BILL ANALYSIS
SJR 7
Page 1
Date of Hearing: June 23, 2009
ASSEMBLY COMMITTEE ON HEALTH
Dave Jones, Chair
SJR 7 (Lowenthal) - As Introduced: April 20, 2009
SENATE VOTE : 36-0
SUBJECT : Pancreatic cancer.
SUMMARY : Urges the President and the Congress of the United
States (U.S.) to expand federally funded research efforts aimed
at developing a reliable means of detecting pancreatic cancer in
its early stages and more effective means of treatment, through
legislative measures, such as H.R. 745. Specifically, this
resolution :
1)Makes the following legislative findings and declarations:
a) Approximately 38,000 Americans, including an estimated
3,625 Californians, will be diagnosed with pancreatic
cancer this year;
b) Seventy-five percent of pancreatic cancer patients die
within the first year of their diagnosis, and 95% die
within five years, making pancreatic cancer the deadliest
of any cancer;
c) Pancreatic cancer is the fourth most common cause of
cancer death in the U.S., with an estimated 3,380
Californians expected to die from pancreatic cancer in
2009;
d) There has been no significant improvement in pancreatic
cancer survival rates in over 30 years, and pancreatic
cancer research is still in the earliest scientific stages;
e) There are no early detection methods and minimal
treatment options for pancreatic cancer;
f) The incidence rate of pancreatic cancer is 40% to 50%
higher in African Americans than in other ethnic groups,
with Jews of Ashkenazi descent also at an increased genetic
risk;
SJR 7
Page 2
g) Pancreatic cancer has struck such notable figures as
Justice Ruth Bader Ginsberg, Patrick Swayze, Dr. Randy
Pausch, and Luciano Pavarotti;
h) Pancreatic cancer research constitutes less than 2% of
the National Cancer Institute's (NCI's) federal research
funding, a figure far too low given the severity of the
disease, its mortality rate, and how little is known about
how to arrest it;
i) There is a critical need to support research that
identifies new methods of detecting and treating pancreatic
cancer; and,
j) H.R. 745 was introduced in the U.S. House of
Representatives by California Congresswoman Anna Eshoo to
require the establishment of a Pancreatic Cancer Initiative
and an Interdisciplinary Pancreatic Cancer Coordinating
Committee to, among other things, provide advice on overall
research objectives and benchmarks for pancreatic cancer
research.
2)Urges the California Legislature, the President and Congress
of the U.S. to expand federally funded research efforts aimed
at developing a reliable means of detecting pancreatic cancer
in its early stages and more effective means of treatment,
through legislative measures, such as H.R. 745.
3)Resolves that the Secretary of the California State Senate
transmit copies of this resolution to the President and Vice
President, to the Speaker of the U.S. House of
Representatives, to each U.S. Senator and Representative from
California in the Congress, and to the directors of the
National Institutes of Health (NIH) and NCI.
EXISTING LAW :
1)Establishes the Ken Maddy California Cancer Registry, which
requires the Director of the California Department of Public
Health (DPH) to establish a statewide system for the
collection of information determining the incidence of cancer,
using population-based cancer registries.
2)Requires the University of California (UC) to establish and
administer the Breast Cancer Research Program as a
SJR 7
Page 3
comprehensive grant and contract program to support research
efforts into the cause, cure, treatment, earlier detection,
and prevention of breast cancer.
FISCAL EFFECT : None
COMMENTS :
1)PURPOSE OF THIS RESOLUTION . According to the sponsors of this
resolution, the Pancreatic Cancer Action Network, pancreatic
cancer is one of the few cancers for which survival has not
improved substantially over the past 30 years. As the most
lethal form of cancer - 75% of pancreatic cancer patients die
within the first year of their diagnosis and only 5% survive
more than five years - pancreatic cancer is the fourth leading
cause of cancer-related death in the U.S. The sponsors
maintain that the number of people diagnosed with pancreatic
cancer in the U.S. and the number of deaths caused by
pancreatic cancer are going up and is expected to reach over
40,000 nationally within the next few years. The sponsor
argues that available pancreatic cancer early detection and
treatment tools for pancreatic cancer today are roughly
equivalent to the tools available for breast cancer in the
1930s. By the 1930s, rudimentary surgical methods to remove
early breast and pancreatic cancer tumors had been developed.
