English: I very much like the tone of the discussion today, because this is a really emotive issue. We've all got family or friends who have had or have cancer, so it's really important we are very measured in the way we discuss this. I think one of the biggest problems with cancer is that people are often very slow to come forward. People really do need to listen to their bodies and think, 'This is not normal, perhaps I need to go to the doctor.' And I think it's a well-known fact that men are much less likely to come forward quickly than women. But also I think people who have poor self-esteem, who have low expectations of what services are going to be able to do for them, just assume that it's part of their story and they just think, 'Well, I'm not feeling well, but nobody's going to do anything about it.' I think it must be really difficult for clinicians to be able to distinguish between the worried well and the reluctant visitor to the GP who may or may not be telling the clinician the full story and be thinking, 'Oh, I don't want to bother the doctor.' So, I think it is really, really difficult, and there's no point in everybody being sent off for a cancer test, because obviously that would completely clog up the services that people who really do have suspected cancer actually need. But it also requires the GP to think intellectually, 'Is this just something that a simple medication will resolve, or is there something more going on here? Has this person lost weight recently?' So, I think it's a very difficult issue and, in the end, we all die of something, and often we die of cancer because we've outlived our usefulness. But clearly, the worst types of cancer are those that are suffered by very young people, including children and young people generally, because the cancer is so much more virulent. I know somebody who's been living with prostate cancer for 15 years; this is quite normal if you're elderly. People do live with cancer perfectly okay with the support of appropriate treatment. I've got a friend, a close friend, who is dying of pancreatic cancer, which I'm aware is one of the most difficult cancers to treat, and so I was particularly interested in taking up the offer of a meeting with Pancreatic Cancer UK recently, and there was an expert witness involved who was the wife of somebody who had died of pancreatic cancer during the pandemic. It was really, really useful to listen to this person about the way in which her husband had been treated, how he had finally got round to seeing the GP during lockdown, but it was only at his insistence that he got to see the nutritionists, so I was very interested to read the national optimal pathway for pancreatic cancer, which unfortunately was published in February 2020 - not a good month for instituting change, for reasons we're all aware of. But I am very pleased to see that that pathway states really, really clearly that people should not wait for a local multidisciplinary team discussion before referring somebody to the local upper gastrointestinal cancer group, but also to the nutritionists. This is absolutely key in order to consider the administration of pancreatic enzyme replacement therapy, because by nature of having pancreatic cancer, your body is not capable of digesting food. It seems blindingly obvious, but I want to understand from the Minister why she thinks it is that only three in five people - according to the Pancreatic Cancer UK organisation - are getting PERT, which is the prions that you need. Because although it didn't save the life of the person whose widow was in the discussion, it did enable this man to have a reasonable quality of life while he was able to, in order to share meals with his family, and I think that that is absolutely crucial and is a good illustration of how treating cancer isn't just for the physician who is a specialist in cancer, but is for a whole multidisciplinary team of people, because it affects so many people. Thank you.
