Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City
17% CONGRESS
First Regular Session

House Bil No, 9763

Introduced by Representative Wes Gatchalian

EXPLANATORY NOTE

Asa global phenomenon, cancer figures among the leading causes of morbidity and
mortality worldwide, with approximately 14 million new cases and 8.2 million cancer
related deaths in 2012 (WHO). It is expected that annual cancer cases will rise from 14
million in 2012 to 22 million within the next 2 decades and over 200,000 children will be
affected yearly (WHO). In a macroeconomic level, according to the World Economic Forum
in 2014, cancer accounts for an estimated $2 trillion in the world economy in terms of lost
output and the cost of treatment, equivalent to around 1.5% of global GDP, as well as
wreaking terrible suffering on millions of individuals, families and communities.

In the Philippines, cancer is the third leading cause of morbidity and mortality in
the country after diseases of the heart and the vascular system (Philippine Health Statistics
2011). In the WHO Globocan 2012: Estimated Cancer Incidence, Mortality and Prevalence
Worldwide in 2012 report, the estimated incidence of cancer in the Philippines for both men
and women (excluding melanoma skin cancer) reached more than 43,000 and will increase
by 64% within 5 years. About 3,500 new cases of cancer will be diagnosed in children every
year — the equivalent of almost 10 children every day (Philippine Children's Medical
Center). These daunting statistics demand action on our part. We cannot go on affirming our
commitment to public health in the constitution while at the same time not take a more
active role in improving cancel health and management in the Philippines.

In 2016 the DOH promulgated AO 2016-0001, Revised Policy on Philippine Cancer
Prevention and Control updating AO 89-A promulgated in 1990. This bill seeks to build on
the AO 2016-0001 by establishing institutions which will enforce the policies laid down. This
bill therefore seeks to establish the creation of the National Cancer Control Committee. This
body will ensure that there is a coordinated cancer control program in the country
overseeing training, research, treatment, as well as the education of the country.

One of the core principles which the NCCC will focus on is the regulation of the
practice of oncology. As a specialization, Oncology is one of the most technical and
sophisticated fields in medicine. This is of course apropos as cancer is very complicated
disease requiring nothing less than years of training and experience on the part of the
physician if the patient is going to have any chance of survival. One of the negative
externalities in this current unregulated paradigm is that there are several instances where
a physician of different specialization takes on the case of treating a cancer patient. The
result is that a patient ends up spending thousands upon thousands of their hard earned
money with the result that in the end they are worse of as they were not accorded the
proper treatment, even worse as in some instances, leading to the death of the patient. A
physician swears to do no harm, and for the most part we pay tribute to the many men and
women who practice their vocation with the most noble of animus. The get@tnment must
however provide for mechanisms to hold liable those who do cause hy

Representative

1+ district, Valenzugfa City



Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City
17% CONGRESS
First Regular Session

House BillNo._9 763

Introduced by Representative Wes Gatchalian

AN ACT CREATING
‘THE NATIONAL CANCER CONTROL COMMITTEE, INSTITUTIONALIZING THE
PHILIPPINE CANCER PREVENTION AND CONTROL PROGRAM,
AND PROVIDING FOR PENALTIES FOR VIOLATIONS THEREOF

Section 1. Title. This Act shall be known as the “Philippine Cancer Prevention and
Control Act of 2017”

Section 2. Statement of Policy.

(A) _ General - This Act is aimed to set overall policy directions and identify the
roles and functions of DOH, its offices and partner agencies in reducing the impact of cancer
and improve the well-being of Filipino people with cancer and their families by providing
holistic services from cancer prevention, screening, diagnosis, palliative care and treatment,
until recovery and end-of-life or hospice care.

(B)_ Specific:

1) To reduce mortality and improve overall survival and quality of life of people
with various cancer types through early diagnosis and prompt treatment;

2) To reduce the incidence of prioritized cancers associated with the most common
avoidable risk factors;

3) To ensure that prioritized cancer control services are provided in an equitable
and sustainable way at all levels of care;

4) To increase and expand the coverage of cancer treatment, including but not
limited to the use of innovative drugs and psychosocial support in the preventive, treatment,
and survivorship stage of the patient and family, if necessary;

5) To set regulatory and accreditation standards for cancer institute / center, as an
integral part of DOH and government hospitals including private hospitals as applicable, that
follows a multi-disciplinary and interdisciplinary team approach to cancer management;

6) To develop and update regularly a compendium of guidelines or standards for
prioritized cancers including childhood cancer; and

7) To promote a multi-disciplinary approach by prescribing guidelines and penal
for violations thereof;

Section 3. Scope - This Act shall apply to all stakeholders of cancer control —
bureaus, national centers, services and attached agencies of the Department of Health and
other key government agencies; local government units (LGUs); government-owned and -
controlled corporations (GOCCs); health professionals and other health care providers, both
public and private; anti-cancer health product providers; professional organizations and
societies, civil society organizations (CSOs); non-government organizations (NGOs), research
and development partners; academe; patients and patients’ groups.

