I 
116TH CONGRESS 
2D SESSION 
H. R. 6092 
To direct the Secretary of Veterans Affairs to establish a national clinical 
pathway for prostate cancer, access to life-saving extending precision 
clinical trials and research, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 5, 2020 
Mr. DUNN (for himself and Mr. CUNNINGHAM) introduced the following bill; 
which was 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, access to 
life-saving extending precision clinical trials and research, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Veteran’s Prostate 
Cancer Treatment and Research Act’’. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
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(1) Prostate cancer is the number one cancer 
diagnosed in the Veterans Health Administration. 
(2) A 1996 report published by the National 
Academy of Sciences, Engineering, and Medicine es-
tablished a link between prostate cancer and expo-
sure to herbicides, such as Agent Orange. 
(3) It is essential to acknowledge that due to 
these circumstances, certain veterans are made 
aware that they are high-risk individuals when it 
comes to the potential to develop prostate cancer. 
(4) In being designated as ‘‘high risk’’, it is es-
sential that veterans are proactive in seeking earlier 
preventative clinical services for the early detection 
and successful treatment of prostate cancer, whether 
that be through the Veterans Health Administration 
or through a community provider. 
(5) Clinical preventative services and initial de-
tection are some of the most important components 
in the early detection of prostate cancer for veterans 
at high risk of prostate cancer. 
(6) For veterans with prostate cancer, including 
prostate cancer that has metastasized, precision on-
cology, including biomarker-driven clinical trials and 
innovations underway through the Prostate Cancer 
Foundation and Department of Veterans Affairs 
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partnership, represents one of the most promising 
areas of interventions, treatments, and cures for 
such veterans and their families. 
SEC. 3. DEPARTMENT OF VETERANS AFFAIRS TREATMENT 
AND RESEARCH OF PROSTATE CANCER. 
(a) ESTABLISHMENT OF CLINICAL PATHWAY.— 
(1) IN
GENERAL.—Not later than 365 days 
after the date of the enactment of this Act, the Sec-
retary of Veterans Affairs shall establish in the Na-
tional Surgery Office of the Department of Veterans 
Affairs a national clinical pathway for all stages of 
prostate cancer, from early detection to end-of-life 
care including recommendations regarding the use of 
transformative innovations, research, and uniform 
clinical data. 
(2) ELEMENTS.—The national clinical pathway 
established under this subsection shall include the 
following elements: 
(A) A multi-disciplinary plan for the early 
detection, diagnosis, and treatment of prostate 
cancer that includes, as appropriate, both De-
partment medical facilities and community- 
based partners and providers and research cen-
ters specializing in prostate cancer, especially 
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such centers that have entered into partner-
ships with the Department. 
(B) A suggested, but not mandatory, pro-
tocol for screening, diagnosis, and treatment or 
care for subpopulations with evidence-based risk 
factors (including race, ethnicity, socioeconomic 
status, geographic location, exposure risks, and 
genetic risks, including family history). 
(C) A suggested treatment protocol time-
frame for each point of care based on severity 
and stage of cancer. 
(3) PUBLIC COMMENT PERIOD.—Upon the es-
tablishment of a proposed clinical pathway as re-
quired under this subsection, the Secretary shall 
publish the proposed clinical pathway in the Federal 
Register and provide for a 45-day period for public 
comments. The Secretary— 
(A) may make any such public comments 
publicly available; and 
(B) make changes to the proposed clinical 
pathway in response to any such comments re-
ceived using the same process and criteria used 
to establish the proposed clinical pathway. 
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(4) COLLABORATION AND COORDINATION.—In 
establishing the clinical pathway required under this 
section, the Secretary shall— 
(A) provide for consideration of other clin-
ical pathways and research findings of other de-
partments and agencies, including guidelines 
that are widely recognized and guidelines that 
are used as the standard for clinical policy in 
oncology care, such as National Comprehensive 
Cancer Network guidelines; and 
(B) collaborate and coordinate with— 
(i) the National Institutes of Health; 
(ii) the National Cancer Institute; 
(iii) the National Institute on Minor-
ity Health and Health Disparities; 
(iv) other Institutes and Centers as 
the Secretary determines necessary; 
(v) the Centers for Disease Control 
and Prevention; 
(vi) the Department of Defense; 
(vii) the Centers for Medicare and 
Medicaid Services; 
(viii) the Patient-Centered Outcomes 
Research Institute; and 
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(ix) the Food and Drug Administra-
tion. 