Welsh: Rwy'n hoff iawn o naws y drafodaeth heddiw, oherwydd mae hwn yn fater emosiynol iawn. Mae gennym ni i gyd deulu neu ffrindiau sydd wedi cael neu sydd â chanser, felly mae'n bwysig iawn ein bod yn ystyriol yn y ffordd rydym yn trafod hyn. Credaf mai un o'r problemau mwyaf gyda chanser yw bod pobl yn aml yn araf iawn i ofyn am gyngor. Mae gwir angen i bobl wrando ar eu cyrff a meddwl, 'Nid yw hyn yn normal, efallai fod angen i mi fynd at y meddyg.' Ac rwy'n credu ei bod yn ffaith hysbys fod dynion yn llawer llai tebygol na menywod o ofyn am gyngor yn gyflym. Ond hefyd rwy'n credu bod pobl sydd â lefelau isel o hunan-barch, sydd â disgwyliadau isel o beth y gall gwasanaethau eu gwneud drostynt, yn cymryd yn ganiataol ei fod yn rhan o'u stori ac maent yn meddwl, 'Wel, nid wyf yn teimlo'n dda, ond nid oes neb yn mynd i wneud unrhyw beth yn ei gylch.' Mae'n rhaid ei bod yn anodd iawn i glinigwyr allu gwahaniaethu rhwng pobl iach sy'n poeni a'r ymwelydd amharod â'r meddyg teulu a allai fod yn dweud y stori lawn wrth y clinigwr, neu a allai beidio â gwneud hynny, a meddwl, 'O, nid wyf am drafferthu'r meddyg.' Felly, rwy'n credu ei bod yn wirioneddol anodd, ac nid oes diben i bawb gael eu hanfon am brawf canser, oherwydd yn amlwg byddai hynny'n tagu'r gwasanaethau y mae pobl yr amheuir bod ganddynt ganser eu hangen mewn gwirionedd. Ond mae hefyd yn ei gwneud yn ofynnol i'r meddyg teulu feddwl yn ddeallusol, 'A yw hyn yn rhywbeth y bydd meddyginiaeth syml yn ei ddatrys, neu a oes rhywbeth mwy na hynny'n digwydd yma? A yw'r person hwn wedi colli pwysau yn ddiweddar?' Felly, rwy'n credu ei fod yn fater anodd iawn, ac yn y pen draw, mae pob un ohonom yn marw o rywbeth, ac yn aml rydym yn marw o ganser oherwydd ein bod wedi byw y tu hwnt i'n defnyddioldeb. Ond yn amlwg, y mathau gwaethaf o ganser yw'r rhai y bydd pobl ifanc iawn yn eu dioddef, gan gynnwys plant a phobl ifanc yn gyffredinol, oherwydd bod y canser yn llawer mwy ffyrnig. Rwy'n adnabod rhywun sydd wedi bod yn byw gyda chanser y prostad ers 15 mlynedd; mae hyn yn eithaf normal os ydych chi'n oedrannus. Mae pobl yn byw gyda chanser yn berffaith iawn gyda chymorth triniaeth briodol. Mae gennyf ffrind, ffrind agos, sy'n marw o ganser y pancreas, ac rwy'n ymwybodol mai dyma un o'r canserau anoddaf i'w trin, ac felly roeddwn yn awyddus iawn i dderbyn y cynnig o gyfarfod gyda Pancreatic Cancer UK yn ddiweddar, ac roedd tyst arbenigol yno a oedd yn wraig i rywun a oedd wedi marw o ganser y pancreas yn ystod y pandemig. Roedd yn ddefnyddiol iawn gwrando ar y wraig yn sôn sut y cafodd ei gŵr ei drin, sut y llwyddodd o'r diwedd i weld y meddyg teulu yn ystod y cyfyngiadau symud, ond dim ond am iddo fynnu y cafodd weld y maethegwyr, felly roedd gennyf ddiddordeb mawr mewn darllen y llwybr cenedlaethol gorau ar gyfer canser y pancreas, a gyhoeddwyd ym mis Chwefror 2020 yn anffodus - am resymau rydym i gyd yn ymwybodol ohonynt nid oedd yn fis da ar gyfer sefydlu newid. Ond rwy'n falch iawn o weld bod y llwybr hwnnw'n datgan yn glir iawn na ddylai pobl aros am drafodaeth tîm amlddisgyblaethol lleol cyn atgyfeirio rhywun at y grŵp canser gastroberfeddol uchaf lleol, yn ogystal ag at y maethegwyr. Mae hyn yn gwbl allweddol er mwyn ystyried rhoi therapi amnewid ensymau pancreatig, oherwydd mae natur canser y pancreas yn golygu na all eich corff dreulio bwyd. Mae'n ymddangos yn amlwg iawn, ond rwyf am glywed gan y Gweinidog pam ei bod yn meddwl mai dim ond tri o bob pump o bobl - yn ôl sefydliad Pancreatic Cancer UK - sy'n cael therapi amnewid ensymau pancreatig, sef y prionau sydd eu hangen arnoch. Oherwydd er na wnaeth achub bywyd y person roedd ei weddw yn y drafodaeth, fe wnaeth ei alluogi i gael ansawdd bywyd rhesymol tra gallai, er mwyn rhannu prydau gyda'i deulu, a chredaf fod hynny'n gwbl hanfodol ac yn enghraifft dda o sut y mae trin canser yn fater ar gyfer tîm amlddisgyblaethol cyfan o bobl, nid y meddyg sy'n arbenigwr canser yn unig, oherwydd mae'n effeithio ar gynifer o bobl. Diolch.