Medical Oncologist, Provincial Director – Systemic Therapy Clinical Trials

Imagine this:

You’ve been diagnosed with cancer, but it is treatable. There are two cancer hospitals you could go to for care. Both have access to all the same treatments. Both have reputable staff and modern facilities. In short, both hospitals look the same to a casual observer. But there is a difference … if you go to one of these two hospitals, you have an 82% higher risk of death. 

What accounts for this difference? The hospital with better outcomes participates in clinical trials . . . that’s it. If you live in Germany and happen to have ovarian cancer, this is a true story[1]. In a review of hospitals that treated ovarian cancer, the risk of death was 82% higher in hospitals that didn’t participate in clinical trials, when other factors were taken into consideration.

The benefit was there for all patients, not just those who volunteered to take part in trials.

Similar data has been shown for other outcomes, not just cancer, and in other countries including Canada. It is interesting that among the industrialized nations, the countries that have the lowest life expectancies are also the countries historically ranking among the lowest in clinical trial participation[2].

You see, there is something termed the “participation effect.” This means that when a cancer center is involved in research, there are benefits for the whole population, not just those involved in the research. This is because of many factors: research centers have to continually demonstrate adherence to basic standards of care; team members (doctors, nurses, etc.) who do research by definition need to be well-versed on what constitutes present best care for the disease they treat, so that’s what you’re likely to get as a baseline; and team members who work in research are more motivated and dedicated to their area of expertise. Then, of course, there is the fact that clinical trials offer access to treatment options when other options may not exist.

These are among the reasons why the staff at the BC Cancer Agency and BC Cancer Foundation are so motivated and passionate about increasing clinical trials activity at all our cancer centres and improving access to trials for patients no matter where they are. We want to do clinical trials so that we can evaluate new treatments and improve outcomes for the next woman, man or child who has to hear those words “you have cancer.” We want to do clinical trials because it’s exciting and rewarding to be at the forefront of cancer care. We want to do clinical trials because it provides access for British Columbians to new therapies. We need to be doing clinical trials everywhere in B.C. because it elevates our game to benefit everyone with cancer.

Bernie



[1] Du Bois, A., et al., Pattern of care and impact of participation in clinical studies on the outcome in ovarian cancer. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2005. 15(2): p. 183-91.

[2] Lyman, G.H. and M. Levine, Comparative Effectiveness Research in Oncology: An Overview. Journal of Clinical Oncology, 2012. 30(34): p. 4181.