Opening Statement of Senator Feinstein At Cancer Coalition Hearing Examining Ways to Improve Access to Quality Cancer Care
October 15, 2003

Washington, DC - The Senate Cancer Coalition today held a hearing, convened by co-chairs Senator Dianne Feinstein (D-Calif.) and Sam Brownback (R-KS), examining ways to improve access to quality cancer care.

Senator Feinstein introduced legislation earlier this year to create a new comprehensive national battle plan to modernize and re-energize the nation's war on cancer. The legislation grew out of Senator Feinstein's work as the chair of the Senate Cancer Coalition and vice-chair of the National Dialogue on Cancer.

Cancer is the second leading cause of death in the United States. An estimated 1.2 million Americans will be newly diagnosed with cancer and 550,000 people will die this year. The following is the prepared text of Senator Feinstein's statement:

"I would like to take a moment to personally thank our first witness with whom I had the pleasure of co-chairing this Coalition for many years until he retired from the U.S. Senate in 2000. Senator Connie Mack continues to be a leader in the fight against cancer through promoting awareness of cancer research and early detection. Thank you for being here today, Connie, and I look forward to your testimony.

Today's hearing is the third in a series that will strive to address the challenges in access to cancer treatment. I thank my co-chair, Senator Brownback, for holding this hearing on what is a very important and timely issue involving the future of access to cancer care.

Due to the advances in human genomics and the development of new, effective cancer drugs like Gleevec for Chronic Myeloid Leukemia and Herceptin for breast cancer, that can target and destroy cancer cells while leaving healthy cells unharmed, we are in a new era in the fight against cancer. I believe that if we work smart we could find a cure for cancer in my lifetime.

As the science of cancer has advanced dramatically since 1971 when President Nixon launched the war on cancer, so too has the treatment and care of cancer. The Generals in today's war are not only the oncologists, but also the nurses, pharmacists and case managers who customize and administer cancer care, specific to each patient.

The battle against cancer is often a lonely, frustrating one with many questions and uncertainties. I saw with my own eyes the ravages of cancer treatment, and I experienced the frustrations, the difficulties, and the loneliness that people suffer when a loved-one has cancer.

For many patients and their families the language of cancer and treatment options is a vast unknown, and for patients who are not fluent in English or who may lack health insurance the process can be truly daunting.

The Institute of Medicine issued a report last year called Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. This report emphasized the importance of "providing advocates for patients who can assist them in asking the appropriate questions, and making the necessary inquiries as they access the health are system..."

The culturally appropriate patient 'navigator' performs a vital role in the access to and understanding of cancer treatment options.

This is why my legislation, the National Cancer Act of 2003 authorizes grants to health centers for the development and operation of programs that assign patient navigators (nurses, social workers, cancer survivors and patient advocates) to individuals of health disparity populations, to assist in following-up on a cancer diagnosis and to help them find the appropriate services and follow-up care, which includes facilitating access to health care services.

Today, as much as eighty percent of cancer care is provided in a convenient and cost-effective physician office setting. Sixty percent of new cancer diagnoses are in Medicare beneficiaries. More than three quarters of all patients who enter cancer clinical trials are registered through community oncology practices.

I recognize that the current system of Medicare reimbursement for cancer care is flawed, but I am very concerned that attempts to reduce Medicare payments for cancer drugs in both the House and Senate Prescription Drug and Medicare Improvement Bills will have the unintended consequence of jeopardizing patient access to quality care.

Provisions in the House and Senate prescription drug bills as well as proposed regulations by the Bush Administration may force more than fifty percent of cancer physicians to limit care for seniors. According to the American Society of Clinical Oncology, nineteen percent of cancer physicians will stop treating Medicare beneficiaries entirely.

Given the already burdensome financial strains on our nation's hospitals, we must address these startling statistics as we seek to resolve issues of payment for cancer care in the outpatient setting.

I look forward to hearing from today's witnesses, and I defer to Senator Brownback to introduce our first witness."

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