so far advanced, treatment with chemotherapy was not an option. Helen felt that, if this information was being available sooner, it may have allowed her to spend more precious time with her family. Another of my constituents, Kirstine Smiley, also wants more awareness of this terrible disease, to which she lost her father, Donald Langan. Kirstine's dad, Donald, had a bit longer with his family. He lived for a year and a half from first peak diagnosed. During those final ones, he had chemotherapy prior to extensive surgery, during which a number of his major organs were removed. Unfortunately, when the cancer returned to his lungs, he sadly only lived for a further nine days. Kirstine and her mum, Christine, Donald's beloved wife and her family continued to fundraise to help to raise awareness and continue to research into this terrible disease. They are currently taking part in pancreatic cancer UK's 10,000 steps a day throughout November. I wish her and all the family the very best in their endeavours. Those are real heartbreaking, real life experiences from some of my constituents that highlight how important early diagnosis is. We must ensure that compassionate care and support is there when people need it. As a member of the nursing team at the St Margaret's Scotland hospice, I saw firsthand how quickly patients deteriorated and died from the cancer. Unfortunately, late diagnosis resulted in palliative and end-of-life care, being the apparent patients-only options. Again, I will never forget the impact that the cancer had on families whose love, compassion and support was unwavering and selfless. That was reflected and recognised and attest to me I have given on behalf of my constituents. I welcome the debate and everything else that has been done to promote the importance of early diagnosis. I am humbled by the determination of my constituents to see more action on this front. In memory of those who have lost their lives to this terrible disease, we must collectively work together to do all that we can to increase awareness of this cancer and aim for more positive outcomes. I thank Clare Adamson for bringing this important debate to the chamber. On behalf of Scottish Labour, I am really proud to highlight the importance of pancreatic cancer awareness month and indeed the importance of marking world pancreatic cancer day tomorrow. Pancreatic cancer truly is one of the most aggressive cancers. Sadly, it is perhaps the deadliest common cancer in our country. It is one that often brings an abrupt end to life of those that it targets. At my local health board of Ayrsharnan, it has killed between 50 and 70 people every single year for the last decade. That is 50 to 70 families, devastating year after year. A close family friend died from this many years ago and I am sure today that he will be thought of by so many people and certainly with some very fond memories from my own parents and family. The Covid-19 pandemic has impacted our lives in many ways, but one of the most concerning impacts has been the reduction in cancer diagnosis at an early stage. Staff shortages, pressure on the NHS, long GP waiting times, amongst a host of other factors have contributed to figures that cancer research you call devastating. Admittedly, the context of a global pandemic has impacted the ability of health services across the world, but in Scotland we have to act with purpose to reverse those concerns. Resume early detection and give those who have cancer the best chance of life. However, it is absolutely devastating that, even after diagnosis and treatment, many of those diagnosed with pancreatic cancer are not given that chance of life due to symptoms not being noticed or treated with concern until too late a stage. It is important to highlight a further time that key symptoms of pancreatic cancer include abdominal or back pain, discomfort, unexplained weight loss or a loss of appetite, yellowing of the skin or itchy skin, a change in bowel habits, nausea or vomiting, and indigestion that does not respond to treatment. Just as importantly, it has to be made very clear to the public that even though under strain and still staff shortages, the NHS is open and accessible. If a member of public has concerns, it is better to have a medical examination than wait until it is too late. The importance of public awareness of symptoms and public awareness that treatment or examination is available to them should they need it cannot be understated. I think that we would all agree in the chamber that, if you are concerned, you should go forward. As Clare Adamson rightly mentions in her motion, despite some recent progress, there are survival rates for pancreatic cancer have been stubbornly somewhere for far too long and it is incumbent on all of us now to do more to act and to raise further awareness of this awful disease to help to secure the early diagnosis and treatment that can be so vitally important to someone's future. However, I