Dec 4, 2014

The Right Clinical Trial for YOU—Part 1

More than 14 million Americans have cancer. At any given time, there are literally thousands of cancer clinical trials available. These studies are most often at or near large medical centers or universities. Many ongoing trials are unable to find enough participants. If the studies testing new treatments aren’t completed we all lose--new treatments don’t become available to the people they might help. How can this happen?

The facts
·         The pharmaceutical companies are interested in testing, proving, and marketing new treatments. Their mission and business success depends on successful development of new drugs. They want the medication to work.
·         The hospitals and doctors want the drugs to be effective so they can help patients. They are responsible for conducting trials of new drugs under strict controls to safeguard patients and to determine the effectiveness and safety of the drugs and treatments. They want the medication to work.
·         You are interested in managing or curing your cancer. You want a treatment or drug without nasty side effects that is going to manage your cancer, lengthen your life, improve your quality of life, and allow you to live happily ever after. You want the medication to work.

There are more than 6,500 cancer clinical trials available at any one time. For more common cancers, there may literally be hundreds of studies underway at the same time. This is good news. When there are many studies, that means there are many new ideas on how we might improve treatment and find cures. But for you, it can make navigating this a jungle and getting usable information a formidable challenge. 

 Start close to home
A conversation with your own doctor is always the best place to start. Tell your doctor that you are interested in experimental therapies. Your doctor or hospital may, in fact, be offering some clinical trials or may be aware of nearby programs that offer clinical trials for patients with your needs and interests. Even if you end up doing most of the research on your own, your doctor will be a key source of support and information. At a minimum, your doctor will need to share information about you and your cancer with those conducting the clinical trial. You will certainly want the support of your doctor and medical team.

Know your disease state: stage, prior, and current treatments

Before you begin searching, you need to know several key pieces of information about your cancer and treatments you’ve had so far. The more you know, the more quickly you’ll be able to narrow your search to what you want and not waste valuable time. Ask questions.

Each clinical trial is carefully designed for specific groups of patients. For example, phase I studies of brand new drugs are typically looking for patients with advanced cancer that has spread (metastasized) and is not responsive to standard treatments. Since we don’t know very much about how successful these new drugs might turn out to be, proven standard treatments should be tried first. But if nothing else is available, and you don’t have a proven standard treatment to fall-back on, a phase I trial is a reasonable direction to go.

Many trials focus on treatments for advanced cancers, but there are also trials for patients with earlier stage cancer. For example, trials of adjuvant treatment are testing cancer treatment that is administered shortly after the primary surgery or radiation in the hope of reducing the risk of disease relapse or recurrence. Some patients may be cancer-free after initial treatment but their particular cancer had characteristics that suggest a high risk of relapse. They may be interested in and eligible for such studies. Patients who are candidates for standard therapy (at any point in the course of the disease) may want to try clinical trials that are examining new approaches that hope to improve on the standard treatment outcomes.

Clinical trials are available for patients at all stages of cancer and with a broad range of prior treatments but the studies for one stage or situation will probably not be the same as those for another. Knowing your stage and treatment history is absolutely necessary before you can sift through all the possible trials to identify those of relevance and interest to you.

Next? See Part 2 in a few weeks

To put a smile on your face see Larry's latest cartoon.
To learn more about clinical trials, take a look at our book.

(c) 2012 Tom Beer and Larry Axmaker

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