[Congressional Record Volume 140, Number 96 (Thursday, July 21, 1994)]
[Extensions of Remarks]
[Page E]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: July 21, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
     INTRODUCTION OF THE PROSTATE CANCER AND TREATMENT ACT OF 1994

                                 ______


                           HON. JIM McDERMOTT

                             of washington

                    in the house of representatives

                        Thursday, July 21, 1994

  Mr. McDERMOTT. Mr. Speaker, the Prostate Cancer Diagnosis and 
Treatment Act of 1994, which I am introducing today, is an important 
part of the campaign to reverse the rising incident of prostate cancer 
in American men.
  Prostate cancer is not some unusual disease that you rarely hear 
about--it is the most commonly diagnosed cancer among men, and the 
second leading cause of cancer death among men. As many as one in three 
men over 50 have a latent form of it. Look around this chamber--every 
third male member is a candidate. We all know a number of our 
colleagues who have been treated for prostate cancer, some of whom lost 
their lives to it.
  Despite recent improvements in diagnosis and treatment, we are 
falling behind in our efforts to stop the spread of this disease. 
Already, prostate cancer is as prevalent and as deadly for men as 
breast cancer is for women. Experts are projecting a troubling growth 
in both the number of diagnosed cases and deaths per year. By the year 
2000 researchers are predicting increases of 90 percent in diagnosed 
cases and 37 percent in deaths per year.
  Mr. Speaker, we are improving our diagnostic and treatment 
capabilities with prostate cancer, but unfortunately we are not making 
these advances available to the population at highest risk--men age 65 
and older.
  Let me explain what is happening. Doctors have been doing digital 
rectal exams for prostate tumors for 50 years. These exams can detect 
some tumors as early as the second stage of growth, but often do not 
detect tumors until the disease has spread outside the prostate gland. 
Two-thirds of the prostate cancers detected today have spread beyond 
the prostate. When the disease is still confined to the prostate, you 
can remove the gland surgically and prevent its spread. If you do not 
catch the cancer until its late stages you can slow its growth with 
hormonal treatment, but you cannot eliminate it.
  In recent years, researchers have developed a simple, inexpensive 
blood test that detects signs of prostate cancer in the blood. This 
prostate specific antigen or PSA test can detect cancers in the early 
stages when they are well-confined to the prostate, and when surgical 
removal of the prostate or radiation treatment can eliminate or shrink 
the tumor and prevent the spread of the disease. Some of our colleagues 
are with us today because they had a PSA test and sought early 
treatment. In recognition of its success in spotting early tumors, all 
the major specialty societies--including the American Cancer Society 
and American Urological Association--now recommend at least an annual 
screening with the PSA test for men over age 50.
  Over 13 million American men are at the highest risk for prostate 
cancer and will not be screened with the most effective test when they 
show up for their annual physical. Why? Because we do not cover 
screening of this test under Medicare. Millions of veterans who use our 
system of veterans medical centers for their care are also not covered.
  For advanced stage prostate cancer, Medicare and veterans programs do 
not cover a full course of hormonal therapy either, or the oral drugs 
that are part of the therapy. This bill would correct the problem and 
make sure that people get the standard treatment whether they are a 
veteran or a Medicare retiree.
  Finally, the bill increases the amount of money we are spending on 
prostate cancer research--to search for causes and new treatments, and 
to identify the most effective treatments on the basis of patient 
outcomes and survival rates.
  As pervasive as prostate cancer is among men, it is hard to believe 
that this cancer has been the neglected stepchild of cancer research. 
Despite similar incidence and death rates, this bill does not begin to 
match the level of funding for breast cancer, although it would 
increase the amount spent on prostate cancer research.
  In all of our health reform discussions nowhere have we heard the 
words ``prostate cancer'' mentioned. Look in the President's or in 
other committee bills--you will find immunizations, mammograms, pap 
smears, cholesterol tests--everything but screening for prostate 
cancer. It is not there.
  The bill we are introducing today is the adjunct to national reform. 
It is the bill that rounds out the diagnostic picture and makes 
national reform work for men, too.
  I think we all tend to look away when the subject of prostate cancer 
comes up, but this is a serious disease that has already struck a 
number of Members in this Chamber, and will strike a lot more of us 
before long. It is time for us to do our job and provide quality care 
and treatment for the most commonly diagnosed cancer among men.