II 

117TH CONGRESS 

1ST SESSION S. 2720 

To direct the Secretary of Veterans Affairs to establish a national clinical 

pathway for prostate cancer, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 13, 2021 

Mr. MORAN (for himself and Mr. TESTER) introduced the following bill; which 

was read twice and referred to the Committee on Veterans’ Affairs 

A BILL 

To direct the Secretary of Veterans Affairs to establish a 

national clinical pathway for prostate cancer, and for 

other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Veterans’ Prostate 

5 Cancer Treatment and Research Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) Prostate cancer is the number one cancer 

9 diagnosed in the Veterans Health Administration. 


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1 (2) A 1996 report published by the National 

2 Academy of Sciences, Engineering, and Medicine es3 tablished a link between prostate cancer and expo4 sure to herbicides, such as Agent Orange. 

5 (3) It is essential to acknowledge that due to 

6 these circumstances, certain veterans are made 

7 aware that they are high-risk individuals when it 

8 comes to the potential to develop prostate cancer. 

9 (4) In being designated as ‘‘high risk’’, it is es10 sential that veterans are proactive in seeking earlier 

11 preventative clinical services for the early detection 

12 and successful treatment of prostate cancer, whether 

13 that be through the Veterans Health Administration 

14 or through a community provider. 

15 (5) Clinical preventative services and initial de16 tection are some of the most important components 

17 in the early detection of prostate cancer for veterans 

18 at high risk of prostate cancer. 

19 (6) For veterans with prostate cancer, including 

20 prostate cancer that has metastasized, precision on21 cology, including biomarker-driven clinical trials and 

22 innovations underway through the Prostate Cancer 

23 Foundation and Department of Veterans Affairs 

24 partnership, represents one of the most promising 


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1 areas of interventions, treatments, and cures for 

2 such veterans and their families. 

3 SEC. 3. DEPARTMENT OF VETERANS AFFAIRS TREATMENT 

4 AND RESEARCH OF PROSTATE CANCER. 

5 (a) ESTABLISHMENT OF CLINICAL PATHWAY.— 

6 (1) IN GENERAL.—Not later than 365 days 

7 after the date of the enactment of this Act, the Sec8 retary of Veterans Affairs shall establish an inter9 disciplinary clinical pathway for all stages of pros10 tate cancer, from early detection to end of life care. 

11 The clinical pathway shall be established in the Na12 tional Surgery Office of the Department of Veterans 

13 Affairs in close collaboration with the National Pro14 gram Office of Oncology, the Office of Research and 

15 Development, and other relevant entities of the De16 partment, including Primary Care. 

17 (2) ELEMENTS.—The national clinical pathway 

18 established under this subsection shall include the 

19 following elements: 

20 (A) A diagnosis pathway for prostate can21 cer that includes early screening and diagnosis 

22 protocol, including screening recommendations 

23 for veterans with evidence-based risk factors. 

24 (B) A treatment pathway that details the 

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1 ment that will interact with veterans receiving 

2 prostate cancer care, including treatment pro3 tocol recommendations for veterans with evi4 dence-based risk factors. 

5 (C) Treatment recommendations for all 

6 stages of prostate cancer that reflect nationally 

7 recognized standards for oncology, including 

8 National Comprehensive Cancer Network guide9 lines. 

10 (D) A suggested protocol timeframe for 

11 each point of care, from early screening to 

12 treatment and end-of-life care, based on sever13 ity and stage of cancer. 

14 (E) A plan that includes, as appropriate, 

15 both Department medical facilities and commu16 nity-based partners and providers and research 

17 centers specializing in prostate cancer, espe18 cially such centers that have entered into part19 nerships with the Department. 