would again, as I often do, bring to the attention of this chamber the health inequalities that underpin survival for cancer. It is again the case in Scotland, according to Public Health Scotland, that increasing areas of deprivation link to poorer survival rates for cancer and we must strive to do something about it. It is unjust and unfair in 2021 Scotland that this remains the case and much more work needs to be done to address the clear health, social and economic inequalities. That means that a person's postcode can come between a stronger or weaker chance of survival from a deadly disease. I would like to take time to thank those organisers that have done so much work to raise awareness of pancreatic cancer, as mentioned by many members. Their work cannot be understated or undervalued and, as parliamentarians, we must do all that we can to support them. As we hope to continue our progress from the Covid-19 pandemic, the Scottish Government needs to ensure that its priorities lie with addressing late diagnosis and focus on early intervention. Indeed, it must do more to tackle the widespread health inequalities which to this day remain a stain in our society and adversely impact those from the most deprived areas. Once again, I would like to wish all those involved in pancreatic cancer awareness month the very best and thank you, Presiding Officer. Thank you very much, Ms Malkin. Before I call Evelyn Tweed, I'm conscious of the number of members that still want to contribute to the debate, so I'm minded to accept a motion without notice under rule 8.14.3 to extend the debate by up to 30 minutes. I would invite Claire Adamson to move such a motion. The question is that the debate be extended by up to 30 minutes. Are we all agreed? Excellent. With that, we move on. Evelyn Tweed, who will be followed by Miles Briggs in four minutes. I am grateful to Claire Adamson for bringing this very important debate forward tonight to highlight pancreatic awareness month and to pancreatic cancer UK for the briefing. The last 18 months have seen the world thrown into an unprecedented public health crisis. As a result, there has been less focus on other illnesses and diseases. As other speakers have noted, sadly, the statistics show that, even without the additional strain on health services across the UK, pancreatic cancer is one of the deadliest and the hardest to detect. It clearly requires more attention. A main problem with this cancer is that it is difficult to diagnose. Even short delays between diagnosis and having surgery or chemotherapy drastically lower the chances of survival. According to the NHS Scotland informed website, in the early stages, a tumour in the pancreas does not usually cause any symptoms. The first noticeable symptoms such as back of stomach pains that come and go at unexplained weight loss can be caused by many different conditions. As a result, people commonly attend three or more GP appointments before hospital referral. Many are diagnosed through emergency presentation, leading to very poor outcomes. Nearly 1,000 people per year are diagnosed with pancreatic cancer in Scotland, with around 50 of those residing in 4th valley. In January, Stirling University student Keir Morton helped to raise thousands of pounds for pancreatic cancer research in memory of his dad, who died just over two weeks after diagnosis. In July, Jennifer Berner from Stirling also raised money for pancreatic cancer research after her mum died again less than two weeks after diagnosis. She had shown no symptoms at all other than exhaustion and loss of appetite. Our NHS does an incredible job in oncology and, of course, the support of Macmillan and cancer research is amazing, but there is so much more to do. We need to raise awareness of the use of pancreatic enzyme replacement therapy, or PERT, for short, with health professionals, which could help people to deal with that cancer. Education is key here. We know that dedicated research and awareness campaigns drove up early diagnosis of breast cancer. It has gone from being one of the most lethal cancers to one of the most treatable and survivable. A similar focus is now required on pancreatic cancer. The message is clear—early detection and treatment is essential. I welcome the Scottish Government's action plan for cancer services. Additional funding for our health boards will support better access to diagnostics and treatment, and the creation of early cancer diagnostic centres is a significant step forward. Patient pathways through cancer services help to define a patient's overall experience and access to treatment and, potentially, their outcomes. I therefore look forward to hearing of a successful redesign of the pancreatic cancer pathway. As we know, Scotland's general health, including cancer rates, are the result of decades of structural inequality that the Scottish Government continues to tackle, and we cannot be complacent. I also start by congratulating