Meeting of the Parliament 20 November 2025
I am grateful to Clare Adamson for securing this important debate, which marks world pancreatic cancer day during pancreatic cancer awareness month.
It is not the first time that I have spoken on this subject in the chamber. As deputy convener of the cross-party group on brain tumours and a member of the cross-party group on cancer, I have always maintained that raising awareness of all cancers is vitally important. As MSPs, we are privileged to have not just the opportunity but the duty to raise awareness.
At this point in the debate, there will always be repetition of statistics, but I make no apology, because highlighting them is so important. Pancreatic cancer is one of the six less survivable cancers and is known as a “silent killer”, because its early symptoms are difficult to spot. The grim reality is that only one in four people diagnosed survives more than a year. In Scotland, survival rates remain among the worst in Europe—we are 35th out of 36 comparable countries—and that is unacceptable.
Around 900 people are diagnosed in Scotland each year, and more than 10,500 across the UK. Tragically, half of those who are diagnosed in Scotland will die within three months and 93 per cent within five years. With incidence rising, pancreatic cancer deaths could soon overtake breast cancer deaths.
One of the major areas of concern is improving pathways for people with pancreatic and liver cancer. Scotland has been leading the way through the then—this is where I get tongue-tied—pancreatic and hepatocellular carcinoma pathway improvement project, whose work was peer reviewed and published in the European Journal of Surgical Oncology. The project has delivered statistically significant improvements across all seven key performance indicators for pancreatic cancer, reducing staging times and improving communication. It proved that expedited diagnostic pathways save lives. However, that service was closed—twice.
We cannot afford to lose momentum. The Scottish Government must act faster, by building on what has worked rather than starting from scratch. Late diagnosis remains a critical factor in influencing outcomes. We need urgent action now, and we need earlier and faster diagnosis, quicker pathways and greater investment in research. Lives depend on that. There is hope. Scotland is working on a national optimal diagnostic pathway for HPB cancers, but time is of the essence. Pancreatic cancer is different—it moves fast, and every delay costs lives.
Previously, I raised awareness of a major problem in Dumfries and Galloway, which was the lack of hospice care. With around 1,200 new cancer diagnoses in D and G each year, the need for accessible, compassionate support has never been greater. That is why I supported efforts to establish a Maggie’s centre in Dumfries, which is the home town of the charity’s founder, Maggie Keswick Jencks. Earlier this year, I was delighted to hear the announcement that a new cancer support centre will be housed locally. That is a giant step forward, because Maggie’s centres across the country are renowned for their holistic approach to cancer care, and having one in Dumfries will make a profound difference to those who live locally.
Returning to pancreatic cancer, the Less Survivable Cancers Taskforce recommends that the Scottish HPB cancer service should become a national initiative, not a regional model. I fully support that, as I did last year.
As I stated in my members’ business debate on rural healthcare yesterday, equity is essential in healthcare. In this instance, equity of access is key—ensuring uniform care across all regions, including Dumfries and Galloway.
Education must be one of the most powerful weapons. Raising awareness is critical, not just for early detection but for improving patient experience and outcomes. I will repeat the symptoms: yellowing of the skin or eyes; darker urine; paler stools; itchy skin; loss of appetite or unexplained weight loss; fatigue; lack of energy; and a high temperature or feeling hot and shivery.
Regrettably, our understanding of the disease is limited, but we know that smoking, obesity and family history increase risks.
Many of us have lost family and friends to pancreatic cancer. Today, on world pancreatic cancer day, once again, I will take the opportunity to remember my pals, Mark Caygill and Peter Murray Usher. This is the most difficult part of any speech—it is not about stats. They were taken far too young. The man who was my mentor, a dear friend and the person who is ultimately responsible for me being here in this place today, is a former Presiding Officer of the Scottish Parliament, Sir Alex Fergusson, who died of cancer only a few months after retiring.
This is Scotland’s deadliest common cancer, so we cannot accept the status quo. We must act urgently, collectively and decisively, because lives depend on it.