Cancer Patients Not Keen To Be Test Subjects

According to a Reuters article reported by CNN, doctorsí failure to refer cancer patients to potentially life-saving experimental treatment and patientsí reluctance to take part in these trials, have led to disturbingly low participation in clinical trials that are our best bets for medical breakthroughs in cancer. A study by researchers at the University of California Davis Cancer Center, including Dr. David Gandara, director of clinical research at the institution set out to determine why only 2-4% of all adult patients with newly diagnosed cancer enroll annually in clinical trials involving experimental treatment. In the study published in the Journal of Clinical Oncology, of 276 patients at the center, the team found that doctors failed to refer approximately 38% of patients, even before determining their eligibility. Physicians often incorrectly assumed that no appropriate clinical trial was available, or that the patients were too ill to be included. Of the 76 patients that were advised by their doctors to join a clinical trial, almost half refused, even though entry into such trials can be associated with a higher survival rate. 34% gave as their reason for non-participation that they lived too far from the center; 8% were denied coverage for the trial by their insurer; and 5% were not comfortable with randomization, in which patients are assigned at random to either treatment or control groups, and so only half will receive the experimental treatment.

One of the conclusions reached by the study was that physicians must do a better job of explaining the value of taking part in clinical trials to their patients, because the better informed a patient is, the more likely he or she is to enter a trial.

Low enrollment in clinical trials has a great impact on cancer research, often prolonging the duration of tests of experimental treatments and delaying the analysis of findings. The low accural rate seen among adults is in opposition to that seen in pediatric clinical trials where over half the children eligible enroll in cancer clinical trials. This paradox has existed for some time. It may be that the perception of gain is different when you are a parent versus when you are a patient.

According to Dr. Gandara, the higher survival rate experienced by cancer patients in clinical trials is not merely a function of potentially better treatment being available. Probably a more compelling reason is that the experimental protocol requires that the patients be treated and followed in a very disciplined manneróand that may translate into better overall treatment.