Clare Adamson on securing this evening's members' debate, and for all her campaigning that she has done with distinction over many years in this Parliament on the issue. As the co-convener of the Parliament's cross-party group on cancer, I am pleased to be able to take part again in this year's debate, as I have gone along with Clare every single year. I look forward to seeing lots of purple displayed across landmarks across our country and especially on social media, which I think has become even bigger hit as we aim to increase knowledge and understanding of this cancer. As with all cancers, early detection and intervention is critical. The five-year survival rate that members have touched upon for pancreatic cancer is as low as just 5.6 per cent still. For other more survivable cancers, as Evelyn Tweed has already pointed out, the average five-year survival rate is nearly 69 per cent. Arguably, early detection of pancreatic cancer is even more critical than other cancers, with a five-year survival rate increasing to around 30 per cent of those diagnosed earlier and those able to access life-saving surgery. It is of huge concern that 80 per cent of people with pancreatic cancer are not still diagnosed until that cancer has developed an advanced stage. Tomorrow is World Pancreatic Cancer Day, and the theme this year is about time. Improving awareness about the risks and symptoms of pancreatic cancer is crucial, and it is important that we all work to make sure that we improve those survival rates. I commend Pancreatic Cancer Action Scotland on their mission of making the 2020s the decade of change for pancreatic cancer. I think that that is something that we can all sign up to and all want to see. Over the last 50 years, there has been a lack of significant improvement in survival rates, and we need that concerted effort to ensure that more people can be diagnosed early and survive the disease. The last year and a half has been dominated by Covid-19, and the shift to which has focused our national health service on treating people for that virus has seen the public health messaging shift away from encouraging people to come forward and present with their concerns. I think that we all share the concern that that is going to impact on cancer outcomes across all cancers. Recent research by Pancreatic Cancer UK revealed that 31 per cent of Scots are saying that they are delaying seeking help for treatment. That is something that we need to turn around and make sure that the messages sent out that people should not be delaying taking those concerns to their GP and medical professionals. Of those, less likely to seek help, around half, 49 per cent said that they did not want to be a burden on the NHS, while a quarter, 24 per cent, said that they were still concerned about contracting Covid-19. So, making people aware that our NHS is up and running and wants people to present is so important. I hope that this debate really sends that message this evening as well. That people should be getting checked out if they are exhibiting any of the symptoms that other members have outlined. It is clear that we have a long way to go to improve survival rates at something that I do not think in all the debates that I have taken place. Sadly, we have not seen that 5 per cent get to 10 per cent to 15 per cent to 20 per cent. I would like if the minister is closing the debate tonight in pointing out where work is going to be taken forward to help to review patient pathways, because I think that that is one of the key things that we all want to see looked at specifically, especially post-pandemic. However, I want to take this opportunity to thank all those who have supported and campaigned over many years to support the work of pancreatic cancer UK. Kim Raehr in my constituent, the wonderful Linda Murray, all those people have done so much work. Sadly, they cannot be in the Parliament yet, next year, I am sure they will be. That is our hope as well. Claire Adamson did start by talking about hope, and I think that that is really important. For me, the person who really personifies that is our former MSP colleague John Scott. John is well and living a happy post-politics life to the full. Those examples of people who have fought pancreatic cancer are really important for so many people and families who are facing the hell of a pancreatic cancer diagnosis. I hope that today's debate to conclude, Deputy Presiding Officer, once again gives us the opportunity to highlight the great work of pancreatic cancer UK and the awareness month's principles and work. There is much progress that needs to be made in the years ahead, and I hope that MSPs from all parties across the chamber will continue to speak out and keep pressure on ministers. However, above all, I agree with what Claire Adamson laid out. There is hope, and we should all work towards a better future on that. Thank you very much indeed, Mr Briggs. I would ask you to convey our best