Mr. President, I rise, along with my Senate Cancer Coalition cochair, Senator Brownback, to introduce the National Cancer Act of 2007, a bipartisan blueprint for winning the war against cancer. It includes: grants for targeted drug…
Mr. President, I rise, along with my Senate Cancer Coalition cochair, Senator Brownback, to introduce the National Cancer Act of 2007, a bipartisan blueprint for winning the war against cancer.
It includes: grants for targeted drug development; creating ``cancer quarterbacks'' in Medicare; Medicaid coverage for smoking cessation treatments; pilot projects for expanding colorectal cancer screening in underserved populations; continued research into the possible benefits of early detection for lung cancer; loan repayment assistance for cancer prevention researchers; incentives for research into drugs that
prevent cancer from developing and spreading in the first place; provisions to promote the collection and storage of tissue sample, to give researchers the tools they need to use genomic research to create individualized cures; promoting access to clinical trials, as well as investigational therapies for those who are terminally ill; addressing the health needs of the growing number of cancer survivors.
Just over 35 years ago, President Nixon signed into law the original National Cancer Act, creating the National Cancer Institute and making cancer research a priority of the Federal Government. This work has led to tremendous breakthroughs against cancer, including innovative drugs, treatments, and a better understanding of the factors that lead to cancer in the first place. Last year, death rates decreased for 11 of the 15 cancers most common in men, and 10 of the cancers most common in women.
Sixty-five percent of people diagnosed with cancer can now expect to survive at least 5 years. This is good news. But it is not enough. The cost of cancer, in both human and economic terms, remains staggering.
An estimated 1,399,790 Americans were diagnosed with some form of cancer last year.
Approximately 1 of 3 women will develop cancer at some point in her lifetime; for men, the risk is slightly less than 1 in 2.
The National Institutes of Health estimated the overall cost of cancer in 2005 at $209.9 billion.
The price of inaction is too steep. Cancer is, first and foremost, a disease of aging. About 76 percent of cancer cases are diagnosed in patients at age 55 or older. If no fundamental changes are made, the aging of the Baby Boom generation will bring a 20 percent increase in cancer diagnoses.
In the face of these challenges, the National Cancer Institute, NCI, with broad support in the cancer community, set the ambitious goal of ending death and suffering from cancer by 2015. This goal has generated unprecedented excitement and unity, with over 80 Members of the United States Senate signing a letter in support of the effort.
It is time to reexamine and reorient our Nation's cancer policy to meet this ambitious goal. This does not mean that cancer will be eradicated by 2015. As our population ages, cancer will not go away. But we can change the meaning of a cancer diagnosis, and that is what the 2015 goal is about.
Meeting this goal will take a comprehensive approach. It requires detecting cancer earlier, before it spreads and becomes harder to treat. It requires targeted therapies, capable of killing cancer cells while leaving healthy cells intact. We must provide access to high quality cancer care for those who do get sick. We must also understand more about why people get cancer in the first place, and ways it can be prevented.
Our legislation takes a multifaceted approach to changing the very nature of a cancer diagnosis. The National Cancer Act of 2007 will do the following:
Authorize grants for the development of targeted drugs.
New drug therapies continue to lead us closer to the day in which cancer is a treatable, chronic condition controlled with a simple pill or injection. It has now been 5 years since the drug company Novartis won approval for Gleevec, a targeted drug that has saved the lives of countless patients with Chronic Myeloid Leukemia, CML.
Gleevec demonstrates the promise of this new kind of drug therapy. It blocks the enzymes that help cancer cells grow and divide, leaving healthy cells untouched. When this drug was first introduced, CML patients who were near death recovered and left the hospital. Yet it could not be determined if their remission would last, or if long-term use of this revolutionary drug would prove safe.
We now know that Gleevec is fulfilling this early promise. Before the advent of this drug, CML patients would often suffer a relapse after 2 or 3 years. But a recent study of CML patients taking Gleevec has demonstrated a remarkable 89 percent survival rate after 5 years. The cancer progressed to a more serious stage in only 7 percent of patients during this time period, and only 5 percent were forced to discontinue treatment because of side effects.
