Thursday, May 31, 2012

Clinical Trials

By Christopher Lukas, Health Guide Wednesday, September 27, 2006
In an essay I wrote several weeks ago I discussed the drop-off in volunteers for clinical trials.

This week, I want to talk more about the trials themselves than about the problem finding volunteers.

But, first, let me clarify what is meant by the word “volunteer.” Simply put, it means patients with cancers who want to enroll in a clinical trial because they believe they can get more advanced treatment for a cancer that is not susceptible to a current treatment.

In the case of prostate cancer, there are fewer clinical trials than in many other forms of cancer because
1) there are three treatments now that seem to work.
2) Because prostate cancer is a slow-growing cancer.
3) Because fewer men have the virulent variety that can’t be treated by current means.
4) Because more attention has been given, traditionally, to breast cancer and other, fast-moving, deadly cancers.

Still, it’s worth noting that there are clinical trials trying to get new or better treatments for prostate cancer, especially for Stage III or IV varieties, ones that threaten the bones or other organs, or have caused pain.

First, let’s talk about clinical trials overall. The material I quote is from the web site of the National Cancer Institute, a government body. They say it all very clearly, so I’m going to use their explanations where I think they do better than I can possibly do.

What is a trial:
A clinical trial is one of the final stages of a long and careful cancer research process. Studies are done with cancer patients to find out whether promising approaches to cancer prevention, diagnosis, and treatment are safe and effective.

While there are a variety of kinds of trials (Treatment, screening, Prevention, and Quality of Life trials), Treatment is the one I’ll deal with this week.

Treatment trials test new treatments (like a new cancer drug, new approaches to surgery or radiation therapy, new combinations of treatments, or new methods such as gene therapy).

While Phase I and Phase II trials are important (determining how a drug should be given, and whether it’s safe,) the most interesting from your point of view is Phase III, where a drug or other treatment is tested against current procedures or medications.

Phase III trials often enroll large numbers of people and may be conducted at many doctors' offices, clinics, and cancer centers nationwide.

One of the things patients want to know – if they enroll in a trial – is whether they’ll be getting the new treatment or the old one. Precisely because the efficacy of the trial depends on randomization of patients, you would not be told. So why get involved?

There are two or three reasons:
1)Because you are helping a process that could lead to new treatment that could benefit you.
2)Because you are helping the medical profession benefit others.
3)Because you need to do something to further your own treatment. (Once again, entering a clinical trial is done only when you and your physicians determine that current treatment(s) aren’t going to protect you against a deterioration of your condition.)

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By Christopher Lukas, Health Guide— Last Modified: 09/04/10, First Published: 09/27/06