wishes to John Scott. That is indeed good news. I call Gillian Martin, who will be followed by Sandish Gohani. Thank you, Presiding Officer. I want to thank Claire Adamson for, I think, it's her fifth consecutive year in securing this debate on pancreatic cancer awareness month. That dedication that she shows to this cause helps us to have a platform to raise awareness of this terrible disease and its impact on those who suffer from it and on their loved ones. I'm always very aware that when we read out statistics on pancreatic cancer or any cancer, but particularly this one, we'll have people watching the debate who've maybe just received a diagnosis or they're in treatment or they're close to someone who is. Mentioning the survival rates of this disease is really difficult to hear. Those with that diagnosis will be only too aware of what their diagnosis could mean for them. However, the reality of those rates makes it particularly important that we have this regular debate and we shine a light and we use the platform that we have on how we catch this disease early. I didn't speak in last year's debate but I sat and listened to every contribution and it was particularly poignant because John Scott was back in the chamber and he was looking a lot better and it's great to hear that he's continuing to do well because that does give us hope that this is a cancer that people can survive. Clare Adamson also talked about the vital research and clinical trial work. It was last year's debate at universities to improve future treatments and outcomes, in particular Glasgow University partnering with the Precision Pank platform, working with the Beatson hospital and other partner universities across the UK. This research is investigating the molecular profile of individuals with pancreatic cancer and is bringing that expertise from 20 UK hospitals offering clinical trials together. Those precision clinical trials use the genomics of the patient and their tumour and they're offering hope for that 85 per cent of pancreatic cancer patients who are not eligible for surgery and maybe we could get the future that Clare Adamson described where we don't have the statistics that we do now on it. As everyone says, early diagnosis of pancreatic cancer is literally vital and for those diagnosed in time for surgery that five year survival rate does increase by 30 per cent and I applaud the awareness raising campaigns of pancreatic cancer action in Scotland and of course I'll be sharing the material as widely as I can and it's important for us as MSPs to use our platforms to help our constituents know those early symptoms so that's how I'm going to end my contribution because you know people do watch those videos that we put up on social media so let's use the platforms to tell people what the symptoms are so get yourself to the GP if you have any of these symptoms if your back or stomach hurts could be a tumour that's pushing against nerves and organs near the pancreas and blocking your digestive tract and similarly if you feel bloated get it checked pancreatic cancer can cause digestive problems like gas and bloating and the build up of extra fluid in the abdomen loss of appetite indigestion nausea and constipation of diarrhea and if you're losing weight and you don't know why it could be because cancer is causing your body to burn more calories than usual and breaking down your muscle and decreasing your appetite and if your skin or eyes look yellow it could be jaundice caused by a tumour blocking the bile duct which should ordinarily be allowing bile to flow from your gall bladder into the small intestine so these are all things that you need to be aware of don't as Miles Briggs has said don't think that you shouldn't be going to see your doctor because within a pandemic these are all signals that something could be wrong hopefully there isn't anything wrong but you must get it checked out. Thank you Presiding Officer. Thank you very much indeed miss Martin and I call Sandra Sweep-Gilhane who will be followed by Emma Harper and Dr Gilhane four minutes please. I thank Claire Adamson for securing today's important debate and commender for a consistent campaigning on pancreatic cancer. Pancreatic cancer is Scotland's deadliest common cancer as we have been hearing and just under a thousand people in Scotland are diagnosed with pancreatic cancer each year with 10,000 across the UK. Despite only being the 12th most common cancer in Scotland, pancreatic cancer is responsible for the sixth highest number of cancer deaths, a significant disproportionate impact. As you may know, I still am a practicing NHS GP and I see first hand the truly devastating impact that pancreatic cancer has on patients and their families. A significant issue is that this disease symptoms are not widely known but as we've just heard from Julian Martin and from people around the chamber tonight, I'm hoping people that are listening and watching are able to