109250. The effective diagnosis, care, treatment or cure of persons
suffering from cancer is of paramount public importance. Vital
statistics indicate that approximately 16 percent of the total deaths
in the United States annually result from one or another of the
forms of cancer. It is established that accurate and early diagnosis
of many forms of cancer, followed by prompt application of methods of
treatment that are scientifically proven, either materially reduces
the likelihood of death from cancer or may materially prolong the
useful life of individuals suffering therefrom.
Despite intensive campaigns of public education, there is a lack
of adequate and accurate information among the public with respect to
presently proven methods for the diagnosis, treatment, and cure of
cancer. Various persons in this state have represented and continue
to represent themselves as possessing medicines, methods, techniques,
skills, or devices for the effective diagnosis, treatment, or cure
of cancer, whose representations are misleading to the public, with
the result that large numbers of the public, relying on the
representations, needlessly die of cancer, and substantial amounts of
the savings of individuals and families relying on the
representations are needlessly wasted.
It is, therefore, in the public interest that the public be
afforded full and accurate knowledge as to the facilities and methods
for the diagnosis, treatment, and cure of cancer available in this
state and that to that end there be provided means for testing and
investigating the value or lack thereof of alleged cancer remedies,
devices, drugs, or compounds, and informing the public of the facts
found, and protecting the public from misrepresentation in these
matters.
The importance of continuing scientific research to determine the
cause or cure of cancer is recognized, and the department shall
administer this article and Article 2 (commencing with Section
109300) with due regard for the importance of bona fide scientific
research and the clinical testing in hospitals, clinics, or similar
institutions of new drugs or compounds.
109255. There is in the department a Cancer Advisory Council
composed of nine physicians and surgeons licensed to practice
medicine in, and residing in, this state, three persons who are not
physicians and surgeons, two persons representing nonprofit cancer
research institutes recognized by the National Cancer Institute, and
the director of the department, who shall be an ex officio member.
The members of the council shall be appointed by the Governor to
serve for terms of four years. The Governor, in appointing the first
members, shall appoint at least one member from the faculty of each
of the schools teaching medicine and surgery and located in this
state that are approved by the Medical Board of California. The
Governor shall endeavor to maintain one member from the faculty of
each school in making subsequent appointments.
109260. The members of the council, other than the director of the
department, shall receive no compensation for their services, but
shall be allowed their actual necessary traveling expenses incurred
in the discharge of their duties.
Except as provided in Section 109390 the council is not required
to conduct meetings open to the public in accordance with Article 9
(commencing with Section 11120) of Chapter 1 of Part 1 of Division 3
of Title 2 of the Government Code.
109265. The council shall annually elect one of its members to
serve as chairman. The council shall meet at least twice each year,
and as often in addition as necessary, for the purpose of carrying
out its duties.
109270. The department shall:
(a) Prescribe reasonable regulations with respect to the
administration of this article and Article 2 (commencing with Section
109300).
(b) Investigate violations of this article and Article 2
(commencing with Section 109300), and report the violations to the
appropriate enforcement authority.
(c) Secure the investigation and testing of the content, method of
preparation, efficacy, or use of drugs, medicines, compounds, or
devices proposed to be used, or used, by any individual, person,
firm, association, or other entity in the state for the diagnosis,
treatment, or cure of cancer, prescribe reasonable regulations with
respect to the investigation and testing, and make findings of fact
and recommendations upon completion of any such investigation and
testing.
(d) Adopt a regulation prohibiting the prescription,
administration, sale or other distribution of any drug, substance, or
device found to be harmful or of no value in the diagnosis,
prevention or treatment of cancer.
(e) Hold hearings in respect of those matters involving compliance
with this article and Article 2 (commencing with Section 109300) and
subpoena witnesses and documents. Any or all hearings may be held
before the Cancer Advisory Council. Any administrative action to be
taken by the department as a result of the hearings shall be taken
only after receipt of the recommendations of the council. Prior to
issuance of a cease and desist order under Section 109345, a hearing
shall be held. The person furnishing a sample under Section 109295
shall be given due notice of the hearing and an opportunity to be
heard.
(f) Contract with independent scientific consultants for
specialized services and advice.
In the exercise of the powers granted by this section, the
department shall consult with the Cancer Advisory Council.
109275. (a) Upon a diagnosis of breast cancer, the physician and
surgeon, meaning the primary provider who initially referred the
patient for the screening or biopsy or, if different, the provider
who has made the diagnosis of breast cancer and initially consulted
with the patient about treatment, shall give the patient the written
summary described in subdivision (c) and required by this section and
shall note on the patient's chart that he or she has given the
patient the written summary. The physician and surgeon may choose to
provide the summary prior to the performance of a screening or biopsy
for breast cancer upon a patient's request or at the discretion of
the physician and surgeon in appropriate cases, including, but not
limited to, instances when a patient has demonstrated risk factors,
has a family history of breast cancer, or is otherwise susceptible.
