Statement of Jerold R. Mande, S. B. NO. 459
Senator Handley, Representative Sayers, and members of the Committee:
Thank you for the opportunity to testify on raised S. B. No. 459, An Act Promoting the Early Detection, Diagnosis and Treatment of Lung Cancer, Breast Cancer, and Cervical Cancer. It is a pleasure to be here again.
My name is Jerold Mande and I am associate director for public policy at the Yale Cancer Center, at the Yale University School of Medicine. Prior to coming to Yale I had the honor of working on cancer policy at the national level for Vice President Al Gore, for the Food and Drug Administration, and for the U.S. Congress. Today, I am also a member of the board of the Connecticut Cancer Partnership, the state cancer planning body.
The Yale Cancer Center strongly supports Connecticut's Comprehensive Cancer Control Plan, and the Connecticut Cancer Partnership. We deeply appreciate your past support for the state cancer plan and ask that you join us in seeing that it is fully implemented. The plan is the state blueprint that will significantly reduce Connecticut's cancer burden. Implementing this plan will bring us closer in Connecticut to the day when we can eliminate the suffering and death due to cancer. Your support will enable Connecticut's cancer professionals to better prevent, detect, and treat cancer, to eliminate disparities in cancer control, and to help improve care for Connecticut’s cancer patients.
I am optimistic about what your investment in this plan can do, because we have reached a time of great hope in our long battle against cancer. In 1961, when President Kennedy challenged us to send a man to the moon and return him safely, our nation’s scientists had already discovered the science needed to achieve this great goal. The challenge was figuring out how to apply it. Ten years later, when another president challenged us to defeat cancer, we did not have the scientific knowledge needed to meet that challenge.
Today, we finally have that science, thanks to the years of investment and hard work by dedicated scientists at centers like Yale. As a result, we are now poised as we were in 1961 when we decided to go to the moon. Our nation can now defeat cancer. That is why the head of the National Cancer Institute has challenged us to eliminate the suffering and death due to cancer by 2015. State cancer plans are the vehicle to reach that goal.
The Yale Cancer Center is a federally designated comprehensive cancer center, and as such plays a critical and unique role in our nation’s and Connecticut’s fight against cancer. Let me explain why. In 1971, when the nation declared war on cancer, it chose a proven model to build the weapons to win that war. During World War II our government created the Manhattan Project to bring together the nation’s top scientists to win the war. In 1971, the president and the Congress launched the comprehensive cancer center
program, establishing mini – “Manhattan Projects” around the nation to develop the weapons to defeat cancer.
Today, the National Cancer Institute oversees that program, and it has designated 39 comprehensive cancer centers scattered across our nation. The Yale Cancer Center is one of those centers, the only one in Connecticut, and it has maintained that designation continuously since being selected in 1974.
I want to emphasize that the designation is highly competitive. Although coveted by virtually ever state, only 24 states have comprehensive cancer centers. The designation is based on our ability to meet rigorous criteria that include breadth and depth of three primary areas of cancer research: 1) basic laboratory research into the causes of cancer; 2) population research in cancer prevention, control, and population and behavioral sciences; and 3) clinical research in testing and developing new and better treatments for cancer. Comprehensive cancer centers must demonstrate strength of the interactions among the three major areas. In addition, the cancer centers must engage in public information, education, and outreach. NCI centers are committed to discovering the scientific breakthroughs that will defeat cancer, to translating those discoveries into new therapies, and to delivering those therapies to patients and the community.
To state more simply the difference between an NCI designated comprehensive cancer center and even the most outstanding non-NCI cancer center, many cancer providers around the country and here in Connecticut can provide state-of-the-art cancer care, but only an NCI center can provide the next state-of-the-art in cancer care. That distinction is crucial, especially now with recent breakthroughs in our understanding of the science of cancer, and it can be a matter of life or death for a cancer patient.
The state comprehensive cancer control plan will help us defeat cancer in Connecticut. It is the result of a national program sponsored by the federal Centers for Disease Control and Prevention or CDC. The CDC defines comprehensive cancer control as “an integrated and coordinated approach to reducing cancer incidence, morbidity, and mortality through prevention (primary prevention), early detection (secondary prevention), treatment, rehabilitation, and palliation.” The plan’s purpose is to help improve coordination of state cancer control activities and is essential to maximize resources and achieve desired cancer control outcomes. Comprehensive cancer control results in many benefits, including increased efficiency for delivering both public health-related messages and services to the public.
Stated more directly, the state cancer plan provides a roadmap of steps we must take here in Connecticut to apply the science to help the residents of our state better prevent, detect, and treat cancer, and to help the growing number of patients and their families who survive cancer, and to improve the end of life care for those who do not.
Let me give you one example of the difference that you can make. This year, the American Cancer Society projects that 2,090 of our residents will be newly diagnosed with colorectal cancer and that 560 will die of this disease. It is the leading cause of cancer deaths in nonsmokers. We could prevent 80 percent of those cancers by widespread use of colonoscopies. This year through your support, 600 colonoscopies will be done on high-risk patients at community health centers who otherwise would not have been able to get one. By further supporting the state cancer plan, we will expand that program and many more cases of colorectal cancer will be prevented.
To reach this goal and the other cancer plan goals in Connecticut, we are asking that you make a multiyear effort to fully implement the plan. The money that you provide this year will allow Connecticut to take critically needed additional steps in the following five areas.
1. Prevention. We will meet the extraordinary state demand for smoking cessation services that was demonstrated this summer when thousands of callers snapped up the supply of pharmacotherapy, such as nicotine patches and gums, that was offered to state residents. We will also begin a counter-marketing campaign like the one in New York City that has dropped their high school smoking rate to less than 10 percent and half of the rate here in Connecticut. It is time we provide state residents, especially the underserved, a comprehensive, effective tobacco control program that is among the top-ranked in the nation, not one ranked dead last. Your investment will provide that. We must also do more to teach our children sensible, life long habits that have been shown to reduce cancer. Your investment will also allow us to undertake key initiatives in nutrition, physical activity, & obesity, and environmental health.
2. Early Detection. We will help thousands of underserved women in the state detect breast and cervical cancer early so that treatment will be more effective. We will also continue a program you funded in 2006 to make colonoscopies available to Connecticut residents who can now not afford them, and by detecting and removing polyps, prevent colon cancer in these patients. We will also begin a program to help discover the right way to detect lung cancer in time to stop the number one cancer killer in the state.
3. Treatment. We will expand the cancer therapies available in the state, by continuing to build a statewide clinical trials network, and programs to assist patients, providers, and researchers with critical information to help get emerging therapies to those who need them.
4. Survivorship. We will do more to educate health care providers about cancer survivorship and the unique health issues their patients who have survived cancer face.
5. End-of-life. We will do more to ensure that those whose cancer we cannot defeat get the help they need to have the best quality of life during the time that remains.
It is a bold plan. But I am confident that together we can succeed. Thank you.