understand those symptoms and I won't repeat them again. According to Pancreatic Cancer UK, two thirds of people in the UK cannot name a single symptom and as a result of this, 20% of people with pancreatic cancer are diagnosed at an early stage and seven in 10 people will never receive the treatment at all. Tratically, 80% of people are diagnosed when the cancer is advanced and too far for life-saving treatments and unfortunately there are no screening or early detection tests that we can do to try and diagnose this in advance. When I recently met with Pancreatic Cancer UK, the focus of our meeting was support because when you're diagnosed with a cancer that kills one in four patients within a month, you need all the support you can get but currently there are too many missed opportunities to provide emotional support that's needed and at key moments diagnosis beginning and end of treatment before and after surgery patients are really vulnerable and they need help because they struggle with their mental health. Discovering the poor survival statistics for pancreatic cancer is a difficult moment for any patient and one through which people need to be effectively and thoroughly supported with specialist mental health support. In my view, the most experienced people outside of those in the NHS to speak with is Pancreatic Cancer UK which has a dedicated helpline which Sue Webber has already read out and they're staffed by specialist pancreatic nurses who provide expert support with symptoms medication and anything in between as well as a much-needed listening ear and that's why I want to ensure that everyone with a diagnosis of pancreatic cancer is immediately signposted to Pancreatic Cancer UK support line and currently only 10% of people diagnosed with pancreatic cancer in Scotland currently access this free service and it's my mission today and it should be our mission over the coming year to drive up awareness of this service so that everyone with a diagnosis or even just a suspicion of pancreatic cancer gets the support they need from day one. We need to reach that remaining 90%. I want to see signposting to Pancreatic Cancer UK support line included as default in all communication shared with those who are diagnosed but I want to go further. When people are diagnosed with cancer, any cancer, I propose they are linked with the appropriate leading third sector organisation. Now this could be Macmillan Cancer support, bowel cancer UK, pancreatic cancer UK or other specialist services. I'd like to see all patients with cancer get the appropriate third party sector agency number, website and telephone number and a leaflet in the diagnosis letter that they get. I'd like to see that given to them in the surgery when they're with their doctor. This enables vulnerable patients to get wraparound support straight away and the special support that they need and can be given the time to speak by the nurses that man a lot of these telephone numbers. Minister, please could you take the suggestion and try to implement it because it would be a very cheap way of us getting help. I'd like to give apologies to the chamber for having to leave early but I must attend a Diwali event here hosted in Parliament but I felt it was very important to speak here. I was compelled to do so despite not being one of the Conservative members now to speak tonight. Thank you very much Dr Gilhane. I now call Emma Harper to be followed by Siobhan Brown again four minutes. I welcome the opportunity to speak in this important debate ahead of World Pancreatic Cancer Day on 18 November, which is tomorrow, and congratulate Claire Adamson who's sitting right in front of me for securing it. Claire has done a huge amount of work to raise awareness of pancreatic cancer and has led this debate each year since 2017. I'm also glad that Miles Briggs and Julie Martin have mentioned former MSP John Scott. It is good to hear how well he's doing and I want to thank all the clinicians and all the staff caring for people with pancreatic cancer and remind chamber that I am still a nurse many of these folks are my former colleagues. It is worth noting that the Covid pandemic has created many additional challenges for cancer services across Scotland and I agree with pancreatic cancer action Scotland that increasing awareness, encouraging awareness of symptoms earlier and improving pathways to diagnosis support and information and care is more important than ever before. If colleagues across chamber have stated that pancreatic cancer is currently the deadliest common cancer in Scotland with statistics indicating that 800 people die each year in Scotland within just two weeks of diagnosis, that's a pretty stark statistic. The Scottish Government have invested in research, recognition of the disease and less survivable cancers in the current recovery and redesign action plan for cancer services. The announcement of £653,000 funding to support the Scottish Hepato-Pancreato