[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.

                          ____________________