The Role of Healthcare Professionals in Clinical Trials

by Molly McGuane

No matter how severe the cancer diagnosis, patients and their families look towards their doctors and healthcare providers to lead them down a path towards treating the disease. Typically, cancer is treated in three ways: with chemotherapy, radiation therapy or, in some cases, surgery. The best treatment options are based on a variety of factors including the type of cancer, the progression of the disease and a patient’s medical history.

Aside from the more common forms of treatments, there are healthcare professionals that are striving towards coming up with new treatments and breakthroughs in the field of cancer. These doctors and researchers are helping care for their patients in the present and working towards the future of cancer treatment. For cancers with a devastating prognosis, or cancers that are not responding well to other forms of treatment, those in the clinical trial field are a ray of hope. Though the road can often be long, the end result is often life changing for patients and their families.

What is a Clinical Trial?

Working with doctors and scientists, patients can participate in clinical trials in order to treat their cancer, manage symptoms, or prevent cancer from forming. Clinical trials are essentially the last step in a research study where data, patterns, new drugs and devices are implemented in real time. Any drug or new technology must be tested in a clinical trial before being approved by the FDA, which is an important step in moving medicine and cancer treatment forward. Although clinical trials can be used at any stage of cancer, they are commonly sought out by patients with difficult diagnoses and those who are not reacting favorably to common treatments.

While treatments like these are in fact “trials,” there are thousands of people who are benefitting by taking part every year, and there are even more who could benefit by testing what types of treatment work for them and what doesn’t. Not every clinical trial is a guaranteed success, but trials are required to go through several steps before making it to the patient stage, including cell and animal studies. Currently, there are several different types of emerging treatments being tested at the leading hospitals across the country, many of which specifically focus on cancer patients.

Immunotherapy

As the name suggests, immunotherapy targets the immune system in order to strengthen or suppress the body’s defenses in order to fight cancer cells or give certain treatments the environment to succeed. Cancer cells effectively harm our organs due to their ability to avoid immune cells, and certain types of immunotherapies can help find and mark the debilitating cancer cells.

Depending on the type of therapy decided on with one’s doctor, immunotherapy drugs can be taken orally, through an IV, through an ointment or cream or in some cases intravesically. As with many forms of treatment, there can still be side effects such as swelling, soreness, congestion and various flu-like symptoms. In the past few years, immunotherapy treatment has been useful for a number of different cancer diagnoses, including lymphoma and lung cancer. 

Gene Therapy

In recent years, gene therapy has been among the most promising treatments to emerge in cancer trials. Our genes are sets of code that help our body and health progress, so manipulating certain genes can help prevent and treat cancer. In gene therapy, doctors can replace faulty genes with functional genes, fix mutated genetic material or strengthen genes to better fight disease. The treatment is generally injected or given intravenously, and has shown progress for patients not only with cancer, but also for those with genetic diseases like muscular dystrophy and cystic fibrosis.

A specific type of gene therapy that has been successful in trials is known as p53 therapy. The p53 gene is responsible for coding proteins that facilitate proper cell function. Doctors have noticed that the p53 is mutated in several different types of cancer, pinpointing that gene as a hinge in cancer treatment. Restoring that specific gene to its correct function can help slow the growth of cancer and potentially help patients improve their prognosis. While the restoration of gene p53 is not eradicating the cancer, it can help slow down the growth of fast moving cancers. For example, these trials would be useful for treating mesothelioma patients, since mesothelioma is an aggressive cancer with an average prognosis of only 6-18 months. So far, doctors have seen a reduction in tumor size and an extended life expectancy for mesothelioma patients in phase 1 clinical trials.

Virotherapy

An effective emerging treatment for cancer patients, virotherapy utilizes viruses to target and eliminate cancer cells in the body using oncolytic viruses–which are viruses that specifically kill cancer cells. The goal of these oncolytic viruses is to find and destroy cancer cells without causing damage to functioning cells or an infection. This is another therapy that is often used in patients with a poor prognosis or those who have advanced stages of cancer.

Virotherapy is often administered in conjunction with other treatments like chemotherapy and immunotherapy. This branch of medicine is a good option for cancer patients because there are few side effects and little to no risk of affecting the mutation of other cells. Oncolytic virotherapy can also be used at any point in the treatment process and is an emerging option for those looking into participating in a clinical trial.

The Importance of Physicians in Trials

Becoming involved in a trial or study that pushes towards a cure for cancer can be extremely exciting and fulfilling for those in the field of science and health. The role of the physician in a clinical trial is more than just a patient’s doctor. These professionals are the bridge between pharmaceutical companies and those in the trenches of a cancer diagnosis. While there are a number of positions and researchers involved in trial, physicians are those who are best equipped to comment on what drugs and therapies will be most useful in practice.

Physicians wear a number of hats, but first and foremost, most doctors desire to serve their patients and seek out miracles in medicine. Those who have a passion for unlocking issues at the forefront of cancer care should not shy away from a role in a clinical trial. For families, friends, and patients who are dealing with a difficult or rare diagnosis, trials and alternative treatments are what provide hope for those fighting for strength and precious time with their loved ones.

 

About the author: Molly McGuane is a Communications Specialist at the MAA Center.

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