Billiary Network, improving pancreatic cancer pathways project, is extremely welcome. One example of research that I would like to focus my comments on, which Julie Martin has already touched on, is the PrecisionPanc platform. I spoke about this last year too. Not all pancreatic cancers are the same, presiding officers. PrecisionPanc clinical trials are delivered through the NHS and they match people who have a diagnosis of pancreatic cancer to the clinical trial most likely to work for them. Precision medicine is about tailoring treatments to an individual's cancer. Those trials, involved with chemotherapy, are based on the genomics of the patient and their tumour. The PrecisionPanc platform brings together expertise from the University of Glasgow, Cancer Research UK, Institutes at the Beastson, Cambridge, Manchester and Cancer Research Institute in London, University of Oxford and, of course, the wider NHS. There is excellent evidence that participation in clinical trials is associated with better outcomes for patients, so there can be optimism. Those types of clinical trials allow researchers across the country to share expertise and knowledge, as well as creating and sharing of infrastructure, leading to trials that are quicker to set up and recruit for. The PrecisionPanc platform has a proven track record of delivering positive outcomes and research for pancreatic cancer patients. Again, there can be optimism, as Claire Adamson has already stated. There have been development of biomarkers, of prognoses and response to treatment, and they have successfully identified why pancreatic cancer is resistant to some drug therapies. Current trials are the Primus 001 through to Primus 005, as well as the master protocol. Some trials are now reaching the clinical report stage schedule for early next year. That work is vitally important. I would ask the minister to give a commitment that the Scottish Government will continue to support it. Our one-ish, I would like to just briefly highlight on its issues facing constituents across Galloway when engaging in treatment for pancreatic and other cancers. People living in D&G, including Stranraer and Wignshire, despite living in one of the most remote and rural parts of Scotland, do not have access to non-means-tested travel reimbursement to and from treatment appointments outside D&G. I know that the minister is aware that I have been pursuing this, and I would ask that she continues to assist me in pursuing this for constituents. In conclusion, I again congratulate Clare Adamson on bringing this debate forward, and I welcome the work that is on-going to advanced treatment of pancreatic cancer, so we can continue to be optimistic. Thank you very much, Ms Harper. I now call the final speaker and the open debate should be on Brown for four minutes, please. Thank you, Deputy Presiding Officer. First, I would also like to thank Clare Adamson for bringing the support debate to the chamber and all the informed contributions to this evening. As we have heard, pancreatic cancer can be ruthless, and I recently was told a very touching story by a family who have been devastated by pancreatic cancer. They have given me permission today to share their story. Bridget was 79 when she died from pancreatic cancer just three months before her 80th birthday. She was at the mother of three and a grandmother to 13 and was back and forth to the doctors for two years. She was told that the pain in her back was due to wear and tear, that the night sweats were her age, that indigestion was a hiatus hernia, that weight loss was her diabetes, and that her low mood was because she was depressed due to caring for her husband. However, when a new doctor joined the practice, she was sent for an ultrasound, which detected black lesions on her liver. The consultant thought that it could be secondary cancer, which had spread from somewhere else, and Bridget was referred for an MRI scan. That never happened. Shortly afterwards, she was rushed to hospital, screaming an uncontrollable pain. She was diagnosed with pancreatic cancer and had spread to her liver and lungs. She died at home 40 days after the diagnosis. Tragically, 17 hours after Bridget died, her husband Dick passed away. The family said it was broken heart, watching his wife of 40 years suffer to this cruel disease. That was seven years ago, but for Bridget's family, the heartache continues daily. Have we made progress since 2014? We have heard from my colleagues today that the facts and figures surrounding pancreatic cancer, the most shocking of which is that it has a lower survival rate and of any of the most common cancers. If Bridget's story tells us anything, it is that early detection is key and that knowing the science is just as important. Pancreatic cancer UK report. Two thirds of people in the UK cannot name a single symptom of the disease, and we need to change that. However, could you spot them? Thanks to the earlier speakers today, we