[Congressional Record Volume 166, Number 164 (Tuesday, September 22, 2020)]
[House]
[Pages H4682-H4684]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
VETERAN'S PROSTATE CANCER TREATMENT AND RESEARCH ACT
Mr. TAKANO. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 6092) to direct the Secretary of Veterans Affairs to
establish a national clinical pathway for prostate cancer, access to
life-saving extending precision clinical trials and research, and for
other purposes.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 6092
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Veteran's Prostate Cancer
Treatment and Research Act''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Prostate cancer is the number one cancer diagnosed in
the Veterans Health Administration.
(2) A 1996 report published by the National Academy of
Sciences, Engineering, and Medicine established a link
between prostate cancer and exposure to herbicides, such as
Agent Orange.
(3) It is essential to acknowledge that due to these
circumstances, certain veterans are made aware that they are
high-risk individuals when it comes to the potential to
develop prostate cancer.
(4) In being designated as ``high risk'', it is essential
that veterans are proactive in seeking earlier preventative
clinical services for the early detection and successful
treatment of prostate cancer, whether that be through the
Veterans Health Administration or through a community
provider.
(5) Clinical preventative services and initial detection
are some of the most important components in the early
detection of prostate cancer for veterans at high risk of
prostate cancer.
(6) For veterans with prostate cancer, including prostate
cancer that has metastasized, precision oncology, including
biomarker-driven clinical trials and innovations underway
through the Prostate Cancer Foundation and Department of
Veterans Affairs partnership, represents one of the most
promising areas of interventions, treatments, and cures for
such veterans and their families.
SEC. 3. DEPARTMENT OF VETERANS AFFAIRS TREATMENT AND RESEARCH
OF PROSTATE CANCER.
(a) Establishment of Clinical Pathway.--
(1) In general.--Not later than 365 days after the date of
the enactment of this Act, the Secretary of Veterans Affairs
shall establish in the National Surgery Office of the
Department of Veterans Affairs a national clinical pathway
for all stages of prostate cancer, from early detection to
end-of-life care including recommendations regarding the use
of transformative innovations, research, and uniform clinical
data.
(2) Elements.--The national clinical pathway established
under this subsection shall include the following elements:
(A) A multi-disciplinary plan for the early detection,
diagnosis, and treatment of prostate cancer that includes, as
appropriate, both Department medical facilities and
community-based partners and providers and research centers
specializing in prostate cancer, especially such centers that
have entered into partnerships with the Department.
(B) A suggested, but not mandatory, protocol for screening,
diagnosis, and treatment or care for subpopulations with
evidence-based risk factors (including race, ethnicity,
socioeconomic status, geographic location, exposure risks,
and genetic risks, including family history).
(C) A suggested treatment protocol timeframe for each point
of care based on severity and stage of cancer.
(3) Public comment period.--Upon the establishment of a
proposed clinical pathway as required under this subsection,
the Secretary shall publish the proposed clinical pathway in
the Federal Register and provide for a 45-day period for
public comments. The Secretary--
(A) may make any such public comments publicly available;
and
(B) make changes to the proposed clinical pathway in
response to any such comments received using the same process
and criteria used to establish the proposed clinical pathway.
(4) Collaboration and coordination.--In establishing the
clinical pathway required under this section, the Secretary
shall--
(A) provide for consideration of other clinical pathways
and research findings of other departments and agencies,
including guidelines that are widely recognized and
guidelines that are used as the standard for clinical policy
in oncology care, such as National Comprehensive Cancer
Network guidelines; and
(B) collaborate and coordinate with--
(i) the National Institutes of Health;
(ii) the National Cancer Institute;
(iii) the National Institute on Minority Health and Health
Disparities;
(iv) other Institutes and Centers as the Secretary
determines necessary;
(v) the Centers for Disease Control and Prevention;
(vi) the Department of Defense;
(vii) the Centers for Medicare and Medicaid Services;
(viii) the Patient-Centered Outcomes Research Institute;
and
(ix) the Food and Drug Administration.
(5) Publication.--The Secretary shall--
(A) publish the clinical pathway established under this
subsection on a publicly available Department website; and
(B) regularly update the clinical pathway as needed by
review of the medical literature and available evidence-based
guidelines at least annually, in accordance with the criteria
under paragraph (2).
(b) Development of National Cancer of the Prostate Clinical
Care Implementation Program.--
(1) Establishment.--Not later than 90 days after the date
of the enactment of this Act, the Secretary shall submit to
Congress a
[[Page H4683]]
plan to establish a comprehensive prostate cancer program.