Section 4. Definition of terms.

A. Cancer is a generic term for a large group of diseases that can affect any part


of the body. Other terms used are malignant tumors and neoplasms. One defining feature of
cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries, and
which can then invade adjoining parts of the body and spread to other organs, the latter
process is referred to as metastasizing, Metastases are the major cause of death from cancer.

B. Cancer Control aims to reduce the incidence, morbidity and mortality of
cancer and to improve the quality of life of cancer patients in a defined population, through
the systemic implementation of evidence-based interventions for prevention, early
detection, diagnosis, treatment, and palliative care.

C Cancer Diagnosis comprises the various techniques and procedures used to
detect or confirm the presence of cancer. Diagnosis typically involves evaluation of the
patient's history, clinical examinations, review of laboratory test results and radiological
data, and microscopic examination of tissue samples obtained by biopsy or fine-needle

aspiration.

D. Cancer Prevention refers to measures and interventions that will decrease
the likelihood or risk of an individual of acquiring cancer.

E, Cancer Survivorship starts at the time of disease diagnosis and continues

throughout the rest of the patient's life. Family caregivers and friends are also considered
survivors. It has three distinct phases: living through, with and beyond cancer.

F. Cancer Treatment is the series of interventions, including psychosocial and
nutritional support, surgery, radiotherapy, chemotherapy and hormone therapy, that is
aimed at curing the disease or prolonging the patient's life considerably (for several years)
while improving the patient's quality of life. Some people with cancer will have only one
treatment. But most people have a combination of treatments, such as surgery with
chemotherapy and/or radiation therapy. Patients may also have immunotherapy, targeted
therapy, or hormone therapy. Source: National Cancer Institute

G. Hospice care is end-of-life care provided by health professionals and
volunteers. They give medical, psychological and spiritual support. The goal of the care is to
help people who are dying to have peace, comfort and dignity.

H. Oncology refers to the study and treatment of tumors.

1.__Interdisciplinary refers to integrating knowledge and methods from different
disciplines, using a real synthesis of approaches, e.g. oncologist — nurse —social worker —
caregiver. Multidisciplinary refers to people from different disciplines working together,
each drawing on their disciplinary knowledge, eg. oncologist — surgeon — radiologist. The
cancer care team may include not only the surgeon, radiation oncologists, and medical
‘oncologists but also the expert in diagnostic imaging, the pathologist, the genetic counselor,
the oncology nurse, the physical therapist, the hospital pharmacist, and others. Well.
Coordinated multi- and interdisciplinary care is the current standard, where patients can
obtain consults and see specialists who all practice in one central location.

J Palliative Care is treatment to relieve, rather than cure, symptoms caused by
cancer. It can help people live more comfortably. Relief from physical, psychosocial and
spiritual problems can be achieved in over 90% of advanced cancer patients through
palliative care.

K___ Patient Navigation refers to individualized assistance offered to patients,
families, and caregivers to help overcome health care system barriers and facilitate timely
access to quality medical and psychosocial care. Cancer patient navigation works with a
patient from pre-diagnosis through all phases of the cancer experience.

Section 5. Framework.

1, The National Cancer Control Committee (NCCC) shall lead in the implementation
of National Cancer Control Program.

2. The DOH-Regional Office shall adopt the national policies and standards and
oversee their implementation at the regional level.

3. The Experts Group shall formulate and update protocols and standards on cancer
screening, diagnosis, and treatment.

4. The NCCC shall come up with a compendium of all updated protocols and
standards on cancer prevention, screening, diagnosis, treatment, and palliative care.


5. The NCCC shall develop the Comprehensive Cancer Management Guidelines for

hospitals and community-based facilities.

6. The NCCC shall develop the Implementing Guidelines on Cancer Patient

Navigation.

Section 6. The National Cancer Control Committee

The National Cancer Control Committee shall be created to lead in the

implementation of the Philippine Cancer Prevention and Control Program (PCPCP).