(5) PUBLICATION.—The Secretary shall— 
(A) publish the clinical pathway estab-
lished under this subsection on a publicly avail-
able Department website; and 
(B) regularly update the clinical pathway 
as needed by review of the medical literature 
and available evidence-based guidelines at least 
annually, in accordance with the criteria under 
paragraph (2). 
(b) DEVELOPMENT OF NATIONAL CANCER OF THE 
PROSTATE
CLINICAL
CARE
IMPLEMENTATION
PRO-
GRAM.— 
(1) ESTABLISHMENT.—Not later than 90 days 
after the date of the enactment of this Act, the Sec-
retary shall submit to Congress a plan to establish 
a comprehensive prostate cancer program. 
(2) PROGRAM
REQUIREMENTS.—The compre-
hensive prostate cancer program shall— 
(A) be multidisciplinary and include the 
authority to work across clinical care lines, spe-
cialties, and the organizational divisions of the 
Veterans Health Administration; 
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(B) receive direct oversight from the Dep-
uty Undersecretary for Health of the Depart-
ment of Veterans Affairs; 
(C) include a yearly program implementa-
tion evaluation to facilitate replication for other 
disease states or in other healthcare institu-
tions; 
(D) be metric driven and include the devel-
opment of quarterly reports on the quality of 
prostate cancer care, which shall be provided to 
the leadership of the Department, medical cen-
ters, and providers and made publicly available 
in an electronic form; 
(E) made available as national decision 
support tools in the electronic medical record; 
(F) include an education plan for patients 
and providers; and 
(G) be funded appropriately to accomplish 
the objectives of this Act. 
(3) 
PROGRAM
IMPLEMENTATION
EVALUA-
TION.—The Secretary shall establish a program 
evaluation tool as an integral component to learn 
best practices of multidisciplinary disease-based im-
plementation and to inform the Department and 
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Congress regarding further use of the disease spe-
cific model of care delivery. 
(4) PROSTATE CANCER RESEARCH.—The Sec-
retary shall submit to Congress a plan that provides 
for continual funding through the Office of Research 
and Development of the Department of Veterans Af-
fairs for supporting prostate cancer research de-
signed to position the Department as a national re-
source for quality reporting metrics, practice-based 
evidence, comparative effectiveness, precision oncol-
ogy, and clinical trials in prostate cancer. 
(5) PROSTATE CANCER REAL TIME REGISTRY 
PROGRAM.—The Secretary, in collaboration with 
data stewards of the Department of Veterans Af-
fairs, scientists, and the heads of other Depart-
ments, agencies, and non-governmental organiza-
tions, such as foundations and non-profit organiza-
tions focused on prostate cancer research and care, 
shall establish a real-time, actionable, national pros-
tate cancer registry. Such registry shall be de-
signed— 
(A) to establish a systematic and standard-
ized database that enables intra-agency collabo-
ration by which to track veteran patient 
progress, enable population management pro-
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grams, facilitate best outcomes, and encourage 
future research and further development of clin-
ical pathways, including patient access to preci-
sion resources and treatments and access to 
life-extending precision clinical trials; 
(B) to employ novel methods of structuring 
data, including natural language processing, ar-
tificial intelligence, structured data clinical 
notes, patient reported outcome instruments, 
and other tools, to ensure that all clinically 
meaningful data is included; and 
(C) to be accessible to— 
(i) clinicians treating veterans diag-
nosed with prostate cancer and being 
treated for prostate cancer in conjunction 
with Department medical facilities; and 
(ii) researchers. 
(c) CLINICAL PATHWAY DEFINED.—In this section, 
the term ‘‘clinical pathway’’ means a health care manage-
ment tool designed around research and evidence-backed 
practices that provides direction for the clinical care and 
treatment of a specific episode of a condition or ailment. 
Æ 
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