107th Congress

Renewing the Cancer Fight: Updating the National Cancer Act -- Hearing Before the Senate Cancer Coalition -- October 10, 2001

Members Present

Senator Dianne Feinstein (D-CA), Co-Chair, Senate Cancer Coalition; Senator Sam Brownback (R-KS), Co-Chair, Senate Cancer Coalition; and Senator GORDon Smith (R-OR).

Witnesses

John R. Seffrin, Ph.D., Co-Chair, National Cancer Legislative Advisory Committee, CEO, American Cancer Society; Vincent Devita, Jr., M.D., Co-Chair, National Cancer Legislation Advisory Committee, Director, Yale Comprehensive Cancer Center; George F. Vande Woude, Ph.D., Director, Van Andel Institute; Anna D. Barker, Ph.D., President and CEO, BIO-NOVA, Inc.; Amy S. Langer, Executive Director, National Alliance of Breast Cancer Organizations

Summary

Purpose of Hearing: The Senate Cancer Coalition convened the hearing to discuss a report from the National Cancer Legislation Advisory Committee (NCLAC) entitled, “Conquering Cancer: A National Battle Plan to Eradicate Cancer in Our Lifetime.”

Opening Remarks: Senator Feinstein welcomed the witnesses and those in attendance. Some of the key issues and remarks in her opening statement included:

• The report represents a roadmap for conquering cancer, once and for all. It lays out 12 broad priority actions, with 34 more specific underlying recommendations.
• During her lifetime we can find a cure for cancer.
• We must move ahead on all fronts in the fight against cancer: translational research, training of researchers and a cancer workforce, accelerating drug approvals, access to care, quality of care, and preventing cancer.
• Mentioned that cancer had touched her and her family.

Statements of Witnesses:

John R. Seffrin: Dr. Seffrin opened the testimony by thanking Senator Feinstein for her vision in being the driving force behind NCLAC; and he thanked several of the NCLAC committee members present in the room.

Vincent T. Devita, Jr.: Dr. Devita began his testimony with a summary of the progress in the war on cancer. Despite the achievements during the past 30 years, the battle is far from won. This year alone, cancer will claim, on average, the lives of 1500 people each day. Thirty years of research, information, and dedication to the war on cancer has set the stage for an unprecedented array of scientific advances and opportunities. To realize the current scientific opportunities, NCLAC determined that we must address all parts of the interdependent cancer system. Those parts include discovery, translation, access, and delivery.

George F. Vande Woude: One overarching recommendation from the panel is for the President and Congress to continue on the current path to double the NIH budget by FY 2003. Dr. Vande Woude then outlined three goals in the discovery portion of the plan. Goal 1 had three recommendations: 1) fund the NCI Bypass Budget now and in future years, 2) increase NCI research investment to 40 percent of approved investigator initiated research and program project grants, and 3) NCI should conduct a 5-year demonstration project to modernize its administrative structure.

Dr. Vande Woude stressed that Goal 2 in the discovery portion of the plan ranked the highest. This goal called for greater emphasis on recruiting and training future cancer researchers and creating incentives for these researchers. Such incentives included a medical school debt foregiveness program, salary increase for postdoctoral cancer research fellows, and insurance coverage for researchers.

The third goal of discovery is to increase funding for cancer research that studies how the complex interactions between environmental factors and gene functions influence the risk of cancer.

Anna D. Barker: Dr. Barker focused her testimony on the goals of Chapter 2 in the NCLAC report entitled, "Translating Scientific Discoveries Into New Cancer Medicines and Technologies." The first goal is to enhance our cancer research centers to build a multidisciplinary network of translational centers. The second goal is to streamline and accelerate the FDA's approval system for cancer drugs, biologics, devices, and technologies. The third goal is to empower Federal agencies to build public-private partnerships across the entire continuum of cancer research.

Amy S. Langer: Ms. Langer opened her testimony by reading a prepared statement on behalf of Susan Parsons, M.D. Ms. Langer's testimony focused on the last three goals in the NCLAC report. Ms. Langer called for a collaborative state-based action plan and called on the state health departments, Indian Health Service, CDC, HRSA, and NCI to create an even more effective, coordinated local effort.

Ms. Langer mentioned the need for better standards for quality care and cancer surveillance. She called on the Agency for Healthcare Research and Quality to expand its efforts in collaboration with the cancer community. She called on America's leaders to implement a National Cancer Prevention Initiative where every person is offered the chance to improve nutrition and increase physical activity.

Questions and Answers:

A question and answer session followed the testimony by the witnesses. Some of the key points are highlighted below.

Senator Feinstein asked the witnesses to comment on the next steps to undertake after the doubling of the NCI budget in FY 2003. Specifically, she mentioned a suggestion of tripling the tobacco tax and how that extra money could be used in the war on cancer. Dr. Devita suggested expanding Medicare to cover anyone diagnosed with cancer so that all populations would have access to cancer treatments. He stated that a 20 percent reduction in cancer mortality would lead to a net increase of $10 trillion to the economy. Furthermore, he suggested that extra money be used to support state cancer control plans. Dr. Barker called for more money to support cancer research training. She stated that there are not enough cancer researchers now and there will not be enough researchers in the future. She suggested using extra money to increase the salaries of post-doctoral researchers as well as other incentives like student loan forgiveness.

Senator Brownback specifically asked why cancer research is unattractive to researchers. Dr. Barker pointed again to lack of adequate pay and incentives. Dr. Devita suggested that there was a need for more collaboration between the public and private sector, which he pointed out would not cost any more money.

Senator Feinstein stated that she noticed a natural competitiveness among researchers in the cancer community, especially now that the Government isn't the only one conducting research. She stated that there was less competition when only the Government conducted the research.

Senator Feinstein thought the committee's recommendations were too vague and that more specific recommendations from the committee were needed. She wanted hard numbers for some of the proposals, especially cost accounting for the suggestion of expanded Medicare coverage. She stated that the next step should be a more detailed plan and that she needed the cancer community to be in agreement and have a unified plan. Dr. Devita responded by saying he did not think it was the committee's task to do cost accounting; although, he agreed that another committee should do this. He also mentioned that a specific recommendation would be to better fund the cancer centers, which are woefully under funded at $150 million per year.

Senator Feinstein was apprehensive about the suggestion of expanded Medicare coverage because she believed that every other disease would want the same coverage. She also stated that Medicare was a sensitive issue and that expanded coverage may not be realistic. Dr. Devita responded that cancer is different from other diseases because by understanding cancer we understand life. He also reiterated the earlier statistic about reducing cancer mortality.

Senator Feinstein asked if the 12 challenges presented in the report were in a priority order. She started to go through the list and address each one. She said that getting the Bypass Budget was unrealistic. She stopped and suggested the committee submit its top three priorities and what it would cost to implement them. She also suggested more specifics were needed for each of the 12 challenges.

Prepared by: Scott Marchand/OLCA/NCI