(b) The failure of a physician and surgeon to inform a patient, by
means of a standardized written summary developed by the department
on the recommendation of the Cancer Advisory Council in accordance
with subdivision (c), in layperson's language and in a language
understood by the patient, of alternative efficacious methods of
treatment that may be medically viable, including surgical,
radiological, or chemotherapeutic treatments or combinations thereof,
when the patient is being treated for any form of breast cancer,
constitutes unprofessional conduct within the meaning of Chapter 5
(commencing with Section 2000) of Division 2 of the Business and
Professions Code.
(c) (1) A standardized written summary in layperson's language and
in a language understood by the patient shall be developed by the
department with the recommendations of the Cancer Advisory Council,
and shall be printed and made available by the Medical Board of
California to physicians and surgeons, for the purposes of informing
the patient of the advantages, disadvantages, risks, and descriptions
of the procedures with regard to medically viable and efficacious
alternative methods of treatment for breast cancer as required by
subdivision (a).
(2) Commencing no later than January 1, 1995, and every three
years thereafter, the department shall review the written summary and
shall revise the written summary if the department determines that
new or revised information should be included in the written summary,
and shall provide a copy of the revised summary to the Medical Board
of California.
(3) At the next revision of the standardized written summary
required by this section, the department shall incorporate all of the
following additional information:
(A) Information regarding methods of treatment for breast cancer
that are in the investigational or clinical trial stage and are
recognized for treatment by the Physician's Data Query of the
National Cancer Institute.
(B) Available reference numbers, including, but not limited to,
the "800" telephone numbers for the National Cancer Institute and the
American Cancer Society, in order for breast cancer patients to
obtain the most recent information.
(C) A discussion of breast reconstruction surgery, including, but
not limited to, problems, benefits, and alternatives.
(D) Statistics on the incidence of breast cancer.
(d) The Medical Board of California shall establish a distribution
system for the breast cancer treatment alternatives written summary,
and shall provide a link to its Internet Web site that may be
accessed by consumers interested in viewing and obtaining a copy of
the summary.
(e) The department and the Medical Board of California shall each
post the summary on its Internet Web site.
109277. (a) Every person or entity who owns or operates a health
facility or a clinic, or who is licensed as a physician and surgeon
and rents or owns the premises where his or her practice is located,
shall cause a sign or notice to be posted where a physician and
surgeon performs breast cancer screening or biopsy as an outpatient
service, or in a reasonably proximate area to where breast cancer
screening or biopsy is performed. A sign or notice posted at the
patient registration area of the health facility, clinic, or
physician and surgeon's office shall constitute compliance with this
section.
(b) The sign or notice shall read as follows:
"BE INFORMED"
"Upon a diagnosis of breast cancer, your physician and surgeon is
required to provide you a written summary of alternative efficacious
methods of treatment, pursuant to Section 109275 of the California
Health and Safety Code. Your physician and surgeon may choose to
provide the summary prior to the performance of a screening or biopsy
for breast cancer at your request or at the physician and surgeon's
discretion, when appropriate."
"The information about methods of treatment was developed by the
State Department of Public Health to inform patients of the
advantages, disadvantages, risks, and descriptions of procedures."
(c) The sign shall be not less than eight and one-half inches by
11 inches and shall be conspicuously displayed so as to be readable.
The words "BE INFORMED" shall not be less than one-half inch in
height and shall be centered on a single line with no other text. The
message on the sign shall appear in English, Spanish, and Chinese.
109278. (a) The medical care provider primarily responsible for
providing to a patient an annual gynecological examination shall
provide to that patient during the annual examination a standardized
summary in layperson's language and in a language understood by the
patient containing a description of the symptoms and appropriate
methods of diagnoses for gynecological cancers. Use of existing
publications developed by nationally recognized cancer organizations
is not precluded by this section.
(b) For the purposes of this section, "medical care provider"
means a health care professional licensed pursuant to Division 2
(commencing with Section 500) of the Business and Professions Code or
pursuant to an initiative act referred to in that division providing
medical care within his or her lawful scope of practice.
109280. (a) A standardized written summary in layperson's language
and in a language understood by patients shall be approved by the
department. The department may approve the use of an existing
publication from a recognized cancer authority as the written
summary. Commencing on January 1, 2003, and every three years
thereafter, the department shall review its approval of the use of an
existing publication from a recognized cancer authority as the
written summary to ensure that the approved written summary comprises
timely, new, and revised information regarding prostate cancer
treatment options as the department determines is necessary. The
written summary shall be printed or made available by the Medical
Board of California to physicians and surgeons, concerning the
advantages, disadvantages, risks, and descriptions of procedures with
regard to medically viable and efficacious alternative methods of
treatment of prostate cancer. Physicians and surgeons are urged to
make the summary available to patients when appropriate.
(b) The department and the Medical Board of California shall each
post this summary on its Internet Web site for public use.
