This column is a monthly feature of “Health & Exercise Forum” in association with the students and faculty of Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).
Clinical Trials – America’s Most Under Used Resource
February is National Cancer Prevention Month and Clinical Trials are Essential for Research in Cancer Prevention and Treatment!
Guest Coauthors: Megan Lombardi and Connor McDonald, 2nd Year Medical Students at Geisinger Commonwealth School of Medicine (GCSOM)
Megan Lombardi is a second year medical student at Geisinger Commonwealth School of Medicine. Megan grew up locally in Dalton, PA before attending Penn State University for her undergraduate degree. She is exploring her options for medical residencies following graduation in 2019.
Connor McDonald is a second year medical student at Geisinger Commonwealth School of Medicine. Connor is from Benton, PA and attended Lebanon Valley College for his undergraduate degree. He is exploring his options for medical residencies following graduation in 2019.
This past summer Megan Lombardi and Connor McDonald partnered with Dr. Chris Peters at Northeast Radiation Oncology Center (NROC) for six weeks to determine oncology clinical trial accrual rates in Northeastern PA and then sought to explore what barriers are preventing local patients from joining trials. They interviewed doctors and nurses from three different oncology practices in the Scranton area and came up with a list of recurring barriers to participation and then brainstormed ideas that could be put into place to help raise accrual rates. Megan and Connor presented their findings to physicians and nurses at NROC and at GCSOM to hopefully help raise accrual rates for clinical trial research.
Cancer is the second leading cause of death in the US with 600,000 deaths each year and over 1.6 million new diagnoses per year. Today, clinical trials have become a forefront necessity for the advancement of cancer treatment. While nearly 70% of all adult cancer patients have shown an interest and willingness to participate in these trials, only about 3-5% of these patients go on to do so. Overall survival rates of cancers have increased very slowly over the past 20 years, but in some cases they have actually declined, which may be attributed to the lack of clinical trial participation. This is in stark contrast to childhood cancers where over 50% of all pediatric cancer patients are placed on trial thereby seeing some survival rates for various cancers skyrocket up over 90%.
A major reason for the low accrual rate among clinical trials is due to the lack of public awareness among the general population. Upon questioning, many patients express the notion that they were simply unaware a clinical trial was even possible as a treatment option. A clinical trial is very simply a research study that is done with humans to help answer specific health questions. One major benefit of joining a trial is that the patient gets to take an active role in their care and generally have access to cutting edge medical technology not yet available to the general public. Safety and security is assured in clinical trials as they are subject to numerous stages and checkpoints by various federal agencies before being allowed to enroll human subjects.
The rational as to why adults should consider clinical trials is the fact that these trials often lead to crucial advancements in treatments. Children were continually signed up on trials for their cancer treatments and now today we see some of these childhood cancers are very easily treated. Additionally, as we are all aware cancer affects everyone, so by placing people of various races, ages, areas of living, etc., we can ensure that these new medical advances are for the benefit of everyone. Furthermore, these clinical trials extend not only to the field of cancer but also to many other major health care problems. We advise adults to pursue and sign up, if applicable, for trials dealing with everyday diseases such as diabetes, hypercholesterol, high blood pressure, and arthritis.
The mindset that clinical trials are only for people with severe diseases or who have exhausted all other treatment possibilities is an idea of past generations. Clinical trials are springing up for every disease these days to help not only cure common diseases but to help alleviate some of the symptoms. Trials can encompass many different components as some require changes in exercise and others changes in diet, while another may not require the administration of various medications or therapies, which many people often cite as a fear of participation in trials. However, when considering a clinical trial for cancer treatment, the most important thing to remember is that every single person will receive the current standard of care. Contrary to popular belief, no one will receive anything less than what is currently being used in everyday treatment and no one will receive any treatment that can be harmful; often many participants will actually receive extra treatment and care, which can be above and beyond the current care.
If clinical trials are so important to the advancement of cancer care, what can the patient do to help the cause? The simple answer is to keep an open mind when your physician and other members of the health care team broach the subject of participation in a clinical trial. Many offices, including your primary care offices, have pamphlets or material available for distribution on clinical trials and many more have physicians experienced on the topic. In addition, physicians are dedicated to serve their patients and provide the best possible care. With this in mind, make time to discuss the possibility of participation with your primary care physician and oncologist (cancer specialist). Additional information can be found by visiting credible internet sites such as American Cancer Society, NIH, and Cancer.net, which offer background, advice, links to speak to clinical trial specialists, and the current open trials in which one can enroll.
In conclusion, please understand that clinical trials are essential for the advancement of prevention and treatment of cancer. It is not dangerous or inhumane. In fact, clinical trials today are subject to more regulation, monitoring, and documentation than most standard practices of care that everyone accepts today. Furthermore, as emphasized above, people in these trials are often subject to more advanced, newer medications than those of the general population!
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” in the Scranton Times-Tribune.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).
