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	U.S. Department of Health and Human Services

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Chairman Harkin, thank you for your passion on the issue of cancer. Senator Specter and you compose a dynamic duo in the fight against this insidious disease.

Mr. Chairman, Senator Specter, members of the committee: Thank you so very much for inviting me to come before you today to discuss the progress we're making in our fight against cancer and President Bush's bold proposals to make sure we win this battle so essential to the health of our country.

Let me also recognize Steve Case of AOL-Time Warner. Steve's brother Dan is waging his own battle against brain cancer, and Steve deserves our thanks for appearing before the Committee to discuss this critical issue ... and for his leadership in forming, with Dan, the "Accelerate Brain Cancer Cure Foundation." That's a wonderful effort that's making a tremendous difference.

Mr. Chairman, in recent years, we have made stunning progress in the war against cancer, some of which I will detail in a moment. But the challenges remain real, and painful. And today, I'm here to report that the President and I join with you and the members of this committee in rededicating ourselves to meeting those challenges head-on.

This year over 1.2 million new cases of cancer are expected in the United States, and about 550,000 Americans are expected to die of cancer - more than 1,500 individuals a day and a quarter of all deaths in our country annually.

The National Institutes of Health estimates the overall monetary cost for cancer was $156.7 billion in the year 2001. That's an astonishing figure - larger than the gross domestic products of all but a few nations on earth. But the greater cost is in the immeasurable suffering of cancer patients and their families and friends as they struggle to survive and cope, and in the lost contributions of those who are taken from us too soon.

I am passionate about this issue because of the high toll it takes on our nation, but also because of cancer's effect on my own family. My grandfather died of brain cancer … my mother died of melanoma … my mother-in-law died of breast cancer … and my wife, Sue Ann, is a breast cancer survivor. Our family knows firsthand the stress of cancer treatment … the worrying and wondering that turns your world upside-down.

And now I have two daughters and a granddaughter … and as Secretary of Health and Human Services, I'm committed to doing everything I can to spare them the pain and anguish of this devastating disease.

That's one reason we have approved 41 state plan amendments that permit states to provide treatment for women with breast and cervical cancer under Medicaid. These are women who are screened through programs funded by the Centers for Disease Control and Prevention and who are not otherwise eligible for Medicaid. This optional benefit was authorized in the Breast and Cervical Cancer Prevention and Treatment Act of 2000.

So, we are moving forward in working to arrest cancer at every level. And the President's budget is a major step in achieving that goal for my family … for your family, Mr. Chairman … and for every American family. Within the FY 2003 budget, we are requesting approximately $5.6 billion for research on cancer throughout the National Institutes of Health. This is an increase of almost $630 million, or nearly 13 percent, over the current fiscal year.

We want to continue ample funding of the war on cancer because we have begun to make some significant breakthroughs. It is not an exaggeration to say that the tide in the battle might well be turning.

One reason is that in recent years, we have begun to think about cancer in a different way. Now we know that cancer is really a collection of up to 200 related but distinct diseases with different properties.

And we are no longer resigned to thinking of cancer as a death sentence. Today, we can successfully treat or increase life expectancy for more than half of all cancer patients. That's a sign of the dramatic progress we have made, and continue to make.

We are at the threshold of a new understanding of cancer at the genetic and molecular level, and now more than ever before we are bringing together researchers with seemingly disparate scientific expertise into interdisciplinary ventures.

For example, last spring we announced that a new drug called Gleevec had been approved for use in the cases of people with chronic myeloid leukemia, or CML, in just two months.

Gleevec marks the wave of the future because it is the first cancer drug that is the product of molecular targeting: the groundbreaking ability to deliver a drug directly to the diseased cells, leaving the healthy cells alone. Gleevec targets a single cancer-causing protein and, like a light switch, turns off its signal to produce leukemia cells.

Earlier this year, scientists from the FDA and the National Cancer Institute reported a new way to find ovarian cancer through a simple blood screening. The test can be completed in as little as 30 minutes from blood obtained from a finger-stick.

Using a sophisticated artificial intelligence computer program, scientists were able to "train" the computer to tell the difference between patterns of small proteins found in the blood of cancer patients versus control samples.

We made a similar breakthrough last year, when artificial intelligence combined with gene-expression micro-arrays to develop a method of genetic fingerprinting that can tell the difference between several closely related types of childhood cancer.

Gene-related research offers great promise. In February, researchers at the National Genome Research Institute, in tandem with scientists at Johns Hopkins and the Cleveland Clinic, said they've found a gene associated with an inherited form of prostate cancer.

And as a final example, recently the FDA approved a capsule you can swallow that contains a tiny camera. The camera snaps pictures twice a second as it is moved by the natural muscular waves of the digestive track through the small intestine. The device enables the physician to see areas that are not reachable by endoscope, potentially facilitating early detection of cancer of the small intestine.

We are working hard to get new interventions out to the people who need them, as quickly as possible. Two NCI programs are especially relevant to this effort.

The Rapid Access to Intervention Development and the Rapid Access to Preventive Intervention Development expedite new agent development by making NCI's pre-clinical drug development resources and expertise available for clinical trials.

In addition, since 1996, the FDA has approved about 80 cancer-related medications or new uses of already-available drugs. Thirty-five of these products have been reviewed and marketed within six months of their submission to the agency.

The Health Resources and Services Administration supports a network of more than 3,300 community health centers that serve 11 million people annually. Nearly 90 percent of the women seen at the health centers are current with their Pap smears and more than 60 percent are up-to-date with mammograms, a higher percentage than the overall national average.

I'd be remiss not to note that tobacco use remains the single most preventable cause of death in the United States, with cigarette smoking accounting for nearly one-third of all cancer deaths each year. So we're actively engaged in public education campaigns to help decrease incidence of smoking, among young people especially.

President Bush and all of us in the Department of Health and Human Services are unrelenting in our dedication to win the battle against cancer. We look forward to continuing to work with this Committee to that end.

Thank you very much, Mr. Chairman, for giving me the opportunity to speak with you today about HHS efforts in the fight against cancer. I would be pleased to answer any questions yo