(c) If the department updates this summary, it shall send the
updated summary to the Medical Board of California and both the
department and the Medical Board of California shall each post this
updated summary on its Internet Web site.
109282. (a) Every person or entity who owns or operates a health
facility or a clinic, or who is licensed as a physician and surgeon
and rents or owns the premises where his or her practice is located,
shall cause a sign or notice to be posted where prostate cancer
screening or treatment is performed by any physician and surgeon, or
in a reasonably proximate area to where prostate cancer screening or
treatment is performed. A sign or notice posted at the patient
registration area of the health facility, clinic, or physician and
surgeon's office shall constitute compliance with this section.
(b) The sign or notice shall read as follows:
"BE INFORMED"
"If you are a patient being treated for any form of prostate
cancer, or prior to performance of a biopsy for prostate cancer, your
physician and surgeon is urged to provide you a written summary of
alternative efficacious methods of treatment, pursuant to Section
109280 of the California Health and Safety Code."
"The information about methods of treatment was developed by the
State Department of Public Health to inform patients of the
advantages, disadvantages, risks, and descriptions of procedures."
(c) The sign shall be not less than eight and one-half inches by
11 inches and shall be conspicuously displayed so as to be readable.
The words "BE INFORMED" shall not be less than one-half inch in
height and shall be centered on a single line with no other text. The
message on the sign shall appear in English, Spanish, and Chinese.
(d) Subject to future, regular production and replacement
schedules from the implementation of the act adding this subdivision,
these signs and notices shall include the Internet Web site address
of the State Department of Public Health and the Medical Board of
California, and a notice regarding the availability of updated
prostate cancer summaries on these Web sites.
109285. For the purposes of this article and Article 2 (commencing
with Section 109300) "cancer" means all malignant neoplasms
regardless of the tissue of origin, including malignant lymphoma,
Hodgkins disease, and leukemia.
109290. No person may undertake to treat or alleviate cancer by use
of drugs, surgery, or radiation unless the person holds a license
issued under a law of this state expressly authorizing the diagnosis
and treatment of disease by use of drugs, surgery, or radiation.
109295. On written request by the department, delivered personally
or by mail, any individual, person, firm, association, or other
entity engaged, or representing himself, or itself, as engaged, in
the diagnosis, treatment, alleviation, or cure of cancer shall
furnish the department with the sample as the department may deem
necessary for adequate testing of any drug, medicine, compound, or
device used or prescribed by the individual, person, firm,
association, or other entity in the diagnosis, treatment,
alleviation, or cure of cancer, and shall specify the formula of any
drug or compound and name all ingredients by their common or usual
names, and shall, upon like request by the department, furnish
further necessary information as it may request as to the composition
and method of preparation of and the use that any drug, compound, or
device is being put by the individual, person, firm, association, or
other entity. This section shall apply to any individual, person,
firm, association, or other entity that renders health care or
services to individuals who have or believe they have cancer. This
section also applies to any individual, person, firm, association, or
other entity that by implication causes individuals to believe they
have cancer.
The failure to either provide the sample, disclose the formula, or
name the ingredients as required by this section shall be
conclusively presumed that the drug, medicine, compound or device
that is the subject of the department's request has no value in the
diagnosis, treatment, alleviation, or cure of cancer.
109250. The effective diagnosis, care, treatment or cure of persons
suffering from cancer is of paramount public importance. Vital
statistics indicate that approximately 16 percent of the total deaths
in the United States annually result from one or another of the
forms of cancer. It is established that accurate and early diagnosis
of many forms of cancer, followed by prompt application of methods of
treatment that are scientifically proven, either materially reduces
the likelihood of death from cancer or may materially prolong the
useful life of individuals suffering therefrom.
Despite intensive campaigns of public education, there is a lack
of adequate and accurate information among the public with respect to
presently proven methods for the diagnosis, treatment, and cure of
cancer. Various persons in this state have represented and continue
to represent themselves as possessing medicines, methods, techniques,
skills, or devices for the effective diagnosis, treatment, or cure
of cancer, whose representations are misleading to the public, with
the result that large numbers of the public, relying on the
representations, needlessly die of cancer, and substantial amounts of
the savings of individuals and families relying on the
representations are needlessly wasted.
It is, therefore, in the public interest that the public be
afforded full and accurate knowledge as to the facilities and methods
for the diagnosis, treatment, and cure of cancer available in this
state and that to that end there be provided means for testing and
investigating the value or lack thereof of alleged cancer remedies,
devices, drugs, or compounds, and informing the public of the facts
found, and protecting the public from misrepresentation in these
matters.
The importance of continuing scientific research to determine the
cause or cure of cancer is recognized, and the department shall
administer this article and Article 2 (commencing with Section
109300) with due regard for the importance of bona fide scientific
research and the clinical testing in hospitals, clinics, or similar
institutions of new drugs or compounds.
