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Testimony on Prostate Cancer
Prevention, Detection and Treatment

June 16, 1999

Statement of Senator Bob Dole
Committee on Appropriations
Subcommittee on Labor, Health and Human Services
June 16, 1999

Bob Dole testified on June 16, 1999 before the Senator Arlen Spector's Senate Appropriations Committee Subcommittee on Labor, Health and Human Services on the need to ensure that Medicare patients have access to the best and newest treatments for the disease.

Mr. Chairman, Senator Harkin:

Thank you for inviting me here this morning to discuss prostate cancer. It seems that just about every family in America has been touched in some way by cancer. My family has. And, I have.

Over eight years ago I was diagnosed with prostate cancer. I was lucky to have had the disease diagnosed early and treated promptly through surgery.

Eight years later, I am happy to say I am cancer free. Since the time of my diagnosis, I have tried to speak out as much as possible about the value and importance of early detection. I truly believed then, and continue to believe today, that early detection saved my life. The cancer was found when it was still contained within the prostate gland and when I had a variety of treatment options from which to choose.

I will use this opportunity today to say it again: if you're a male over age 40, particularly if you have a family history, ask your doctor about getting a prostate check up. People ask me how I can be so open about my own experience with prostate cancer. I must admit, when I first started speaking out about this disease there were plenty awkward moments. But, then I decided that the alternative -- silence -- can be deadly. So, when I am fortunate enough to be asked to testify before Congress on this issue, I do it.

While my message of the importance of early detection is one that I will continue to deliver, I would like to take a moment to talk about treatment options.

When I was diagnosed, I was basically given two options: surgery or radiation. That was it. I was told of the side effects of both, the risks of the procedures, and the probability for cure. I have to admit, it was almost a toss up. Both had side effects that sounded unpleasant, to say the least, but both also had high rates of success. I chose surgery. And, since I am cancer free today, I of course believe I made the right decision.

But, every day there is a scientist looking for the cure for cancer, or looking for a new treatment option. And, one of these days -- I think in the not so distant future -- there will be a cure. But, the question is will we recognize it when we see it? And, I think that is an important question for members of Congress and the administration to think about. Is our government prepared to take the steps that are necessary so that when a new technology for treatment becomes available, patients with the disease can access it?

One example is a proposed change in the reimbursement rate for an innovative prostate treatment known as brachytherapy. This therapy involves the implantation of radioactive seeds into the prostate directly. The seeds emit radiation that destroys cancer cells while minimizing exposure to surrounding tissues. For some patients, this minimally invasive procedure, done on an outpatient basis, has been shown to treat some forms of prostate cancer.

Currently, Medicare reimburses for this procedure. But, if the reimbursement is reduced, as is currently proposed, this type of technology will become less available to patients.

I am on the advisory board of a company that makes a cryosurgical device that freezes the prostate so that the cancer can no longer grow. When I had my surgery, I was in the hospital for a week and recovering for months. With cryosurgery, a patient can leave the hospital the same day and return to work the next.

It's not for every patient, of course, but neither is surgery. Yet, despite it's success, Medicare took three years to cover this procedure, and it actually will not begin coverage until next month. I wonder how many patients could have benefited from cryosurgery, but couldn't because of the government's reimbursement policies.

Please do not misunderstand me. I have been and will continue to be an advocate for Medicare's solvency. But, as our health care system continues to evolve and change, policy makers must encourage the adoption of innovative therapies. What's the point of science making advances everyday if there is no way to deliver the technologies to patients who need them?

The private sector readily accepts new therapies partly because they are often cost effective, but mostly because the consumers in the market demand them. As the baby boomers age, I believe Medicare will feel the same pressure from its consumers.

When the country's 77 million baby boomers start becoming Medicare eligible in 2011, the government is going to have to deliver -- the demand will be so high. In order to satisfy that demand, the Medicare program will have to be modernized. That means looking at new therapies and keeping pace with scientific advances.

Of course, in 2011, Michael Milken and CaPCURE will have found a cure for prostate cancer, Joe Torre will own the Yankees, and I will be writing my memoirs on being the country's "first gentleman".

Thank you very much.


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