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About Clinical Trials

December 21, 2010

I wanted to start by speaking a bit about the Clinical Trials Unit at the Abbotsford Centre.

  “Clinical trials” is a term that encompasses a lot of different research questions and goals. 

The National Institute of Health (NIH) has a definition (here it is), but for ease, I think of clinical trials as being any research experiment being conducted on human patients.

In our context, these include specific questions such as, “Is chemotherapy X better than chemotherapy Y?” and peripheral questions such as, “Does herb X reduce nausea better than drug Y?” or, “Is a PET/CT scan helpful prior to cancer treatment?”

  As one might imagine, there are a lot of research questions out there, and we have to answer them in a regimented, rigorous way.  If we didn’t, no one would take the answers and proof seriously. 

So to prove that chemotherapy X is better than chemotherapy Y, you can’t just give one patient X and another patient Y and see who has the best outcomes.  You might require hundreds or thousands of patients.  And of course you would want the patients who get chemo drug X to be similar to those who get chemo drug Y, so someone has to screen all the potentially eligible patients before the trial starts. 

During the course of chemotherapy, you will also want to carefully scrutinize how the patients are doing to see if one therapy is better tolerated than the other.  You may have to follow the patients for years after they receive the drug to see if the cancer comes back and/or if there are late side effects associated with the chemotherapy.

All of this takes time and effort and, therefore, it may be many years from the start of a clinical trial until we know if the new therapy is beneficial.  But this is how we advance our ability to treat cancer — a continuous process of layering new information over old.

Oncologists actually do get excited (maybe even giddy) as we approach answers  during a clinical trial.  For us, participating in something that may alter the care of cancer patients and potentially cure more patients is extremely rewarding.  Our patients matter and deserve the newest and best care. 

Sometimes, clinical trials tell us that what we’re testing won’t work as a new treatment.  That is tough for the medical team who devoted years to the trial and obviously more so for those patients hoping for new and better therapies. 

But proving that something isn’t useful is also helpful.  We can say that at least we did the trial; otherwise, no one would know this treatment isn’t beneficial, and patients would continue to receive less beneficial treatment. So it is still helpful overall.

And when a clinical trial is successful, all of our hard work really pays off.  That’s when we really get to make a difference for patients.

It’s rewarding when we can look back and show that we improved a treatment, or when statistics start to show that a group of patients are doing better now than they were before a treatment changed.

I hope that’s helped to answer some of the basics about clinical trials!