109255. There is in the department a Cancer Advisory Council
composed of nine physicians and surgeons licensed to practice
medicine in, and residing in, this state, three persons who are not
physicians and surgeons, two persons representing nonprofit cancer
research institutes recognized by the National Cancer Institute, and
the director of the department, who shall be an ex officio member.
The members of the council shall be appointed by the Governor to
serve for terms of four years. The Governor, in appointing the first
members, shall appoint at least one member from the faculty of each
of the schools teaching medicine and surgery and located in this
state that are approved by the Medical Board of California. The
Governor shall endeavor to maintain one member from the faculty of
each school in making subsequent appointments.
109260. The members of the council, other than the director of the
department, shall receive no compensation for their services, but
shall be allowed their actual necessary traveling expenses incurred
in the discharge of their duties.
Except as provided in Section 109390 the council is not required
to conduct meetings open to the public in accordance with Article 9
(commencing with Section 11120) of Chapter 1 of Part 1 of Division 3
of Title 2 of the Government Code.
109265. The council shall annually elect one of its members to
serve as chairman. The council shall meet at least twice each year,
and as often in addition as necessary, for the purpose of carrying
out its duties.
109270. The department shall:
(a) Prescribe reasonable regulations with respect to the
administration of this article and Article 2 (commencing with Section
109300).
(b) Investigate violations of this article and Article 2
(commencing with Section 109300), and report the violations to the
appropriate enforcement authority.
(c) Secure the investigation and testing of the content, method of
preparation, efficacy, or use of drugs, medicines, compounds, or
devices proposed to be used, or used, by any individual, person,
firm, association, or other entity in the state for the diagnosis,
treatment, or cure of cancer, prescribe reasonable regulations with
respect to the investigation and testing, and make findings of fact
and recommendations upon completion of any such investigation and
testing.
(d) Adopt a regulation prohibiting the prescription,
administration, sale or other distribution of any drug, substance, or
device found to be harmful or of no value in the diagnosis,
prevention or treatment of cancer.
(e) Hold hearings in respect of those matters involving compliance
with this article and Article 2 (commencing with Section 109300) and
subpoena witnesses and documents. Any or all hearings may be held
before the Cancer Advisory Council. Any administrative action to be
taken by the department as a result of the hearings shall be taken
only after receipt of the recommendations of the council. Prior to
issuance of a cease and desist order under Section 109345, a hearing
shall be held. The person furnishing a sample under Section 109295
shall be given due notice of the hearing and an opportunity to be
heard.
(f) Contract with independent scientific consultants for
specialized services and advice.
In the exercise of the powers granted by this section, the
department shall consult with the Cancer Advisory Council.
109275. (a) Upon a diagnosis of breast cancer, the physician and
surgeon, meaning the primary provider who initially referred the
patient for the screening or biopsy or, if different, the provider
who has made the diagnosis of breast cancer and initially consulted
with the patient about treatment, shall give the patient the written
summary described in subdivision (c) and required by this section and
shall note on the patient's chart that he or she has given the
patient the written summary. The physician and surgeon may choose to
provide the summary prior to the performance of a screening or biopsy
for breast cancer upon a patient's request or at the discretion of
the physician and surgeon in appropriate cases, including, but not
limited to, instances when a patient has demonstrated risk factors,
has a family history of breast cancer, or is otherwise susceptible.
(b) The failure of a physician and surgeon to inform a patient, by
means of a standardized written summary developed by the department
on the recommendation of the Cancer Advisory Council in accordance
with subdivision (c), in layperson's language and in a language
understood by the patient, of alternative efficacious methods of
treatment that may be medically viable, including surgical,
radiological, or chemotherapeutic treatments or combinations thereof,
when the patient is being treated for any form of breast cancer,
constitutes unprofessional conduct within the meaning of Chapter 5
(commencing with Section 2000) of Division 2 of the Business and
Professions Code.
(c) (1) A standardized written summary in layperson's language and
in a language understood by the patient shall be developed by the
department with the recommendations of the Cancer Advisory Council,
and shall be printed and made available by the Medical Board of
California to physicians and surgeons, for the purposes of informing
the patient of the advantages, disadvantages, risks, and descriptions
of the procedures with regard to medically viable and efficacious
alternative methods of treatment for breast cancer as required by
subdivision (a).
(2) Commencing no later than January 1, 1995, and every three
years thereafter, the department shall review the written summary and
shall revise the written summary if the department determines that
new or revised information should be included in the written summary,
and shall provide a copy of the revised summary to the Medical Board
of California.
(3) At the next revision of the standardized written summary
required by this section, the department shall incorporate all of the
following additional information:
(A) Information regarding methods of treatment for breast cancer
that are in the investigational or clinical trial stage and are
recognized for treatment by the Physician's Data Query of the
National Cancer Institute.
(B) Available reference numbers, including, but not limited to,
the "800" telephone numbers for the National Cancer Institute and the
American Cancer Society, in order for breast cancer patients to
obtain the most recent information.
