Lack of Study Volunteers May Hobble Cancer Fight

"Why can we put a man on the moon yet we can't cure cancer?" Usually I respond, "That's an unfair question." But not today.

On one hand, it is unfair. Why? Because when JFK proposed that American astronauts would walk on the moon, scientists already had the knowledge needed to make it happen. It was a matter of applying what was already known about space travel to build the equipment. In contrast, when Nixon declared a war on cancer, scientists didn't have the basic knowledge needed. They were learning -- and are still learning -- how cancer develops and how to fix the problem.

On the other hand, it is an excellent question. An article by Gina Kolata in today's NYTimes outlines the trouble with the methods used to advance our scientific understanding of the biology of cancer, the problems that are slowing down progress. Here is what we need to do:

1) Increase the number of adults who enroll in trials
Progress in the treatment of childhood cancers has far outpaced progress for adults. A key reason is that most children with cancer have been treated in trials, while few adults have been. Today ~55-65% of children diagnosed with cancer are treated in trials as compared to ~3% of adults diagnosed with cancer.

As an analogy, if you are trying to solve a 100 piece puzzle, you will be given 60 pieces to solve the puzzle of childhood cancer and only 3 pieces to solve the puzzle of adult cancer. We need more pieces, folks! Kolata does an excellent job of explaining some of the reasons scientists get so few pieces to work with.

2) Find faster method of executing trials
The methods used for trials are tedious and slow. We can speed things up. 

Going back to our puzzle analogy, today's process would give you one piece every week while newer, faster methods would give you one piece every hour. Speeding the process should shorten the time to solving the puzzle.

I am living proof that research leads to answers. In 1993 I participated in the Phase I trial of the first monoclonal antibody used to treat cancer. In 1994 and 1997 I participated in two Phase I-II trials. The drug is now the most commonly prescribed treatment for lymphoma. Click here to hear story.

Healthy Survivors know that cancer research is the one and only way to improved cancer care. It's time to help the research.

Comments

[Kairol Rosenthal]

I think we also have to look at funding sources and where people are treated.

Peds have huge access to clinical trials because they are treated in Children's Hospitals that have huge endowments - compared to your average adult community hospital. This allows the ped hospitals themselves to pic up the tab of much of the research. In essence their is loads more private money and support for kids to participate than for adults. Just a small % of their reserach funds come from the NCI.

Only 10% of adults are treated at university teaching institutions, and often our insurance companies will not pic up the tab of costs related to clinical trials. The Kennedy-Hutchinson Bill addressed this issue. Let's hope some good political action is taken on it.

Additionally, there are a lot of misconceptions out there about clinical trials and their safety that scare patients away. I interact a lot with young adult cancer survivors - and we have the lowest participation rate of all. It is telling to hear the stories that patients relay to me about why they don't want to participate - there is a lot of misinformation out there.

Great post Wendy.

Best,

Kairol
blog http://everythingchangesbook.com/

[Wendy S. Harpham, MD]

Yes, the fact that children are usually treated at academic medical centers (if not comprehensive cancer centers) plays a major role in why so many children are enrolled in trials.

So we need to have greater ties between adult academic centers and community centers.

And I agree: We need to do all we can to debunk myths about trials.
The Center for Information and Study on Clinical Research Participation (CISCRP) is helping in this arena. http://www.ciscrp.org/

[cancer guide]

Even though every one wants to be a volunteer, because of lack of knowledge very few people will be as active volunteer. my heartily thanks for each one of the volunteer those who are fighting for cancer cause.