Hansard

I, too, thank my colleague Marie McNair for bringing the motion to the chamber, and I welcome the opportunity to close today’s debate on cholangiocarcinoma. I also acknowledge the valuable contributions that my colleagues have made tonight, especially as this is liver cancer awareness month.

Even though it is estimated that one in two people will develop cancer in their lifetime, the reality of receiving a diagnosis of cancer can still come as a complete shock, especially for the rarer cancers such as cholangiocarcinoma.

Liver cancers continue to have a devastating impact on far too many individuals and families across Scotland. As members will be aware, the Scottish Government published our ambitious 10-year cancer strategy in June 2023. We remain determined to improve cancer survival rates and to provide excellent and equitable care for all people who face cancer. At the forefront of that strategy is a dedicated focus on the less survivable cancers, including liver cancer, and improving outcomes for people who are affected.

Earlier this year, I had the privilege of speaking at the rethink liver cancer reception, which was hosted by AMMF and sponsored by my colleague Ben Macpherson MSP. As other members have done, I welcome Benjamin Carey to the gallery, as well as Ann and Derek Winter. It was a deeply moving experience to meet them and families affected by cholangiocarcinoma. I heard at first hand about the challenges that they face. I also thank Jeremy Balfour for sharing his constituent’s experience and I ask Mr Balfour to pass on my thoughts to his constituent, as I am sure that everybody else in the chamber would wish to do.

Cholangiocarcinoma is a lesser-known and rarer cancer, so taking the opportunity in the chamber today to raise awareness of its common symptoms is vital to improving outcomes. I am thankful to my colleagues who have done that so eloquently.

We all know that the sooner cancer is detected and diagnosed, the better the outcome for the individual. Our earlier cancer diagnosis vision underpins our investment in a range of programmes aimed at supporting earlier diagnosis and ensuring that people receive timely and effective care. Our detect cancer earlier programme “be the early bird” continues, and the latest campaign, which was launched last month, encourages individuals aged 40 and over, particularly those in more deprived communities, to feel confident in seeking help with possible cancer symptoms. As Carol Mochan stated, we must ensure that we consider all groups in our society so that we avoid inequalities.

In August, we published the refreshed Scottish referral guidelines for suspected cancer, which are designed to support primary care clinicians in recognising symptoms that may indicate cancer and to ensure that people are on the right pathway at the right time. For the first time, those guidelines include criteria for non-specific symptoms. That update is especially important for rare or lesser-known cancers such as cholangiocarcinoma, where early signs, such as unexplained nausea or weight loss, can be subtle and easily missed. They are, as Elena Whitham described them, symptoms hiding in plain sight.

This year, we also launched Scotland’s sixth rapid cancer diagnosis service. Those services rule cancer in or out more quickly for those with non-specific symptoms. Additionally, a primary care cancer education platform called GatewayC was launched across NHS Scotland in April 2024. It provides innovative and tailored information to support earlier cancer diagnosis efforts and enable effective decision making. That free online platform is accessible to all primary care clinicians and includes information about liver cancers.

The Scottish Government has provided more than £14 million of funds in 2025-26 to reduce cancer waiting times across NHS Scotland, directing that work towards the most challenged pathways. We have also committed to additional funding for chemotherapy services that will reach up to £10 million a year by 2027, with £6.6 million being provided in 2025-26. By continuing to invest in cancer services and by reducing waiting times, we will detect cancer earlier and faster so that we can improve outcomes for people.

We have commissioned the Scottish HepatoPancreatoBiliary Network to lead the development of standardised pathways for HPB cancers. That work has been carried out in collaboration with the Scottish cancer network, the national centre for sustainable delivery and third sector partners, and includes reviewing existing clinical guidelines, identifying gaps and aligning best practice across Scotland. Tumour subtypes, such as bile duct cancers, will be included. That work is progressing at pace, and we expect the HPB network to work with the centre for sustainable delivery, which will separately be delivering the optimal diagnostic pathway for upper gastrointestinal cancers, including HPB, in 2026.

I understand the importance of expanded genomic testing for people with cholangiocarcinoma and the direct impact that that has on their care and their access to life-saving precision medicines. That was made very clear to me at the event in Parliament earlier this year.

Members will be aware that a wider programme of laboratory transformation and investment planning is under way to support a sustainable expansion of genomic testing. That is part of our long-term approach to deliver bold and ambitious action to reform and renew Scotland’s health and care systems.

However, recognising the importance of that test to cholangiocarcinoma patients and their families, I have asked the NHS National Services Scotland, as the commissioner of genomic testing, to bring that testing into service ahead of the wider reform programme. Implementation planning within the service is now progressing rapidly and I will be able to provide members with an update before the end of this year. Although I understand the impact of any further delay, I assure members that we are doing all that we can to bring that testing to the people who need it as quickly as possible.

I sincerely thank those who provide valuable information, help and support to anyone who is affected by cholangiocarcinoma or liver cancer. The Scottish Government and our NHS continue to work closely with third sector, community partners and social care partners to deliver our ambitious cancer strategy. We know that research is key to advancing how we prevent, diagnose and treat all forms of cancer and that it is of particular importance to cholangiocarcinoma.

I take this opportunity to recognise the significant investment that AMMF has made in both international and UK research institutions to fund research teams that are working to uncover the causes of cholangiocarcinoma, improve early diagnosis and develop more effective treatments. That includes nearly £150,000 that has been invested in Scottish institutions to fund cholangiocarcinoma-specific research, such as the trial in Glasgow that many of us have heard about today. I am pleased to learn that some patients have benefited from that trial, and it further reinforces our commitment to expanding genomic testing across Scotland, as I mentioned earlier.

I extend my thanks to all the third sector organisations, including AMMF, for supporting patients and families who are affected by cholangiocarcinoma, and to members for their contributions tonight. I look forward to working with them all to improve awareness, earlier diagnosis and outcomes for those who face less survivable cancers such as cholangiocarcinoma and to give those people hope.