(2) Program requirements.--The comprehensive prostate
cancer program shall--
(A) be multidisciplinary and include the authority to work
across clinical care lines, specialties, and the
organizational divisions of the Veterans Health
Administration;
(B) receive direct oversight from the Deputy Undersecretary
for Health of the Department of Veterans Affairs;
(C) include a yearly program implementation evaluation to
facilitate replication for other disease states or in other
healthcare institutions;
(D) be metric driven and include the development of
quarterly reports on the quality of prostate cancer care,
which shall be provided to the leadership of the Department,
medical centers, and providers and made publicly available in
an electronic form;
(E) made available as national decision support tools in
the electronic medical record;
(F) include an education plan for patients and providers;
and
(G) be funded appropriately to accomplish the objectives of
this Act.
(3) Program implementation evaluation.--The Secretary shall
establish a program evaluation tool as an integral component
to learn best practices of multidisciplinary disease-based
implementation and to inform the Department and Congress
regarding further use of the disease specific model of care
delivery.
(4) Prostate cancer research.--The Secretary shall submit
to Congress a plan that provides for continual funding
through the Office of Research and Development of the
Department of Veterans Affairs for supporting prostate cancer
research designed to position the Department as a national
resource for quality reporting metrics, practice-based
evidence, comparative effectiveness, precision oncology, and
clinical trials in prostate cancer.
(5) Prostate cancer real time registry program.--The
Secretary, in collaboration with data stewards of the
Department of Veterans Affairs, scientists, and the heads of
other Departments, agencies, and non-governmental
organizations, such as foundations and non-profit
organizations focused on prostate cancer research and care,
shall establish a real-time, actionable, national prostate
cancer registry. Such registry shall be designed--
(A) to establish a systematic and standardized database
that enables intra-agency collaboration by which to track
veteran patient progress, enable population management
programs, facilitate best outcomes, and encourage future
research and further development of clinical pathways,
including patient access to precision resources and
treatments and access to life-extending precision clinical
trials;
(B) to employ novel methods of structuring data, including
natural language processing, artificial intelligence,
structured data clinical notes, patient reported outcome
instruments, and other tools, to ensure that all clinically
meaningful data is included; and
(C) to be accessible to--
(i) clinicians treating veterans diagnosed with prostate
cancer and being treated for prostate cancer in conjunction
with Department medical facilities; and
(ii) researchers.
(c) Clinical Pathway Defined.--In this section, the term
``clinical pathway'' means a health care management tool
designed around research and evidence-backed practices that
provides direction for the clinical care and treatment of a
specific episode of a condition or ailment.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
California (Mr. Takano) and the gentleman from Tennessee (Mr. David P.
Roe) each will control 20 minutes.
The Chair recognizes the gentleman from California.
General Leave
Mr. TAKANO. Mr. Speaker, I ask unanimous consent that all Members may
have 5 legislative days in which to revise and extend their remarks and
to include extraneous material on H.R. 6092.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from California?
There was no objection.
Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in support of H.R. 6092, the Veteran's Prostate
Cancer Treatment and Research Act.
The number one cancer diagnosed by the Veterans Health Administration
is prostate cancer. Nearly half a million veterans are currently
undergoing treatment, with disproportionate diagnoses of this disease
impacting Black veterans and those exposed to Agent Orange.
This legislation would create a national clinical pathway and
standardized system of care for treatment of prostate cancer at all
stages. This will ensure more widespread early detection efforts,
increase access to clinical trials, and create a registry and research
program.
Mr. Speaker, our veterans battle prostate cancer at twice the rate of
their civilian counterparts. A unified systems-wide approach that
builds on the incredible work of the Department's research efforts is
essential.
I want to thank Dr. Dunn for his steadfast leadership and his passion
on this matter.
Mr. Speaker, I also encourage all of my colleagues to support H.R.
6092, and I reserve the balance of my time.
Mr. DAVID P. ROE of Tennessee. Mr. Speaker, I yield myself such time
as I may consume.
Mr. Speaker, I rise today in support of H.R. 6092, the Veteran's
Prostate Cancer Treatment and Research Act. This bill is sponsored by
my good friend and ranking member of the Subcommittee on Health,
Congressman Neal Dunn of Florida.
Like me, Dr. Dunn is an Army veteran and a physician. During his many
years in private practice, he helped to found the Advanced Urology
Institute and the Bay Regional Cancer Center, where he specialized in
treating advanced prostate cancer.
Suffice it to say, improving care for prostate cancer is a personal
one for him. It is also a personal one for me.
A few years ago, when I was chairman of the Veterans' Affairs
Committee, I was diagnosed with prostate cancer. Early detection and
effective treatment helped save my life, and I know that it will do the
same for many of my fellow veterans.
