S. HRG. 110–984 CANCER: CHALLENGES AND OPPORTUNITIES IN THE 21ST CENTURY HEARING OF THE COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS UNITED STATES SENATE ONE HUNDRED TENTH CONGRESS SECOND SESSION ON EXAMINING CANCER RELATING TO CHALLENGES AND OPPORTUNITIES IN THE 21ST CENTURY MAY 8, 2008 Printed for the use of the Committee on Health, Education, Labor, and Pensions ( Available via the World Wide Web: http://www.gpoaccess.gov/congress/senate U.S. GOVERNMENT PRINTING OFFICE 42–368 PDF WASHINGTON : 2010 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2250 Mail: Stop SSOP, Washington, DC 20402–0001 VerDate Nov 24 2008 10:18 Jan 26, 2010 Jkt 035165 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 S:\DOCS\42368.TXT DENISE COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS EDWARD M. KENNEDY, Massachusetts, Chairman CHRISTOPHER J. DODD, Connecticut MICHAEL B. ENZI, Wyoming TOM HARKIN, Iowa JUDD GREGG, New Hampshire BARBARA A. MIKULSKI, Maryland LAMAR ALEXANDER, Tennessee JEFF BINGAMAN, New Mexico RICHARD BURR, North Carolina PATTY MURRAY, Washington JOHNNY ISAKSON, Georgia JACK REED, Rhode Island LISA MURKOWSKI, Alaska HILLARY RODHAM CLINTON, New York ORRIN G. HATCH, Utah BARACK OBAMA, Illinois PAT ROBERTS, Kansas BERNARD SANDERS (I), Vermont WAYNE ALLARD, Colorado SHERROD BROWN, Ohio TOM COBURN, M.D., Oklahoma J. MICHAEL MYERS, Staff Director and Chief Counsel ILYSE SCHUMAN, Minority Staff Director (II) VerDate Nov 24 2008 10:18 Jan 26, 2010 Jkt 035165 PO 00000 Frm 00002 Fmt 0486 Sfmt 0486 S:\DOCS\42368.TXT DENISE CONTENTS STATEMENTS THURSDAY, MAY 8, 2008 Page Kennedy, Hon. Edward M., Chairman, Committee on Health, Education, Labor, and Pensions, opening statement ........................................................... 1 Murkowski, Hon. Lisa, a U.S. Senator from the State of Alaska, statement ..... 3 Hutchison, Hon. Kay Bailey, a U.S. Senator from the State of Texas, state- ment ...................................................................................................................... 5 Harkin, Hon. Tom, a U.S. Senator from the State of Iowa, prepared state- ment ...................................................................................................................... 7 Burr, Hon. Richard, a U.S. Senator from the State of North Carolina, state- ment ...................................................................................................................... 8 Brown, Hon. Sherrod, a U.S. Senator from the State of Ohio, statement .......... 8 Prepared statement .......................................................................................... 9 Edwards, Elizabeth, J.D., Senior Fellow, Center for American Progress, Washington, DC ................................................................................................... 11 Armstrong, Lance, Chairman and Founder, Lance Armstrong Foundation, Austin, TX ............................................................................................................. 13 Prepared statement .......................................................................................... 15 Case, Steve, Chairman and CEO, Revolution Health, Washington, DC ............. 18 Prepared statement .......................................................................................... 20 Benz, Edward J., Jr., M.D., President, Dana Farber Cancer Institute, Boston, MA ......................................................................................................................... 38 Prepared statement .......................................................................................... 41 Simon, Gregory C., J.D., President, FasterCures, Washington, DC .................... 44 Prepared statement .......................................................................................... 45 Moddelmog, Hala, M.A., CEO, Susan G. Komen Foundation, Dallas, TX .......... 51 Prepared statement .......................................................................................... 54 ADDITIONAL MATERIAL Statements, articles, publications, letters, etc.: Enzi, Hon. Michael B., a U.S. Senator from the State of Wyoming, pre- pared statement ............................................................................................ 68 Mikulski, Hon. Barbara A., a U.S. Senator from the State of Maryland, prepared statement ....................................................................................... 69 Obama, Hon. Barack, a U.S. Senator from the State of Illinois, prepared statement ....................................................................................................... 