By Fadlo R. Khuri, MD, FACP
As a physician focused on the treatment of patients with cancer, many of whom face a potentially incurable disease, I make 3 promises to my patients:
1) We will always tell them the truth.
2) We will always do our very best for them, placing their interests and those of their families above all others.
3) We will never abandon them.
These are important words to relay to a patient, particularly those who are considering participating in clinical trials. The question, then, is, "Why should cancer patients participate in clinical trials?"
Cancer clinical trials are one of the most important methods we have to move the field forward. After all, it was through clinical trials that we have developed cures for childhood acute leukemia, Hodgkin disease, and testicular cancer, how we developed long-term highly effective therapies for chronic myeloid leukemia and breast cancer, and how we created personalized genetic therapies for lung cancer, melanoma, and other diseases. Cancer clinical trials also let us know how patients are feeling about their care, and can improve approaches for the treatment, prevention, and cancer screening tests for cancer patients.
One of the first things I do as the treating physician is to complete a history and physical exam of the patient. The information I gather helps me form an opinion, and it helps me gain the trust of the patient and his or her family.
After obtaining the history and physical information that I need, I discuss standards of care and explain why this care, like radiation or chemotherapy, might work (or not work). It is important to acknowledge our limits while reassuring patients of our considerable experience in treating others with a similar disease. I have occasionally seen physicians who rush to discuss the clinical trial before going through the full range of standard treatment options available. Identifying the standards of care and presenting them as a viable option for patients is far more likely to reassure patients that all options have been carefully considered. More...