(C) A discussion of breast reconstruction surgery, including, but
not limited to, problems, benefits, and alternatives.
(D) Statistics on the incidence of breast cancer.
(d) The Medical Board of California shall establish a distribution
system for the breast cancer treatment alternatives written summary,
and shall provide a link to its Internet Web site that may be
accessed by consumers interested in viewing and obtaining a copy of
the summary.
(e) The department and the Medical Board of California shall each
post the summary on its Internet Web site.
109277. (a) Every person or entity who owns or operates a health
facility or a clinic, or who is licensed as a physician and surgeon
and rents or owns the premises where his or her practice is located,
shall cause a sign or notice to be posted where a physician and
surgeon performs breast cancer screening or biopsy as an outpatient
service, or in a reasonably proximate area to where breast cancer
screening or biopsy is performed. A sign or notice posted at the
patient registration area of the health facility, clinic, or
physician and surgeon's office shall constitute compliance with this
section.
(b) The sign or notice shall read as follows:
"BE INFORMED"
"Upon a diagnosis of breast cancer, your physician and surgeon is
required to provide you a written summary of alternative efficacious
methods of treatment, pursuant to Section 109275 of the California
Health and Safety Code. Your physician and surgeon may choose to
provide the summary prior to the performance of a screening or biopsy
for breast cancer at your request or at the physician and surgeon's
discretion, when appropriate."
"The information about methods of treatment was developed by the
State Department of Public Health to inform patients of the
advantages, disadvantages, risks, and descriptions of procedures."
(c) The sign shall be not less than eight and one-half inches by
11 inches and shall be conspicuously displayed so as to be readable.
The words "BE INFORMED" shall not be less than one-half inch in
height and shall be centered on a single line with no other text. The
message on the sign shall appear in English, Spanish, and Chinese.
109278. (a) The medical care provider primarily responsible for
providing to a patient an annual gynecological examination shall
provide to that patient during the annual examination a standardized
summary in layperson's language and in a language understood by the
patient containing a description of the symptoms and appropriate
methods of diagnoses for gynecological cancers. Use of existing
publications developed by nationally recognized cancer organizations
is not precluded by this section.
(b) For the purposes of this section, "medical care provider"
means a health care professional licensed pursuant to Division 2
(commencing with Section 500) of the Business and Professions Code or
pursuant to an initiative act referred to in that division providing
medical care within his or her lawful scope of practice.
109280. (a) A standardized written summary in layperson's language
and in a language understood by patients shall be approved by the
department. The department may approve the use of an existing
publication from a recognized cancer authority as the written
summary. Commencing on January 1, 2003, and every three years
thereafter, the department shall review its approval of the use of an
existing publication from a recognized cancer authority as the
written summary to ensure that the approved written summary comprises
timely, new, and revised information regarding prostate cancer
treatment options as the department determines is necessary. The
written summary shall be printed or made available by the Medical
Board of California to physicians and surgeons, concerning the
advantages, disadvantages, risks, and descriptions of procedures with
regard to medically viable and efficacious alternative methods of
treatment of prostate cancer. Physicians and surgeons are urged to
make the summary available to patients when appropriate.
(b) The department and the Medical Board of California shall each
post this summary on its Internet Web site for public use.
(c) If the department updates this summary, it shall send the
updated summary to the Medical Board of California and both the
department and the Medical Board of California shall each post this
updated summary on its Internet Web site.
109282. (a) Every person or entity who owns or operates a health
facility or a clinic, or who is licensed as a physician and surgeon
and rents or owns the premises where his or her practice is located,
shall cause a sign or notice to be posted where prostate cancer
screening or treatment is performed by any physician and surgeon, or
in a reasonably proximate area to where prostate cancer screening or
treatment is performed. A sign or notice posted at the patient
registration area of the health facility, clinic, or physician and
surgeon's office shall constitute compliance with this section.
(b) The sign or notice shall read as follows:
"BE INFORMED"
"If you are a patient being treated for any form of prostate
cancer, or prior to performance of a biopsy for prostate cancer, your
physician and surgeon is urged to provide you a written summary of
alternative efficacious methods of treatment, pursuant to Section
109280 of the California Health and Safety Code."
"The information about methods of treatment was developed by the
State Department of Public Health to inform patients of the
advantages, disadvantages, risks, and descriptions of procedures."
(c) The sign shall be not less than eight and one-half inches by
11 inches and shall be conspicuously displayed so as to be readable.
The words "BE INFORMED" shall not be less than one-half inch in
height and shall be centered on a single line with no other text. The
message on the sign shall appear in English, Spanish, and Chinese.
(d) Subject to future, regular production and replacement
schedules from the implementation of the act adding this subdivision,
these signs and notices shall include the Internet Web site address
of the State Department of Public Health and the Medical Board of
California, and a notice regarding the availability of updated
prostate cancer summaries on these Web sites.