Veterans are diagnosed with prostate cancer, as the chairman said, at
twice the rate of the general population, making prostate cancer the
most commonly diagnosed cancer in male veterans. An estimated one in
five male veterans is expected to be diagnosed with prostate cancer in
their lifetime, compared to one in nine American men, generally.
The Veteran's Prostate Cancer Treatment and Research Act would
require the VA to establish a national clinical pathway for prostate
cancer and to update that clinical pathway every year to reflect the
latest and greatest and best practices for, and the medical
understanding of, this deadly disease. It would also require the VA to
establish a comprehensive prostate cancer program and a national
prostate cancer registry.
Together, these provisions would make the VA a national leader with
respect to prostate cancer.
Most importantly, it would give veterans with prostate cancer the
very best chance of making a full recovery and going on to lead long,
healthy lives after their diagnosis.
Mr. Speaker, it is fitting that the House advance this important bill
today in the final week of Prostate Cancer Month. I urge all of my
colleagues to join me in supporting it, and I reserve the balance of my
time.
Mr. TAKANO. Mr. Speaker, I also want to acknowledge the leadership of
the gentleman from South Carolina (Mr. Cunningham), who worked with the
subcommittee ranking member, Dr. Neal Dunn.
Mr. Speaker, I yield 5 minutes to the gentleman from South Carolina
(Mr. Cunningham), my good friend.
Mr. CUNNINGHAM. Mr. Speaker, I rise in support of this bipartisan
legislation introduced by my colleague, Representative Dunn, and
myself, which would ensure that lifesaving research and clinical trials
are made available to reduce the rate of prostate cancer for our
Nation's veterans.
Prostate cancer is the number one cancer diagnosed in the Veterans
Health Administration, and numerous reports have established a link
between cancer and military service, including exposure to certain
herbicides like Agent Orange.
Early detection of this disease is critical, and veterans deserve a
health system that provides both early detection and successful
treatment. This bill will do just that.
It is our job to ensure that, when our brave men and women return
home from their service, the VA is there to rehabilitate them and
reintegrate them back into civilian life. They deserve our
unconditional support, which is why I urge my colleagues to join me in
honoring our obligation to our veterans and vote in support of this
bipartisan legislation.
Mr. DAVID P. ROE of Tennessee. Mr. Speaker, Dr. Dunn, because of
travel restrictions, couldn't make it to this debate.
[[Page H4684]]
Mr. Speaker, I yield 3 minutes to the gentleman from North Carolina
(Mr. Murphy), with whom I serve on the Education and Labor Committee
and the Doctors Caucus.
Mr. MURPHY of North Carolina. Mr. Speaker, I rise today in support of
H.R. 6092, the Veteran's Prostate Cancer Treatment and Research Act.
Prostate cancer is the most common cancer diagnosis amongst U.S.
veterans. I speak in two roles: one as a practicing urologist who has,
for over 30 years, taken care of prostate cancer patients, and then
also as a Congressman, too, to the Third District of North Carolina,
which is home to roughly 95,000 veterans, the third most in the
country. So this bill is especially important to me.
This legislation requires the Department of Veterans Affairs to
establish a national clinical pathway and a national registry related
to the diagnosis, research, and treatment of prostate cancer. This
information will be critical to help ensure our VA's prostate cancer
patients have the best opportunity for early diagnosis and treatment.
Prostate cancer often sneaks up silently, without symptoms, and,
thus, early detection is the key. Early diagnosis leads to a much
greater chance for cure.
Also, very important is this bill's requirements for the VA to
develop a real-time, actional national prostate cancer registry online.
The more we can keep the VA up to date with the medical advances of the
21st century, the more veterans' lives we will save.
I want to thank my colleague and fellow urologist, Congressman Neal
Dunn, for leading this initiative in the House. Bills like this one are
the reason more and more veterans are surviving this horrible disease.
I am proud to be a cosponsor and look forward to its passage.
Mr. Speaker, I urge my colleagues to vote for this legislation.
Mr. TAKANO. Mr. Speaker, I have no further speakers. I am prepared to
close, and I reserve the balance of my time.
Mr. DAVID P. ROE of Tennessee. Mr. Speaker, I yield myself the
balance of my time.
Mr. Speaker, I strongly encourage my colleagues to support this very
important bill. I am surprised, over the years, that the VA hasn't had
an active registry.
I want to thank Dr. Dunn and the other sponsors of this bill. I think
it will help save lives in the VA.
Mr. Speaker, I urge my colleagues to support this bill, and I yield
back the balance of my time.
Mr. TAKANO. Mr. Speaker, I would like to withdraw my motion to
suspend the rules and pass H.R. 6092.
The SPEAKER pro tempore. The motion is withdrawn.
____________________