‘The Committee shall be composed as follows:

a
b

c
a.

e

f

&

‘The Department of Health Secretary shall be the ex officio Chairman;
The Director-General of Food and Drug Administration (FDA) as an ex officio
member;

The CEO of the PhilHealth as an ex officio member;

‘The Chairman of the Professional Regulation Commission (PRC) as an ex officio
member;

‘A Member from each of the Disciplines of Oncology as later determined in the
Implementing Rules of this law, to be appointed by the president on the
recommendation of the Secretary of Health, who shall serve for a term of 2-years.

‘A Member from Patient Organizations to be appointed by the president on the
recommendation of the Secretary of Health, who shall serve for a term of 2-years.

A Member from the Academe to be appointed by the president on the
recommendation of the Secretary of Health, who shall serve for a term of 2-years.

Section 7. The Functions of the NCCC.

In addition to those specified in Article 5 of this Act, the NCCC shall perform the
following functions:

a)
b)

Co)
a)
°)
8)
h)

D}
k)
»

Shall set the roadmap of Philippine Cancer Prevention and Control Program
(PcPcP);

Shall plan, establish and implement policies, guidelines and standards throughout
the continuum of holistic health care (preventive, promotive, curative, rehabilitative
and palliative) thru multidisciplinary and interdisciplinary team and_patient-
centered approach. For this purpose, it shall have the power to convene an Experts
Group;
Shall ad
the country;

Shall be the coordinating body for all cancer works in the country;

Shall ensure the implementation of PCPCP down to the local government units;

Shall establish and carry out an effective nationwide cancer education program and
its dissemination;

Shall provide technical and financial support on cancer prevention, early detection,
palliative care, treatment and hospice care;

Shall establish and carry out effective training program. For this purpose, it shall
accredit a Training Institution upon evaluation that it has the capacity to provide
training in line with the Standards set by the Committee. The Committee shall also
accredit physicians who have successfully completed their trainings in line with
their specified discipli

Shall ensure the collection and analysis of data from registry and surveillance. For
this purpose, it shall coordinate a national research program;

Shall implement, monitor and evaluate the PCPCP regularly through implementation
review and impact evaluation;

Shall empower and engage all the stakeholders to actively work on and participate
in on various areas of PCPCP;

Shall endorse support for researchers in the clinical, epidemiological, public health

or recommend upgrading of existing cancer management facilities in



and knowledge management areas and in collaboration with international institutes;

m) Shall provide other forms of assistance as may be identified and approved by the
Secretary of Health;

1) Shall have exclusive appellate jurisdiction over cases decided by the Regional Cancer
Control Committee for violations of this Act. For this purpose, a simple majority vote
by all the members of the committee shall be sufficient to affirm the decision of the
DOH-Regional Office;

Se

8. DOH-Regional Office.

‘The DOH-Regional office shall be charged with the implementation of the policies
and programs related to cancer prevention and control as determined by the NCCC.

The Director of the regional office shall hear and decide cases involving violations of
this Act as defined in the next succeeding section.

Section 9. Illegal Practice of Oncology.

Any person, who, not having the proper training and accreditation as provided in
Section 7 of this Act, engages in the practice of Oncology as regards a discipline to which he
is not accredited in, shall be subject to a fine of not less than one-hundred thousand pesos (P
100 000.00), and depending on the circumstance of each case, to the suspension or
cancellation of his accreditation.

The decision of the Regional Director shall become final and executory upon the
lapse of ten (10) days from notice to the person accused of illegal practice of oncology if no
appeal is taken therefrom.

Section 10. Implementing Rules and Regulation. - Within thirty (30) days from the
effectivity of this Act, the Secretary of Health, in consultation with appropriate government
agencies and other stakeholders, shall promulgate the necessary rules and regulations to
implement this Act.

Section 11, Appropriation. - An initial funding of five hundred million pesos (P 500
000 000.00) shall be allocated for the establishment of the National Cancer Control
Committee (NCCC) and the implementation of the Philippine Cancer Prevention and Control
Program (PCPCP). Thereafter it shall be part of the budget of the Department of Health in the
General Appropriation Act.

Section 12. Repealing Clause. - All laws, presidential decress, executive orders, rules
and regulations or part thereof, contrary to or inconsistent with the provisions of this Act,
are hereby repealed or modified accordingly.

‘Section 13. Separability Clause. - If any section or provision of this Act is held

unconstitutional or invalid, all other sections or provisions shall remain in full force and
effect.

Section 14, Effectivity Clause. - This Act shall take effect fifteen (15) days after its
‘complete publication in any two (2) newspapers of general circulation.

Approved,