109285. For the purposes of this article and Article 2 (commencing
with Section 109300) "cancer" means all malignant neoplasms
regardless of the tissue of origin, including malignant lymphoma,
Hodgkins disease, and leukemia.
109290. No person may undertake to treat or alleviate cancer by use
of drugs, surgery, or radiation unless the person holds a license
issued under a law of this state expressly authorizing the diagnosis
and treatment of disease by use of drugs, surgery, or radiation.
109295. On written request by the department, delivered personally
or by mail, any individual, person, firm, association, or other
entity engaged, or representing himself, or itself, as engaged, in
the diagnosis, treatment, alleviation, or cure of cancer shall
furnish the department with the sample as the department may deem
necessary for adequate testing of any drug, medicine, compound, or
device used or prescribed by the individual, person, firm,
association, or other entity in the diagnosis, treatment,
alleviation, or cure of cancer, and shall specify the formula of any
drug or compound and name all ingredients by their common or usual
names, and shall, upon like request by the department, furnish
further necessary information as it may request as to the composition
and method of preparation of and the use that any drug, compound, or
device is being put by the individual, person, firm, association, or
other entity. This section shall apply to any individual, person,
firm, association, or other entity that renders health care or
services to individuals who have or believe they have cancer. This
section also applies to any individual, person, firm, association, or
other entity that by implication causes individuals to believe they
have cancer.
The failure to either provide the sample, disclose the formula, or
name the ingredients as required by this section shall be
conclusively presumed that the drug, medicine, compound or device
that is the subject of the department's request has no value in the
diagnosis, treatment, alleviation, or cure of cancer.
109250. The effective diagnosis, care, treatment or cure of persons
suffering from cancer is of paramount public importance. Vital
statistics indicate that approximately 16 percent of the total deaths
in the United States annually result from one or another of the
forms of cancer. It is established that accurate and early diagnosis
of many forms of cancer, followed by prompt application of methods of
treatment that are scientifically proven, either materially reduces
the likelihood of death from cancer or may materially prolong the
useful life of individuals suffering therefrom.
Despite intensive campaigns of public education, there is a lack
of adequate and accurate information among the public with respect to
presently proven methods for the diagnosis, treatment, and cure of
cancer. Various persons in this state have represented and continue
to represent themselves as possessing medicines, methods, techniques,
skills, or devices for the effective diagnosis, treatment, or cure
of cancer, whose representations are misleading to the public, with
the result that large numbers of the public, relying on the
representations, needlessly die of cancer, and substantial amounts of
the savings of individuals and families relying on the
representations are needlessly wasted.
It is, therefore, in the public interest that the public be
afforded full and accurate knowledge as to the facilities and methods
for the diagnosis, treatment, and cure of cancer available in this
state and that to that end there be provided means for testing and
investigating the value or lack thereof of alleged cancer remedies,
devices, drugs, or compounds, and informing the public of the facts
found, and protecting the public from misrepresentation in these
matters.
The importance of continuing scientific research to determine the
cause or cure of cancer is recognized, and the department shall
administer this article and Article 2 (commencing with Section
109300) with due regard for the importance of bona fide scientific
research and the clinical testing in hospitals, clinics, or similar
institutions of new drugs or compounds.
109255. There is in the department a Cancer Advisory Council
composed of nine physicians and surgeons licensed to practice
medicine in, and residing in, this state, three persons who are not
physicians and surgeons, two persons representing nonprofit cancer
research institutes recognized by the National Cancer Institute, and
the director of the department, who shall be an ex officio member.
The members of the council shall be appointed by the Governor to
serve for terms of four years. The Governor, in appointing the first
members, shall appoint at least one member from the faculty of each
of the schools teaching medicine and surgery and located in this
state that are approved by the Medical Board of California. The
Governor shall endeavor to maintain one member from the faculty of
each school in making subsequent appointments.
109260. The members of the council, other than the director of the
department, shall receive no compensation for their services, but
shall be allowed their actual necessary traveling expenses incurred
in the discharge of their duties.
Except as provided in Section 109390 the council is not required
to conduct meetings open to the public in accordance with Article 9
(commencing with Section 11120) of Chapter 1 of Part 1 of Division 3
of Title 2 of the Government Code.
109265. The council shall annually elect one of its members to
serve as chairman. The council shall meet at least twice each year,
and as often in addition as necessary, for the purpose of carrying
out its duties.
109270. The department shall:
(a) Prescribe reasonable regulations with respect to the
administration of this article and Article 2 (commencing with Section
109300).
(b) Investigate violations of this article and Article 2
(commencing with Section 109300), and report the violations to the
appropriate enforcement authority.
(c) Secure the investigation and testing of the content, method of
preparation, efficacy, or use of drugs, medicines, compounds, or
devices proposed to be used, or used, by any individual, person,
firm, association, or other entity in the state for the diagnosis,
treatment, or cure of cancer, prescribe reasonable regulations with
respect to the investigation and testing, and make findings of fact
and recommendations upon completion of any such investigation and
testing.
