Experimental Treatments for Cancer: The Clinical Trial
Clinical trials or protocols are the best way to test new treatments.
In clinical trials doctors test new treatments (surgery, chemotherapy,
biological response modifiers, and radiation therapy) scientifically.
In some trials, all patients receive the new, experimental treatment,
usually to learn the effects on the tumor and how patients react. If
the results are promising, a second type of trial is conducted in
which patients are randomly given either the best standard treatment
for their disease or a new, experimental treatment. People with cancer
take part in clinical trials for two reasons: the new treatments may
help the people participating in the trial, or they may help future
patients. The goal of a clinical trial is to determine whether the
new, experimental treatment is better than the standard treatment.
You may want to try a new, exploratory treatment for your disease.
This is understandable, especially if the standard treatments don't
appear to be helping or cannot cure the cancer. The most important
thing to remember when considering experimental treatments is that the
accepted medical treatment for your cancer is the best scientifically
tested treatment available. If you do try experimental treatments, you
will be carefully monitored. Your doctor and nurse will explain what
care you will need while you are participating in the trial.
Not everyone is eligible to participate in a clinical trial. Each
trial is designed to test a specific treatment with a specific group
of patients. Usually a trial will be limited to a certain type of
cancer at a certain stage. Sometimes researchers also exclude certain
patients, such as those who have other illnesses in addition to their
cancer or who have already received a particular treatment. Your
doctor will know what trials you will qualify for.
How Can You Join A Clinical Trial?
Before you consider participating in a trial, remember that a clinical
trial attempts to answer a question that may or may not be important
for your case. In general, trials have several choices or treatment
"arms." One of the arms may be a standard form of treatment, while the
others may be experimental. In either case no one knows which arm is
better. In a multi- arm trial, one treatment is compared with another.
You will be assigned to one arm by a computer, and you and your doctor
agree to accept the assigned arm.
Clinical trials are carried out in cancer centers, community
hospitals, and private oncology practices. The best way to become
involved in a clinical trial is to talk to your doctor, who will know
if clinical trials are available for your type of cancer. He or she
may be participating in a clinical trial or will refer you to a center
or hospital where a trial is being performed. You may call
1-800-4-CANCER to request information about a clinical trial, or write
to the NCI for the booklet "What Are Clinical Trials All About?"
- Participating in a clinical trial does not mean that you are allowing
your survival to be determined by a computer. All arms of a trial have
been found to have some effect. No clinical trial is ever allowed in
which it is known that one arm is worse than another. That would be
unethical. The real question to be decided is which arm is better,
given the fact that both arms seem to be effective.
- The use of biologic response modifiers (BRMs) is an example of how
advances in cancer treatment are made through the clinical trial.
Before BRMs can be approved as standard treatment, clinical trials
must be conducted to compare them with standard chemotherapy and
radiation therapy. When these trials show that BRMs are effective,
this treatment will become standard for certain types of cancer.
- Clinical trials are organized by teams of doctors who belong to
national "study groups." Doctors belong to these national groups in
order to test new treatments on large groups of people. In this way,
they can obtain information about better treatments more quickly than
if doctors studied these treatments by themselves. The National Cancer
Institute also organizes clinical trials.
To keep track of all of the standard and experimental treatments for
cancer, the National Cancer Institute has set up a system called the
Physician Data Query (PDQ). The PDQ contains information on standard
treatments for cancer, plus information on more than 1,000 active
clinical trials. If your doctor does not have computer access to the
PDQ, the National Cancer Institute can explain other ways in which he
or she can obtain PDQ information. You can obtain this information by
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