These results suggest that patients may be able to stay on Gleevec indefinitely, keeping this formerly deadly cancer under control while leading full and productive lives.
Targeted therapies are now offering hope to patients with many different kinds of cancer: Herceptin for some breast cancers, Iressa for those with small cell lung cancer, Avastin for colorectal cancer. Avastin can extend survival by interfering with the growth of blood vessels that feed the tumor, literally starving it.
These drugs are the future of cancer research. We need more drugs like Gleevec, which transform cancer from a killer to a controllable health condition. This legislation would authorize NCI to make grants to further develop these treatments.
To help with the development of targeted drugs, the bill also calls for the establishment of a task force on surrogate endpoints and biomarkers. They are the mechanisms for measuring the efficacy of cancer treatment at the molecular level, allowing doctors to precisely gauge how a patient is reacting to a treatment, or if a cancer is progressing.
Developing biomarkers for different types of cancer is an essential step, and our bill will establish a program to develop the biomarkers with the most immediate clinical promise.
The bill will also create special reimbursements for coordinating physicians, or ``cancer quarterbacks'' in Medicare. Successful cancer treatment is increasingly complex, reaching across the entire spectrum of the medical profession. It can involve lab tests, CT-scans, surgery, chemotherapy, and a full team of specialists who offer this care. Many patients have no single physician who can guide them through the complicated and sometimes contradictory course of cancer treatment, no professional to advise them what is best.
This bill would require Medicare to pay oncology doctors or nurses to become the overall managers of patients' care, in effect providing every cancer patient with a ``cancer quarterback'' physician to help them coordinate care and make the necessary decisions.
This cancer quarterback can direct care in the manner that best meets the patient's needs, instead of focusing on only a small segment of his or her care.
This legislation requires that State Medicaid drug programs cover smoking cessation treatments in the same manner as all other approved therapies. I have long believed that we will not truly address the burden of cancer until we address tobacco use. I have asked all kinds of cancer experts about what we can do to stop death from cancer, and their answer is always the same: Stop tobacco use.
Tobacco causes 30 percent of cancer deaths and 1 in 5 of all deaths in the United States. It is the leading cause of preventable death. Smoking related costs total $167 billion annually.
According to the CDC, more than 70 percent of American smokers would like to quit. Studies indicate that tobacco use treatment, including smoking cessation aids, will double their chances of success.
Yet under current law, State Medicaid programs are exempted from providing coverage of smoking cessation agents in the same way as they provide coverage of other drugs. Other exemptions include fertility treatments, drugs to promote hair growth, and drugs for erectile dysfunction.
Simply put, smoking cessation aids, which are FDA approved and proven to be effective, do not belong on this list. Denying people access to treatments to help them break a deadly and expensive addiction is flawed policy.
Our bill will remove tobacco cessation products from this list of exemptions, leveling the playing field with other FDA approved products.
Our bill establishes pilot projects for expanding colorectal cancer screening for low-income, uninsured individuals. The Breast and Cervical Cancer Early Detection Program has proven very successful in providing low income women with access to potentially life saving screenings. It is now time to provide similar access to colorectal cancer screening.
The need is great. A 2006 study conducted by Northwestern University researchers found that only 7 percent of minority patients without regular
health care access at risk for developing colon cancer are being screened. A 2005 study of New York City residents found that those least likely to have been recommended colorectal screening are low- income or uninsured.
Early detection allows physicians to identify patients with pre- cancerous polyps, and treat them before cancer even develops. These pilot projects identify the best ways to provide access to this lifesaving care for those who are not currently receiving recommended screenings.
This bill will authorize continued research on the potential of CT scans to detect lung cancer early. before it becomes fatal. Despite all the promising advances against many types of cancer, lung cancer remains the Nation's leading cause of cancer death in both men and women. About 20,000 people who have never smoked are diagnosed with lung cancer each year, and this number is increasing.
We need to learn more about how to screen for lung cancer and detect it early, before it has advanced. There is much we need to learn before scientists can make a definitive recommendation about screening and its potential benefits for both smokers and non-smokers.