However, according to the sponsor, while mammography was
developed by the 1950s, and many effective breast cancer
treatments followed, similar early detection and treatment
tools for pancreatic cancer still do not exist. The sponsors
maintain that current federal funding levels for pancreatic
cancer have rendered scientific progress for this disease
fatally slow.
According to the sponsors there are a number of factors that
make pancreatic cancer research particularly challenging, such
as: a) Pancreatic cancer research has been drastically
under-funded and as a result there a relatively few
researchers investigating the disease; b) Pancreatic cancer
cells are surrounded by tough, dense fibrotic cells that make
it extremely difficult for treatments to reach and enter the
actual cancer cells; and, c) Pancreatic cancer patients die
quickly, making it difficult to include them in clinical
trials and/or collect tissue samples. These challenges,
according to the sponsors, are not insurmountable, but require
disease specific solutions.
SJR 7
Page 4
2)BACKGROUND . According to the MayoClinic, pancreatic cancer
begins in the tissues of the pancreas - a large organ that
lies horizontally behind the lower part of the stomach. The
pancreas is a crucial part of the digestive system. It
secretes hormones, including insulin, to help the body process
sugar. And, it produces digestive juices to help the body
digest food. Pancreatic cancer occurs when cells in the
pancreas develop genetic mutations. These mutations cause the
cells to grow uncontrollably and to continue living after
normal cells would die. These accumulating cells can form a
tumor.
The MayoClinic further states that pancreatic cancer often has a
poor prognosis, even when diagnosed early. Pancreatic cancer
typically spreads rapidly and is seldom detected in its early
stages, which is a major reason why it's a leading cause of
cancer death. Signs and symptoms of pancreatic cancer often
don't occur until the disease is advanced. When signs and
symptoms do appear, they may include: a) Upper abdominal pain
that may radiate to the back; b) Jaundice - yellowing of the
skin and the whites of the eyes; c) Loss of appetite; d)
Weight loss; and, e) Depression. Risk factors for the disease
include: smoking; being overweight; personal or family history
of chronic inflammation of the pancreas (pancreatitis);
personal or family history; family history of genetic
syndromes that increase cancer risk, including a BRCA2 gene
mutation, Peutz-Jeghers syndrome, Lynch syndrome and familial
atypical mole-malignant melanoma; older age - pancreatic
cancer occurs most often in older adults. Most people
diagnosed with pancreatic cancer are in their 70s and 80s;
and, finally pancreatic cancer occurs more frequently in
blacks than in whites.
