Headlines & Helpful Information, Research
By: Elly Cohen
Guest post by Elly Cohen, Program Director of BreastCancerTrials.org and Assistant Professor of Surgery, UCSF School of Medicine
After being diagnosed with early-stage breast cancer in 1998, I had the option of having either a lumpectomy, followed by radiation, or a mastectomy. My mother, who was diagnosed with early-stage breast cancer in 1974, was offered only a mastectomy. The reason I had options was because two landmark clinical trials confirmed that women who have breast-conserving surgery followed by radiation have the same survival rates as women who have a mastectomy.
These studies dramatically changed how breast cancer was treated. But they did even more: they validated clinical trials as the gold standard for comparing one medical treatment to another.
Since that time, doctors have relied on the findings from clinical trials to guide all aspects of breast cancer care, from diagnosis to treatment to survivorship. These include advances inchemotherapy and hormone therapy as well as targeted anti-HER2 therapy, starting with Herceptin® and, most recently Kadcyla® (TDM-1), which was recently approved for the treatment of HER2-positive metastatic breast cancer after trials led by Komen Scholar Dr. Kimberly Blackwell showed that the drug slowed the disease progression with fewer side effects than standard therapies. Some of the latest trials are evaluating targeted therapies, anti-cancer vaccines, and “smart bombs,” such as Kadcyla®, which carry chemotherapy payloads directly to HER2-positive cells. Might one or more of these treatments prevent breast cancer from recurring, make metastatic breast cancer a chronic disease, or eradicate breast cancer all together? Clinical trials will give us the answers.
Advancing breast cancer care through clinical trials requires an ongoing partnership between patients and clinical investigators. Today, there are more than 500 breast cancer trials taking place throughout the U.S. In fact, in 2010-2011, Komen provided more than $54 million to 74 grants that supported 83 clinical trials in the U.S. and around the globe, helping us test new therapies, develop new early detection methods and improve health care access and quality of life for low-income individuals facing breast cancer.
Yet, a relatively small number of patients volunteer for studies slowing the pace at which effective new treatments reach the clinic. Through our collaboration with Komen, we are able to provide more information about clinical trials and encourage individuals to participate. Barriers to participation are often linked to misunderstandings about clinical trials that are commonly held among patients, so sharing accurate information about the importance of clinical trials is critical.
In our work at BreastCancerTrials.org, we have found five of the most common myths to be:
Myth: Clinical trials are only for people with metastatic breast cancer.
Fact: There are treatment trials for breast cancer patients at all stages of disease. Breast cancer trials also look at prevention, screening, and quality of life, including those for post-treatment survivors looking at long-term consequences of cancer and ways of preventing recurrences.
Myth: If I take part in a treatment trial, I might be given a placebo (sugar pill).
Fact: All patients who join cancer treatment trials receive at least the standard of care. Only in the rare instance that there is no standard of care would patients in a control group receive a placebo.
Myth: Any new breast cancer treatment can be studied in a clinical trial.
Fact: A new breast cancer treatment is tested in humans only after there is good scientific evidence from laboratory and animal studies that the treatments will be potentially safer or better than the current standard therapy.
Myth: Researchers do not treat clinical trial participants well.
Fact: Patients in clinical trials are cared for by a team of healthcare providers and are monitored closely during the course of the study. A survey conducted by the Coalition of Cancer Cooperative Groups found that the vast majority of cancer survivors who had taken part in clinical trials were very satisfied with their experience.
Myth: If I choose to enter a breast cancer trial, I have to stay in the trial, no matter what.
Fact: You can change your mind and stop participating in the trial at any time, for any reason.
How can you learn about ways to participate in research? First, discuss the availability of trials with your doctor, and if your physician is not supportive, consider a second opinion. Second, be proactive by visiting online resources that can help you identify studies on your own. BreastCancerTrials.org in collaboration with Komen offers a custom matching service that can help you find trials personalized to your situation. Other sites include government registries such as ClinicalTrials.gov (run by the National Library of Medicine) and Cancer.gov (run by the National Cancer Institute).
Clinical trials may not be right for everyone. And there might not always be an appropriate trial The Importance of Clinical Trials in Breast Cancer Treatment available at the right time. But as a community of patients and survivors, we can play a significant role in advancing breast cancer care by simply considering trials as a routine option for care throughout our cancer journey, and encouraging others we meet to do so as well.
To read more about clinical trials and Komen’s role in funding trials, go to Komen.org and check out the following resources:
• Clinical trials section on komen.org• Clinical Trials Facts for Life fact sheet• Research Fast Facts sheet• Komen Perspectives article: The Importance of Clinical Trials in Breast Cancer Treatment
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