20 (3) COLLABORATION AND COORDINATION.—In 

21 establishing the clinical pathway required under this 

22 section, the Secretary may collaborate and coordi23 nate with— 

24 (A) the National Institutes of Health; 

25 (B) the National Cancer Institute; 


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1 (C) the National Institute on Minority 

2 Health and Health Disparities; 

3 (D) the Centers for Disease Control and 

4 Prevention; 

5 (E) the Centers for Medicare and Medicaid 

6 Services; 

7 (F) the Patient-Centered Outcomes Re8 search Institute; 

9 (G) the Food and Drug Administration; 

10 (H) the Department of Defense; and 

11 (I) other Institutes and Centers as the 

12 Secretary determines necessary. 

13 (4) CONSULTATION REQUIREMENT.—In estab14 lishing the clinical pathway required under this sec15 tion, the Secretary shall consult with, and incor16 porate feedback from, veterans who have received 

17 prostate cancer care at Department medical facilities 

18 as well as experts in multi-disciplinary cancer care 

19 and clinical research. 

20 (5) PUBLICATION.—The Secretary shall— 

21 (A) publish the clinical pathway estab22 lished under this subsection on a publicly avail23 able Department website; and 

24 (B) update the clinical pathway as needed 

25 by review of the medical literature and available 


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1 evidence-based guidelines at least annually, in 

2 accordance with the criteria under paragraph 

3 (2). 

4 (b) DEVELOPMENT OF COMPREHENSIVE PROSTATE

5 CANCER PROGRAM AND IMPLEMENTATION OF THE PROS6 TATE CANCER CLINICAL PATHWAY.— 

7 (1) ESTABLISHMENT.—Not later than 180 days 

8 after the date of the enactment of this Act, the Sec9 retary shall submit to Congress a plan to establish 

10 a prostate cancer program using the comprehensive 

11 prostate cancer clinical pathway developed under 

12 subsection (a). 

13 (2) PROGRAM REQUIREMENTS.—The com14 prehensive prostate cancer program shall— 

15 (A) receive direct oversight from the Dep16 uty Undersecretary for Health of the Depart17 ment of Veterans Affairs; 

18 (B) include a yearly program implementa19 tion evaluation to facilitate replication for other 

20 disease states or in other healthcare institu21 tions; 

22 (C) be metric driven and include the devel23 opment of biannual reports on the quality of 

24 prostate cancer care, which shall be provided to 

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1 ters, and providers and made publicly available 

2 in an electronic form; and 

3 (D) include an education plan for patients 

4 and providers. 

5 (3) PROGRAM IMPLEMENTATION EVALUA6 TION.—The Secretary shall establish a program 

7 evaluation tool to learn best practices and to inform 

8 the Department and Congress regarding further use 

9 of the disease specific model of care delivery. 

10 (4) PROSTATE CANCER RESEARCH.—The Sec11 retary shall submit to Congress a plan that provides 

12 for continual funding through the Office of Research 

13 and Development of the Department of Veterans for 

14 supporting prostate cancer research designed to po15 sition the Department as a national resource for 

16 prostate cancer detection and treatment. Such plan 

17 shall— 

18 (A) include details regarding the funding 

19 of and coordination between the National Preci20 sion Oncology Program of the Department and 

21 the PCF–VA Precision Oncology Centers of Ex22 cellence as related to the requirements of this 

23 Act; and 

24 (B) affirm that no funding included in 

25 such funding plan is duplicative in nature. 


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1 (c) REPORT ON NATIONAL REGISTRY.—The Sec2 retary of Veterans Affairs shall submit to Congress a re3 port on the barriers and challenges associated with cre4 ating a national prostate cancer registry. Such report shall 

5 include recommendations for centralizing data about vet6 erans with prostate cancer for the purpose of improving 

7 outcomes and serving as a resource for providers. 

8 (d) DEFINITIONS.—In this section: 

9 (1) The term ‘‘clinical pathway’’ means a health 

10 care management tool designed around research and 

11 evidence-backed practices that provides direction for 

12 the clinical care and treatment of a specific episode 

13 of a condition or ailment. 

14 (2) The term ‘‘evidence-based risk factors’’ in15 cludes race, ethnicity, socioeconomic status, geo16 graphic location, exposure risks, genetic risks, in17 cluding family history, and such other factors as the 

18 Secretary determines appropriate. 

Æ 


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