To help scientists learn more, this bill will authorize funding to provide CT scans to those with a history of heavy smoking. This further study will help determine whether this promising technology is indeed the method we need to make progress against the leading cancer killer.
This legislation expands the existing NIH loan repayment program to provide assistance to researchers who make a commitment to working on cancer prevention research. This will encourage the best and brightest to pursue work that will help us to better understand what causes cancer and how we can stop it from occurring.
The bill will encourage and support research into new drugs and treatments, called chemopreventatives, which can stop precancerous cells from becoming tumors. Decades of research has enabled physicians to prescribe medications to prevent serious illness, such as statin drugs to lower cholesterol, and drugs to treat high blood pressure before it leads to strokes.
Progress in drug development to stop cancer has been far more limited. The promise of this field was made clear when, last year, the Food and Drug Administration, FDA, licensed Gardasil, a vaccine to stop the spread of cervical cancer. Gardasil protects against the two forms of the human papillomavirus, or HPV, which causes approximately 70 percent of cervical cancer cases. This vaccine could virtually eliminate cervical cancer during the lifetime of our daughters and granddaughters.
We need more chemoprevention techniques like Guardasil to guard against other types of cancer. People at high risk for a specific type of cancer may one day take a daily pill to stop abnormal cells from progressing to full blown cancer. Though it will take a long time for these promises to become reality, this research is the future of cancer care.
In order to encourage this work, our legislation would grant Orphan Drug Act protections to treatments designed to treat high-risk conditions in individuals who have not yet been diagnosed with cancer, but if left untreated, face a high risk of developing cancer.
This research will require new resources in order to have the best chance of success. To build the foundations for success, our bill will encourage biospecimen collection.
Scientists are beginning to understand the significant role that genetics plays in the development of cancer. To encourage further study, scientists need access to a variety of tissue, blood, and other samples from both cancer patients and those who are healthy. Our bill codifies guidelines for the collection of these samples and requires that the Medicare Payment Advisory Commission, MedPAC, draft a report examining potential payment systems for these activities.
We are on the cusp of an age of personalized medicine, in which a cancer patient's tumor can be analyzed to determine what type of treatment will be most effective. Patients will no longer undergo round after round of chemotherapy or radiation in the hopes of finding a treatment regime that works. Collecting and storing blood and tissue samples will provide our researchers with the materials they need to make these important discoveries.
Our bill will promote clinical trial enrollment. Patients willing to try these cutting edge cancer therapies as they emerge face a variety of obstacles. They, or their physicians, might not know what clinical trial opportunities exist. They may need to travel to a far away facility to participate. Our legislation requires the Director of the National Cancer Institute to create a clinical trials program, which includes: an outreach program, to assure that all patients, especially minorities, participate in trials; and a coordination program, to help patients with logistical challenges and the support costs of trial participation.
Our bill creates an oncology compassionate access program. No patient should lose a battle with cancer because bureaucratic hurdles denied him or her access to a potentially lifesaving therapy. Our bill provides for the creation of a new compassionate access program to speed access of investigational therapies for terminally ill patients who have exhausted all other available treatment options.
Our bill will address the needs of a growing number of cancer survivors. As cancer increasingly becomes a manageable, chronic condition, there will be an increasing number of cancer survivors confronting yet-unknown health challenges. Current cancer survivors number almost 10 million, and this number will only grow. This bill will: expand current cancer surveillance systems to track the health status of cancer survivors; implement a national cancer survivorship action plan, including post treatment health programs; require States to consider the needs of cancer survivors, and their families, in addition to current patients, when drafting their comprehensive cancer control plans.
Require the National Cancer Institute and the National Institute of Environmental Health Sciences, NIEHS, to report on their strategies, benchmarks, and progress in meeting the 2015 goal. This will allow Congress to adjust policy as necessary to ensure that the promise of ending death and suffering from cancer is realized.
The state of cancer care has changed drastically since 1971, and it is time that our Federal policies reflect these changes. The 2015 goal is ambitious, and it requires no less than ambitious legislation in response.
I urge you to join me in supporting this legislation.