3)NCI FUNDING . The NCI is the federal government agency that
supports and conducts research in cancer biology, causation,
prevention, detection, treatment, and survivorship. Federal
funding for pancreatic cancer research totaled $87.3 million
in fiscal year 2008 (FY 08), the latest year for which NCI
statistics are available. This means that 1.81% of NCI's
$4.828 billion dollar budget is spent on research discoveries
for the 4th deadliest cancer. The following chart shows
funding in millions for the total NCI budget, and funding for
the top five cancer killers:
SJR 7
Page 5
-----------------------------------------------------------
| | FY | FY | FY | FY |% in 2008 |
| | 2004 | 2005 | 2006 | 2008 | of |
| | | | | |total NCI |
| | | | | | Budget |
|--------+---------+---------+---------+---------+----------|
|Disease | Actual | Actual | Actual | Actual | |
| | | | | | |
|Area | | | | | |
|--------+---------+---------+---------+---------+----------|
|Total | $4,723.9| $4,794.7| $4,792.6| $4,827.6| |
|NCI | | | | | |
|Budget | | | | | |
|--------+---------+---------+---------+---------+----------|
|Breast | $566.2| $560.1| $584.7| $572.4| 11.85%|
|--------+---------+---------+---------+---------+----------|
|Colon | $262.0| $253.1| $244.1| $258.4| 5.35%|
|--------+---------+---------+---------+---------+----------|
|Lung | $276.5| $266.1| $242.9| $226.9| 4.7 %|
|--------+---------+---------+---------+---------+----------|
|Prostate| $308.5| $309.0| $293.2| $296.1| 6.13%|
| | | | | | |
|--------+---------+---------+---------+---------+----------|
|Pancreat| $ 52.7| $ 66.7| $ 74.2| $ 73.3|1.81% |
|ic | | | | | |
-----------------------------------------------------------
4)PANCREATIC CANCER RESEARCH AND EDUCATION ACT . The Pancreatic
Cancer Research and Education Act (the Act), or H.R. 745, was
introduced in the U.S. House of Representatives by California
Congresswoman Anna Eshoo to assist in coordinating activities
to address the high mortality rate associated with pancreatic
cancer. H.R. 745 is based on the National Plan to Advance
Pancreatic Cancer Research, a report developed by the
Pancreatic Cancer Action Network. Key components of the Act
include: a) Launching a pancreatic cancer research initiative
which would be established by the Secretary of the Department
of Health and Human Services in consultation with the
Directors of the NIH, NCI and the Centers for Disease Control
and Prevention (CDC) to: a) Provide strategic direction and
accountability; b) Establish a five-year grant for a caner
research incubator pilot project at the NCI specifically for
research into the most deadly cancers.; c) Strengthen and
expand Centers of Excellence for Pancreatic Cancer to provide
increased opportunities for cancer research; and, d) Promote
SJR 7
Page 6
physician and public awareness by asking NIH and CDC to work
with patient advocacy organizations to develop a primary care
provider education program on pancreatic cancer and a
communication tool kit for patients.
5)SUPPORT . According to the sponsors of the bill, the
Pancreatic Cancer Action Network, this resolution explains the
deadly impact of pancreatic cancer, referencing its impact on
Americans in general and Californians in particular. The
sponsors maintain that more significantly, the resolution puts
California on record in support of such federal efforts as HR
745 which will not only provide a spotlight on pancreatic
cancer, but help move the issue forward in the national arena.
6)PREVIOUS LEGISLATION .
a) AJR 28 (Robert Pacheco), Chapter 24, Resolution Statutes
of 2002, urges the U.S. President and Congress to expand
federally funded research efforts aimed at developing a
reliable means of detecting pancreatic cancer in its early
stages.
b) AB 1843 (Robert Pacheco) of 2001 would have required the
Department of Health Services (DHS now DPH) to establish
and administer the Pancreatic Cancer Research and Education
Project Act to award grants to qualifying entities for
pancreatic cancer research and education. Would have
appropriated $500,000 from the General Fund to DHS for the
2002-03 FY for the purpose of this bill. AB 1843 was held
under submission in the Senate Appropriations Committee.
c) AB 480 (Robert Pacheco), Chapter 246, Statutes of 2001,
originally proposed to create the Pancreatic Cancer
Research Program, to be administered by UC, to award grants
to support research for the development of improved methods
of detecting and treating pancreatic cancer and to increase
public education and information about the disease. The
version of AB 480 that was signed into law instead requires
the Cancer Research Fund (Fund) for the Cancer Research
Program to consist of money accepted by DHS (now DPH) from
grants and donations from private entities and of public
moneys transferred to the Fund.
SJR 7
Page 7
REGISTERED SUPPORT / OPPOSITION :
Support
Pancreatic Cancer Action Network (sponsor)
Several individuals
Opposition
None on file.
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097