(d) Adopt a regulation prohibiting the prescription,
administration, sale or other distribution of any drug, substance, or
device found to be harmful or of no value in the diagnosis,
prevention or treatment of cancer.
(e) Hold hearings in respect of those matters involving compliance
with this article and Article 2 (commencing with Section 109300) and
subpoena witnesses and documents. Any or all hearings may be held
before the Cancer Advisory Council. Any administrative action to be
taken by the department as a result of the hearings shall be taken
only after receipt of the recommendations of the council. Prior to
issuance of a cease and desist order under Section 109345, a hearing
shall be held. The person furnishing a sample under Section 109295
shall be given due notice of the hearing and an opportunity to be
heard.
(f) Contract with independent scientific consultants for
specialized services and advice.
In the exercise of the powers granted by this section, the
department shall consult with the Cancer Advisory Council.
109275. (a) Upon a diagnosis of breast cancer, the physician and
surgeon, meaning the primary provider who initially referred the
patient for the screening or biopsy or, if different, the provider
who has made the diagnosis of breast cancer and initially consulted
with the patient about treatment, shall give the patient the written
summary described in subdivision (c) and required by this section and
shall note on the patient's chart that he or she has given the
patient the written summary. The physician and surgeon may choose to
provide the summary prior to the performance of a screening or biopsy
for breast cancer upon a patient's request or at the discretion of
the physician and surgeon in appropriate cases, including, but not
limited to, instances when a patient has demonstrated risk factors,
has a family history of breast cancer, or is otherwise susceptible.
(b) The failure of a physician and surgeon to inform a patient, by
means of a standardized written summary developed by the department
on the recommendation of the Cancer Advisory Council in accordance
with subdivision (c), in layperson's language and in a language
understood by the patient, of alternative efficacious methods of
treatment that may be medically viable, including surgical,
radiological, or chemotherapeutic treatments or combinations thereof,
when the patient is being treated for any form of breast cancer,
constitutes unprofessional conduct within the meaning of Chapter 5
(commencing with Section 2000) of Division 2 of the Business and
Professions Code.
(c) (1) A standardized written summary in layperson's language and
in a language understood by the patient shall be developed by the
department with the recommendations of the Cancer Advisory Council,
and shall be printed and made available by the Medical Board of
California to physicians and surgeons, for the purposes of informing
the patient of the advantages, disadvantages, risks, and descriptions
of the procedures with regard to medically viable and efficacious
alternative methods of treatment for breast cancer as required by
subdivision (a).
(2) Commencing no later than January 1, 1995, and every three
years thereafter, the department shall review the written summary and
shall revise the written summary if the department determines that
new or revised information should be included in the written summary,
and shall provide a copy of the revised summary to the Medical Board
of California.
(3) At the next revision of the standardized written summary
required by this section, the department shall incorporate all of the
following additional information:
(A) Information regarding methods of treatment for breast cancer
that are in the investigational or clinical trial stage and are
recognized for treatment by the Physician's Data Query of the
National Cancer Institute.
(B) Available reference numbers, including, but not limited to,
the "800" telephone numbers for the National Cancer Institute and the
American Cancer Society, in order for breast cancer patients to
obtain the most recent information.
(C) A discussion of breast reconstruction surgery, including, but
not limited to, problems, benefits, and alternatives.
(D) Statistics on the incidence of breast cancer.
(d) The Medical Board of California shall establish a distribution
system for the breast cancer treatment alternatives written summary,
and shall provide a link to its Internet Web site that may be
accessed by consumers interested in viewing and obtaining a copy of
the summary.
(e) The department and the Medical Board of California shall each
post the summary on its Internet Web site.
109277. (a) Every person or entity who owns or operates a health
facility or a clinic, or who is licensed as a physician and surgeon
and rents or owns the premises where his or her practice is located,
shall cause a sign or notice to be posted where a physician and
surgeon performs breast cancer screening or biopsy as an outpatient
service, or in a reasonably proximate area to where breast cancer
screening or biopsy is performed. A sign or notice posted at the
patient registration area of the health facility, clinic, or
physician and surgeon's office shall constitute compliance with this
section.
(b) The sign or notice shall read as follows:
"BE INFORMED"
"Upon a diagnosis of breast cancer, your physician and surgeon is
required to provide you a written summary of alternative efficacious
methods of treatment, pursuant to Section 109275 of the California
Health and Safety Code. Your physician and surgeon may choose to
provide the summary prior to the performance of a screening or biopsy
for breast cancer at your request or at the physician and surgeon's
discretion, when appropriate."
"The information about methods of treatment was developed by the
State Department of Public Health to inform patients of the
advantages, disadvantages, risks, and descriptions of procedures."
(c) The sign shall be not less than eight and one-half inches by
11 inches and shall be conspicuously displayed so as to be readable.
