Some 30 years after passage of the original National Cancer Act, a coterie of legislators is pushing what they bill as a new, "comprehensive national battle plan." Backed by 3 years of soul-searching among cancer researchers, physicians, advocates, and survivors, the sweeping bills ambition is no less than transforming cancer "from a terminal illness to a fully treatable disease, 100 percent of the time."
The bill seeks to improve a staggering array of enterprises: basic, translational, and clinical research; insurance coverage; community-based treatment; and screening and prevention measures, including U.S. Food and Drug Administration oversight of tobacco.
In a press conference in late February, the legislations leader, Sen. Dianne Feinstein (D-Calif.), rallied an impressive array of Democrats and Republicans, old and young, to tout the bill. Former Sen. Bob Dole, Sen. Majority Leader Tom Daschle (D-S.D.), Sens. Hilary Clinton (D-N.Y.) and Kay Bailey Hutchinson (R-Texas), along with junior members of both houses and a host of cancer survivors, joined Feinstein in mounting an energetic pitch.
|
While Clinton represented the new Congressional cancer coalition, Dole played the role of old-timer. "Im the only one up here who voted for the 1971 bill," he said, referring to the original National Cancer Act. He praised research advances made possible by that bill, including those that led to the successful treatment of his prostate cancer.
Long Process
The rally-like gathering capped a winding process that began after Feinstein attended a 1998 meeting of the National Dialogue on Cancer, a roundtable of cancer advocates backed by 160 private, governmental, and nonprofit groups. She became inspired by the idea of updating the 1971 legislation and charged John Seffrin, Ph.D., American Cancer Society chief executive officer, and Vincent DeVita, M.D., former National Cancer Institute director and director of the Yale Comprehensive Cancer Center, New Haven, Conn., with pounding the oncological pavement to develop comprehensive recommendations. After talking with hundreds of people, the National Cancer Legislation Advisory Committee handed Feinstein 12 major recommendations (see News, Nov. 7, 2001, p. 1592). A political exploration of that report yielded the "National Cancer Act of 2002." The legislation puts into play about half of the advisory committees suggestions.
|
With some 400 potential cancer drugs awaiting human testing, the bill also provides $100 million annually to unclog the clinical trials pipeline. However, the legislation does not identify the recipients of the new funds; rather, it states that private and public insurance plans will be required to reimburse routine costs of clinical trials. A number of states have adopted similar measures.
Researcher Support
More young cancer professionals would receive support from grants that forgive medical and nursing school debts. The grants will assist 100 physicians who commit to spending 3 or more years on cancer research and give $100 million annually to the Health Resources Services Administration to recruit and train oncology nurses.
The workforce measure would also boost the salaries of 1,000 postdoctoral fellows each year. Current starting salaries of $28,000 are outrageously low, said Seffrin: "We have such a need for new cancer researchers. Right now they cant earn enough to sustain themselves so they go into other fields." Again, outside of the nursing provision, the legislation does not identify the keeper of the new grants.
Inspired by the success of the leukemia drug Gleevec, Feinstein praised tax and marketing incentives aimed at encouraging pharmaceutical companies to produce drugs for orphan cancers, those with fewer than 200,000 new cases per year.
Perhaps the acts most unusual featureproviding patients with a "cancer quarterback"did not appear in the advisory committees report. "Cancer can be a lonely disease," said Feinstein. "Patients dont have the same doctors with them while considering treatments." To remedy the situation, the bill would require all insurers to pay a physician, preferably an oncologist, to guide each patient from diagnosis through treatment and beyond.
The bill would also move regulation of tobacco production and marketing to the FDA and provide the Centers for Disease Control and Prevention with $300 million to expand screening programs for breast, cervical, and colorectal cancers.
Several prominent recommendations from the advisory committee failed to make the final cut: the provision of adequate health insurance coverage for all Americans concerned about or diagnosed with cancer; the development of universal guidelines and standard practices to provide quality care for all patients; and the initiation of a National Cancer Prevention Initiative to eliminate tobacco use, increase physical activity, and improve nutrition.
![]() |
||||
|
Oxford University Press Privacy Policy and Legal Statement |