have heard of some of the symptoms, but it is important to reiterate them again. Back pain, stomach pain, weight loss, yellowing of skin or eyes, and there is one that Bridget had such as hot flushes, the shivers and indigestion. Thanks also goes to people like Gavin Oates, a trun-born author and comedian. Last year he was asked by pancreatic cancer Action Scotland to share the story of his father who died from the disease. Gavin set out to spread awareness of the symptoms and to encourage people to seek out a diagnosis. His father, Eric, died at just 65. He was given six months to live, but he fought bravely for 16 months. His symptoms presented as indigestion. The message that keeps being repeated today is that early diagnosis is key. Under Scotland's cancer recovery plan, three early diagnosis centres are being piloted across Scotland, including one at the hospital that I visited earlier this year. Under the Ayrshire and Arran health board, the centre is dedicated to early diagnosis, aiming to get patients tested and, if required, referred to as specialist in 21 days. This is a life-saving and will help to pick up cancer earlier if patients don't meet referral guidelines, non-specific symptoms like Bridget's weight loss and fatigue. We are getting better, but we have a long way to go. Let's look at Australia. Although Australia has one of the highest cancer rates in the world, it also has one of the lowest mortality rates of cancer. Why is that? According to the World Economic Forum, the answer is sound policy and planning. Every country needs a cancer control plan, which is monitored by data and aims to treat and prevent cancer. We need to continue to raise awareness of the signs of this cruel disease. We owe it to the people like Bridget and their families. The message again is now the signs, the symptoms, visit your doctor, trust your instincts. I want to thank Claire Adamson for raising this motion in the chamber today and for all of my colleagues' powerful and often personal contributions. It's wonderful to hear that John Scott is doing well. It's great to see so many members actively engaged in this debate, which has given us an opportunity to reflect on the work that we've achieved and what further work there is still to do. There are a few points that were raised that I would like to touch upon before we close off this debate. Before doing that, I want to make sure that the members know that the Scottish Government buildings will be lit up to raise awareness tomorrow evening on 18 November on World Pancreatic Cancer Day. Raising awareness of pancreatic cancer and its common symptoms—back pain, yellowing skin and digestion, tummy pain and weight loss—is absolutely crucial in detecting this cancer early. We know that earlier that cancer is detected, the easier it is to treat. That's why we continue to invest in our £44 million detect cancer early programme with an additional £20 million committed over the parliamentary term. We know that over the pandemic, our urgent suspicion of cancer referral rates fell below pre-Covid levels. In order to increase uptake, public awareness campaigns and messaging have run throughout the pandemic to encourage those with possible cancer symptoms to seek help. I'm pleased to say that our urgent referral rates are now above pre-Covid levels. I would absolutely encourage any individual who might be experiencing common symptoms of cancer to present to their GP. I want to let the chamber know that we will have a national awareness campaign on the NHS being open running from December this year, including a national door drop. Unfortunately, pancreatic cancer continues to be one of the less survivable cancers. Pancreatic cancer UK has stated that only one in four people diagnosed with pancreatic cancer survived beyond a year. The five-year survival rate is even fewer, with only 5.6 per cent surviving in Scotland, compared to the average five-year survival rate of 69 per cent for other more survivable cancers. It's for those reasons that we have focused on improving outcomes for the less survivable cancers in our national cancer plan. The Scottish Government works closely with a number of partners to raise awareness of pancreatic cancer and to improve their outcomes after diagnosis. Pancreatic cancer UK is a key partner alongside the less survivable cancer task force in continuing to push forward workstreams and to improve cancer outcomes. Over the course of the pandemic, we know that the need for further support of patients was amplified with third sector organisations such as pancreatic cancer UK, seeing a significant increase in helpline calls with a peak of 50 per cent increase. I thank our third sector partners for their continued work and support of cancer patients. In addition, we are working with the Scottish Hepatopancreato Billiary Network, SHPBN—I'll just use the acronym next time—to improve pathways across pancreatic and liver cancers. We have provided £653,000 of funding to that network over two financial years to redesign those cancer pathways, and that work is aimed to improve patient outcomes and experiences. We know that patients with a cancer diagnosis and those around them, as we've heard so powerfully in the chamber this evening, can be impacted mentally as well as physically from a diagnosis and subsequent treatment. The work of SHPBN is looking at investigative and diagnosis stage of the pathway, but in order to improve the pathway, there will be a new navigation team that will help to improve communications within the health service and directly with patients. That work is one step that we are taking to increase the support that is offered to patients. I hope that response to the points raised by Dr Gilhane. Alongside the work, the national cancer plan outlines the development of the single point of contact and our transforming cancer care partnerships with Macmillan's support. A single point of contact will help to ensure that patients are being supported in all clinical aspects, including mental health, along their cancer journey. We recently awarded funding to 12 pilot programmes that are based across the three cancer networks. In the Scottish Government's partnership with Macmillan, we will ensure that every cancer patient in Scotland has access to a specialist key worker who can provide emotional, financial and practical support to those who need it most. Further to providing patients with support, we must focus on the best available treatment. Many members will be aware of the pancreatic enzyme replacement therapy part. That therapy is a capsule taken that replaces the enzymes that your pancreas would normally make. If you have pancreatic cancer, taking pancreatic enzymes can help you to digest your food. However, as has been mentioned, not all patients are offered part at the point of diagnosis. That is for a variety of reasons. Those reasons could be legitimate. Perhaps the patients on a palliative care pathway or cultural preference. Equally, many pancreatic cancer patients present as asymptomatic, despite pancreatic exocrine insufficiency. Lastly, patients are diagnosed through lots of different pathways, so not all clinicians have the knowledge and experience to know about the importance of part. On the use of stereotactic ablative radiotherapy, Claire Adamson has raised it. I am pleased to inform the chamber that there was a project funded in the most recent funding round. Up to £1.6 million over two years has been committed, and we are taking a once-for-scotland approach to roll out this treatment across Scotland. The precision pan research, which was highlighted by a number of contributors, including Emma Harper, is led by a team at Glasgow University, and it is indeed absolutely world leading. Research into precision medicine remains a high priority for the Scottish Government. In order to inform best practice, the Scottish Government continues to learn from the best available evidence. As members have highlighted, the Scottish Cancer Patient Experience Survey, run in partnership with Macmillan Cancer Support, has a survivability bias. That survey is designed to be comparable with cancer patient experience surveys that are run in England and Wales. A change in methodology such as altering the sample population, certainly. Thank you very much, minister, for taking the intervention. Just on this survey, I wonder if the minister would have a look at the timescales in which the survey is actually delivered. As we have heard about the difficulties around pancatic cancer, very often patients have passed away in the timescale in which that is delivered. I wonder if that is something that she could reflect on. Absolutely. I am very keen to take that point on board. In order to capture the experience of patients with less survivable cancer, we are using tools such as care opinion and working with our third sector partners to collect the best evidence available, but I am happy to get back to Claire Adamson with any further evidence that we have. Members may be aware that NHS England has announced a new national pancreatic cancer audit, which NHS Wales is partnering with. Unfortunately, in Scotland, our partners in the Scottish HPV network have completed audits annually since 2010. The 2013 to 19 audits are based on quality performance indicators, including some specific to pancreatic cancer. Those annual audit reports are available on the SHPBN website. The 2020 audit is currently in progress. As we have heard this evening, the Scottish Government, along with all of us here, are absolutely committed to increasing awareness of pancreatic cancer and improving cancer parents' patients' experiences and outcomes. I want to thank all of our partners who help us in achieving those goals, from the clinicians working in the NHS, to our third sector partners who have been tirelessly supporting patients. Together, we can improve and achieve our ambitions.