The words "BE INFORMED" shall not be less than one-half inch in
height and shall be centered on a single line with no other text. The
message on the sign shall appear in English, Spanish, and Chinese.
109278. (a) The medical care provider primarily responsible for
providing to a patient an annual gynecological examination shall
provide to that patient during the annual examination a standardized
summary in layperson's language and in a language understood by the
patient containing a description of the symptoms and appropriate
methods of diagnoses for gynecological cancers. Use of existing
publications developed by nationally recognized cancer organizations
is not precluded by this section.
(b) For the purposes of this section, "medical care provider"
means a health care professional licensed pursuant to Division 2
(commencing with Section 500) of the Business and Professions Code or
pursuant to an initiative act referred to in that division providing
medical care within his or her lawful scope of practice.
109280. (a) A standardized written summary in layperson's language
and in a language understood by patients shall be approved by the
department. The department may approve the use of an existing
publication from a recognized cancer authority as the written
summary. Commencing on January 1, 2003, and every three years
thereafter, the department shall review its approval of the use of an
existing publication from a recognized cancer authority as the
written summary to ensure that the approved written summary comprises
timely, new, and revised information regarding prostate cancer
treatment options as the department determines is necessary. The
written summary shall be printed or made available by the Medical
Board of California to physicians and surgeons, concerning the
advantages, disadvantages, risks, and descriptions of procedures with
regard to medically viable and efficacious alternative methods of
treatment of prostate cancer. Physicians and surgeons are urged to
make the summary available to patients when appropriate.
(b) The department and the Medical Board of California shall each
post this summary on its Internet Web site for public use.
(c) If the department updates this summary, it shall send the
updated summary to the Medical Board of California and both the
department and the Medical Board of California shall each post this
updated summary on its Internet Web site.
109282. (a) Every person or entity who owns or operates a health
facility or a clinic, or who is licensed as a physician and surgeon
and rents or owns the premises where his or her practice is located,
shall cause a sign or notice to be posted where prostate cancer
screening or treatment is performed by any physician and surgeon, or
in a reasonably proximate area to where prostate cancer screening or
treatment is performed. A sign or notice posted at the patient
registration area of the health facility, clinic, or physician and
surgeon's office shall constitute compliance with this section.
(b) The sign or notice shall read as follows:
"BE INFORMED"
"If you are a patient being treated for any form of prostate
cancer, or prior to performance of a biopsy for prostate cancer, your
physician and surgeon is urged to provide you a written summary of
alternative efficacious methods of treatment, pursuant to Section
109280 of the California Health and Safety Code."
"The information about methods of treatment was developed by the
State Department of Public Health to inform patients of the
advantages, disadvantages, risks, and descriptions of procedures."
(c) The sign shall be not less than eight and one-half inches by
11 inches and shall be conspicuously displayed so as to be readable.
The words "BE INFORMED" shall not be less than one-half inch in
height and shall be centered on a single line with no other text. The
message on the sign shall appear in English, Spanish, and Chinese.
(d) Subject to future, regular production and replacement
schedules from the implementation of the act adding this subdivision,
these signs and notices shall include the Internet Web site address
of the State Department of Public Health and the Medical Board of
California, and a notice regarding the availability of updated
prostate cancer summaries on these Web sites.
109285. For the purposes of this article and Article 2 (commencing
with Section 109300) "cancer" means all malignant neoplasms
regardless of the tissue of origin, including malignant lymphoma,
Hodgkins disease, and leukemia.
109290. No person may undertake to treat or alleviate cancer by use
of drugs, surgery, or radiation unless the person holds a license
issued under a law of this state expressly authorizing the diagnosis
and treatment of disease by use of drugs, surgery, or radiation.
109295. On written request by the department, delivered personally
or by mail, any individual, person, firm, association, or other
entity engaged, or representing himself, or itself, as engaged, in
the diagnosis, treatment, alleviation, or cure of cancer shall
furnish the department with the sample as the department may deem
necessary for adequate testing of any drug, medicine, compound, or
device used or prescribed by the individual, person, firm,
association, or other entity in the diagnosis, treatment,
alleviation, or cure of cancer, and shall specify the formula of any
drug or compound and name all ingredients by their common or usual
names, and shall, upon like request by the department, furnish
further necessary information as it may request as to the composition
and method of preparation of and the use that any drug, compound, or
device is being put by the individual, person, firm, association, or
other entity. This section shall apply to any individual, person,
firm, association, or other entity that renders health care or
services to individuals who have or believe they have cancer. This
section also applies to any individual, person, firm, association, or
other entity that by implication causes individuals to believe they
have cancer.
The failure to either provide the sample, disclose the formula, or
name the ingredients as required by this section shall be
conclusively presumed that the drug, medicine, compound or device
that is the subject of the department's request has no value in the
diagnosis, treatment, alleviation, or cure of cancer.
