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« Revoking FDA Approval: Right or Wrong? - Part VIII | Main | Revoking FDA Approval: Conclusion »

January 10, 2012


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Kirk Hartley

Well said - let's hope it happens !!


Wendy: I work as a cancer research coordinator and the real solution to this problem is for EVERY patient with cancer to participate in an available clinical trial if they meet eligibility criteria. Unfortunately only 3-5% of eligible cancer patients participate. This leaves a small segment of the patient population assuming treatment risks and the small sample size brings into question the generalizability of the clinical trial data. Additionally, yesterday I attended a lecture by David Casarett MD who spoke on "the science of hope: are we hardwired to overestimate our effectiveness." What I took away was this: without rigorous clinical trials and the strong desire to practice evidence-based medicine (versus anecdotal) we are not providing effective proven treatment to patients and our willingness to overlook data that doesn't fit our desired results harms patients.

Wendy S. Harpham, MD

Dear Annette,

Thank you for pointing out that relatively few adult Americans with cancer participate in trials. Many eligible patients don't know about trials. Some eligible patients decline because of misperceptions. In addition, I've known many patients who have wanted to be treated in a trial but could not find a single trial that would accept them. Either the trials were closed or these patients were ineligible due to their age (too young; too old), having received certain treatments in the past, having other medical conditions (such as heart disease), and so on.

Thanks also for sharing your conclusions after hearing Dr. Casarett's presentation. Professionals and patients alike can benefit from the wealth of information that has become available recently from studies designed to explore how patients make decisions and experience hope. I'll devote some upcoming blog posts to this provocative topic.

BTW, if interested, Casarett wrote an excellent book on end-of-life care, titled Last Acts.

Keep up the good work, Annette. We need you. With hope, Wendy

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