70 (III) VerDate Nov 24 2008 10:18 Jan 26, 2010 Jkt 035165 PO 00000 Frm 00003 Fmt 0486 Sfmt 0486 S:\DOCS\42368.TXT DENISE VerDate Nov 24 2008 10:18 Jan 26, 2010 Jkt 035165 PO 00000 Frm 00004 Fmt 0486 Sfmt 0486 S:\DOCS\42368.TXT DENISE CANCER: CHALLENGES AND OPPORTUNITIES IN THE 21ST CENTURY THURSDAY, MAY 8, 2008 U.S. SENATE, COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS, Washington, DC. The committee met, pursuant to notice, at 9:04 a.m. in Room SH–216, Hart Senate Office Building, Hon. Edward M. Kennedy, chairman of the committee, presiding. Present: Senators Kennedy, Dodd, Harkin, Murray, Reed, Brown, Burr, and Murkowski. Also Present: Senator Hutchison. OPENING STATEMENT OF SENATOR KENNEDY The CHAIRMAN. Well, there are many important hearings that are taking place in the U.S. Congress probably this year. I think, for many of us on this committee, this really is one of the most im- portant. Not only is it related to something that families across this coun- try are concerned about, but we also have three very extraordinary individuals in our first panel, others that will follow who really rep- resent the best in terms of knowledge and understanding and com- mitment on this issue. So today is a very special day for our com- mittee and for many of us on this committee who had a long-time interest and association with trying to deal with the challenges of cancer. I will make a brief opening statement. I will ask Senator Mur- kowski if she would make a brief opening statement. We have some time issues, then we will listen to, hear from our witnesses. We are honored today to have such distinguished guests. We wel- come Elizabeth Edwards, a dear friend. My wife, Vicki, and I have enjoyed the times that we have spent with Elizabeth, John, and the Edwards family. Elizabeth is currently an inspiration to me, and I know she is for millions of Americans, as she shares with the Na- tion her spirit of determination, her hope, optimism, and we admire her very much. We also welcome Lance Armstrong. America cheered you on to seven Tour de France victories, cheered you in your battle with cancer. Now you are doing the cheerleading, urging us to do all we can to find the cure. We are honored to welcome Steve Case. We know that he was a pioneer at AOL and in our transition to a high-tech economy. (1) VerDate Nov 24 2008 10:18 Jan 26, 2010 Jkt 035165 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 S:\DOCS\42368.TXT DENISE 2 Today, he has dedicated those same talents and extraordinary abilities to fight against cancer. So each one comes to this issue from different paths, with a vari- ety of experiences and insights to offer, but we have a common commitment to do all we can to stand with those facing cancer and to find a cure. So I thank you all for the enormous difference you are making on this issue and for being with us today. Thirty-seven years ago, a Republican president and a Democratic Congress came together in a new commitment to find a cure for cancer. At the time, cancer was the second-leading cause of death in the Nation. Americans lived in fear that they or someone they loved would be lost to this dreadful disease. In 1971, in response to these serious concerns, we passed the Na- tional Cancer Act with broad bipartisan support and launched the war on cancer. Since then, significant progress has been made. New methods to prevent and treat cancer have led to more bene- ficial and more humane ways of dealing with the illness. The expansion of basic research, the use of large-scale clinical trials, the development of new drugs, and the enhanced focus on early detection have led to breakthroughs unimaginable only a gen- eration ago. And as a result, today cancer is no longer the auto- matic death sentence that it was a generation ago. But despite the impressive achievements in fighting cancer, our society now faces a perfect storm of conditions, have expanded the number of our citizens suffering from cancer—the aging of our pop- ulation, the new environmental issues, increased life expectancy, and unhealthy behavior. As a result, today cancer is still the sec- ond-highest cause of death in America. Clearly, we need a new way forward in battling this frightening disease. We must build on what the Nation has already accom- plished and launch a new war on cancer for the 21st century. We stand on the threshold of unprecedented new advances in life sciences, such as much earlier diagnosis based on molecular evi- dence and astonishing new treatments tailored to an individual’s own DNA and capable of blocking the gene’s effects. To make the promise of this new century of discovery a reality, we must see the patients’ DNA tests are free from any fear that their genetic information will be used against them to deny them health insurance or even jobs. Congress took