Forging a New Plan to Battle Cancer - The Sacramento Bee

A groundbreaking study released last month revealed a new piece of the cancer puzzle. Researchers found that the number of breast cancer cases diagnosed between 2002 and 2003 had dropped by an unprecedented 7 percent. This drop, the researchers believe, could be directly related to the decreased number of women using hormone replacement therapies. This latest news takes us one step closer to understanding breast cancer and finding a way to stop it.

Discoveries like this show that we are on the cusp of a bright new day in the fight against cancer -- a day when death and suffering are no longer the unavoidable outcome of a cancer diagnosis.

But this nation needs a new battle plan. The National Cancer Act, which dictates the federal government's involvement in cancer research and treatment, remains largely unchanged since it was signed into law in 1971.

That's why I am working with Sen. Sam Brownback, R-Kan., to forge new legislation to make the elimination of cancer death and suffering a top priority. This legislation will reflect new advances in molecular biology and the human genome, as well as a deeper understanding of cancer.

The National Cancer Institute, with wide support from the cancer community, believes the elimination of death and suffering from cancer could be a reality by 2015. The disease won't disappear, but the meaning of a cancer diagnosis would be drastically changed. Cancer would not be a death sentence for so many, but a disease that can be controlled and managed.

It is my great hope that this goal is reached. Like millions of Americans, I have been touched by this disease. I have lost family members and close friends. I have witnessed the suffering that cancer patients endure. I have felt the pain of loss.

Just a year ago, my stepdaughter was diagnosed with breast cancer. She went through chemotherapy and radiation, and today, she is doing fine. My stepdaughter represents a new generation of cancer patients: a generation of survivors. She is one of millions who may have beaten cancer.

This is a result of enormous strides in research and treatments. Targeted drug therapies, for instance, are transforming cancer from a killer to a manageable health condition. They are designed to kill only the bad cells, not the good ones. Therefore patients do not experience hair loss and nausea from standard chemo.

One striking example is a drug called Gleevec. For five years, patients with chronic myeloid leukemia have been using Gleevec. The drug has helped patients who were near death to recover. And it's proving to be more than a short-lived mirage. A new study of patients taking Gleevec has demonstrated a remarkable 89 percent survival rate after five years.

This is not the only promising new drug. There are dozens of targeted drug therapies for many different kinds of cancer: Iressa for those with small cell lung cancer, Avastin for colorectal cancer and Herceptin for some breast cancers. These drugs are the future.

So now is the time to build on these successes and develop a comprehensive plan. The National Cancer Institute's goal of eliminating death and suffering from cancer by 2015 is ambitious. But I believe it can be reached. But many obstacles must be overcome.

First, we must learn to detect cancer earlier, before it spreads. This is critical, because only 10 percent of cancer deaths come from the primary tumor. So we need to develop early detection tools for ovarian cancer, lung cancer and other leading killers that are often found too late.

Second, we need to better understand why people get cancer in the first place and ways it can be prevented. This requires a major investment in basic scientific research.

Third, we have to improve research into the most virulent and intractable forms of cancer. The five-year survival rate for all cancers has reached a remarkable 64 percent, yet only 4 percent of patients diagnosed with pancreatic cancer will survive five years.

Fourth, income-based and racial disparities must be reduced. More than 46 million Americans are uninsured, and many of them forgo screenings. Ability to pay should not determine a person's chance of surviving cancer. Similarly, the toll of cancer varies widely by racial group and ethnicity. African-Americans, for instance, have the highest rate of cancer mortality; they bear a disproportionate burden.

There is much we still do not understand about these disparities and the ways in which genetics, the environment and culture intertwine to create them.

And finally, we need more information about the lifelong health risks posed to cancer survivors. A 2004 report found a record 9.8 million cancer survivors in the United States. But there are many unanswered questions about the long-term needs and health challenges these survivors face.

The legislation I intend to introduce seeks to tackle these challenges by reorienting our nation's cancer policy. We need a significant federal investment and a comprehensive plan to direct this investment.

Here's what the legislation would do:

  • Bolster the cancer care workforce by expanding the existing education loan repayment program to include post-doctoral students who make a commitment to cancer research. This will help to encourage promising young physicians and researchers to enter the field of cancer research despite lower pay levels.
  • Arm those on the front lines with the newest and most effective weapons in the fight against cancer. We've got to provide more grants for research and development of new targeted drugs, such as Gleevec. At the same time, we must encourage the development of a new kind of drug that could prevent dangerous tumors from developing in the first place. This would mean millions of dollars for the most promising research.
  • Develop a strategy to make the goal of eliminating death and suffering from cancer a reality. Our legislation will ask the National Cancer Institute to devise a comprehensive approach to meeting the 2015 goal, and report on their progress and milestones. No war can be won without a well-crafted battle plan.
  • Create a new compassionate access program for cancer drugs. This would provide critically ill patients with access to developmental drugs. No patient should lose a battle with cancer because bureaucratic red tape denied him or her access to a potentially lifesaving therapy.
  • Create special reimbursements for "cancer quarterbacks." This bill would require Medicare to pay doctors, preferably oncologists, to become the overall managers of a patient's care. "Cancer quarterback" physicians would 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.
  • Build on programs with a proven history of success. The National Breast and Cervical Cancer Early Detection Program has already saved the lives of countless low-income women by reimbursing safety net providers who perform mammograms, pap smears and the appropriate follow-up care. This legislation would create a similar pilot program for colorectal screenings to detect colorectal cancer early when it is most treatable.

This is an ambitious agenda, but the results would be measurable and meaningful. I hope we can reach a point when the majority of cancer treatments don't have the toxicity, the hair loss, the nausea associated with chemo and radiation. When all Americans, regardless of race or income level, have access to the most advanced detection and treatment options. When patients have help navigating the complex world of cancer treatment.

I hope we will see a day soon when death and suffering caused by this terrible disease are eliminated.