[Congressional Record Volume 144, Number 40 (Wednesday, April 1, 1998)]
[Senate]
[Pages S3008-S3009]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          ADDITIONAL STATEMENT

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                  NATIONAL BREAST CANCER SURVIVORS DAY

 Mr. MURKOWSKI. Mr. President, today is National Breast Cancer 
Survivors Day and I want to take this opportunity to focus my 
colleague's attention on the importance of continued research and early 
detection efforts for this tragic disease.
  Mr. President, one out of nine American women will suffer the tragedy 
of breast cancer. It is today the leading cause of death for women 
between the ages of 35 to 54.
  Alaskan women are particularly vulnerable to this disease. We have 
the second highest rate of breast cancer in the Nation. One in 7 Alaska 
women will get breast cancer and tragically it is the Number One cause 
of death among Native Alaskan women.
  Mr. President, these tragic Alaska deaths are not inevitable. Health 
experts agree that the best hope for lowering the death rate is early 
detection and treatment. It is estimated that breast cancer deaths can 
be reduced by 30 percent if all women avail themselves of regular 
clinical breast examination and mammography.
  But for many Alaska women, especially native women living in one of 
our 230 remote villages, regular screening and early detection are 
often hopeless dreams.
  For more than 20 years, my wife Nancy has recognized this problem and 
tried to do something about it. In 1974, she and a group of Fairbanks' 
women created the Breast Cancer Detection Center, for the purpose of 
offering mammographies to women in remote areas of Alaska--regardless 
of a woman's ability to pay.
  Now, the Center uses a small portable mammography unit which can be 
flown to remote areas of Alaska, offering women in the most rural of 
areas easy access to mammographies at no cost. Additionally, the Center 
uses a 43-foot long, 14 foot high and 26,000 pound mobile mammography 
van to travel through rural areas of Alaska. The van makes regular 
trips, usually by river barge, to remote areas in Interior Alaska such 
as Tanana.
  Julie Roberts, a 42-year-old woman of Tanana, who receives regular 
mammographies from the mobile mammography van, knows the importance of 
early screening:

       There's a lot of cancer here (in Tanana)--a lot of cancer. 
     That's why it's important to have the mobile van here . . . I 
     know that if I get checked, I can catch it early and can 
     probably save my life. I have three children and I want to 
     see my grandchildren.

  I am proud to say that the Fairbanks Center now serves about 2,200 
women a year and has provided screenings to more than 25,000 Alaska 
women in 81 villages throughout the state. To help fund the efforts of 
the Fairbanks Center, each year Nancy and I sponsor a fishing 
tournament to raise money for the operation of the van and mobile 
mammography unit. After just three years, donations from the tournament 
have totalled $830,000.
  Mr. President, Nancy and I are committed to raising more funds for 
this important program so that every woman in Alaska can benefit from 
the advances of modern technology and reduce their risk of facing this 
killer disease.
  Mr. President on this day that we recognize survivors of breast 
cancer, I want take a moment to discuss legislation that I am 
cosponsoring with Senator D'Amato to end the practices of so-called 
``drive-through'' mastectomies.
  In too many cases women who survive the trauma of a mastectomy are 
being forced to get out of the hospital only hours after their surgery. 
How can medical care professionals allow this? Simply because many 
insurance companies demand that the procedure of a mastectomy be 
considered an out-patient service.''
  Here's the horror that many insurance companies cause:
  Nancy Couchot, a 60 year old woman had a radical mastectomy at 11:30 
a.m. She was released from the hospital five hours-- even though she 
was not able to walk or use the rest room without assistance.

  Victoria Berck, had a mastectomy and lymph node removal at 7:30 a.m. 
7 hours late. She was given instructions on how to empty two drains 
attached to her body and sent home. Ms. Berck concludes, ``No civilized 
country in the world has a mastectomy as an out-patient service.''
  Mr. President that is why I am proud to co-sponsor the Women's Health 
and Cancer Rights Act of 1997, which would put an end to the drive-
through mastectomies.
  Specifically, the Act will require health insurance companies to 
allow physicians to determine the length of a mastectomy patient's 
hospital stay according to medical necessity. In other

[[Page S3009]]

words, the bill makes it illegal to punish a doctor for following good 
medical judgment and sound medical treatment.
  Another important provision of this bill ensures that mastectomy 
patients will have access to reconstructive surgery. Scores of women 
have been denied reconstructive surgery following mastectomies because 
insurers have deemed the procedure to be cosmetic'' and, therefore, not 
medically necessary.
  Mr. President, far too often breast cancer victims, who believe that 
they have adequate health care coverage, are horrified when they learn 
that reconstruction is not covered in their health plan.
  In Alaska, of the 324 mastectomies and lumpectomies performed in 
1996, reconstruction only occurred on 11 of the patients. That means 
that only 3.4% of women who have their breast removed have 
reconstructive surgery, compared to the national average of 23%.
  Mr. President, the simple reason for this tragically low figure is 
simple: women can't afford the procedure.
  Breast reconstruction costs average about $5,000 for just the 
procedure. If hospital, physician and other costs are included--the 
costs escalate to around $15,000.
  Dr. Sarah Troxel, of Providence hospital, the only doctor in the Mat-
Su Valley who does breast reconstruction, states the importance of 
reconstruction:

       Women who are unable to receive reconstructive surgery, 
     suffer from depression, a sense of loss, and need more cancer 
     survivor counseling . . . Additionally reconstructive surgery 
     can be preventative medicine--women who don't have 
     reconstructive surgery often develop other medical problems 
     or complications with their spine.

  Mr. President, these issues are not partisan issues. We may have our 
differences regarding managing and financing health reform, but I think 
we all endorse accessible and affordable health care that preserves 
patient choice and physician discretion. Cancer does not look to see 
the politics of its victims.
  It is my hope that we will adopt this legislation this year.

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