Clinical Trials
with Gary Cohen, MD
Cancer. The word alone is frightening, but while a cancer diagnosis is still not what you want to hear, today many people survive cancer and are able to lead full, productive lives. These improved cancer survival rates are due to earlier detection and also in great part to clinical trials.
Gary Cohen, MD, Medical Director of Medical Oncology at GBMC, says, “The only way we can be sure about our progress in treating cancer is through clinical trials.”
A clinical trial is basically the application of medical science to medical treatments. In many trials, new treatment approaches are compared to traditional approaches to determine which treatment is most effective. Dr. Cohen explains that it’s not enough to have a new drug work well with mice or in a test tube. It has to be tested on humans before it is considered a valid therapy. The effectiveness of the drug and its potential side effects need to be thoroughly understood and this is only accomplished through clinical trials. Extensive participation in clinical trials goes on at GBMC, which means that patients have an opportunity to be treated by some of the newest therapies available.
Dr. Cohen says, “We are able to offer our patients some of the very newest medications and therapies in their latest stages of development but before they are approved for general use by the FDA (Federal Drug Administration). We are actually leaders in testing many of these drugs. This is a tremendous advantage to patients.” He also points out that when a medication is eventually approved by the FDA, GBMC physicians already have extensive experience using it. This is another major advantage to patients.
Many of the 50 or more cancer treatment studies that GBMC is participating in at any one time are cooperative studies with the National Cancer Institute or with pharmaceutical companies. GBMC has a large staff of professionals who are experienced in conducting clinical trials, including nurses, data managers, and physicians.
Breast cancer is an example of an area where many studies are continually being conducted all over the country because there are so many different questions associated with this disease. For instance, the following kinds of questions related to breast cancer treatment are being addressed in a variety of studies:
• How do we prevent breast cancer in women who are healthy but have an increased risk because of genetics or family history?
• When patients have hormone receptor positive disease, a form of breast cancer where the cancer cells have protein molecules on their surface that are particularly sensitive to estrogen, which of the many new hormonal therapies would be most advantageous?
• What about treating patients who have tested positive for cancer in their lymph nodes versus those who have no cancer present in their lymph nodes?
• How should we modify our treatment for patients with non-invasive cancer compared to those with the more aggressive invasive cancer?
• Should age be a factor in determining the appropriate treatment?
There are multiple varieties of breast cancer and each different scenario requires individual considerations and treatments. Clinical trials are the way scientists determine the most effective treatments for each type of breast cancer.
Clinical trials are also being conducted for treating almost every other type of cancer, such as lung cancer, colon cancer, and many others. GBMC physicians not only participate in clinical trials but they are also involved in designing them. Much of their work results in publishing studies results that help educate other physicians.
Not every patient qualifies to be in a clinical trial and occasionally patients who do qualify are hesitant to participate because they may feel they are putting themselves at risk. Dr. Cohen emphasizes that clinical trials are always optional and medical centers have review boards that look closely at each study with a focus on what is best for the patient and on maintaining patient confidentiality. He adds that GBMC is a community hospital where the primary focus is always taking care of patients and that clinical trials are an adjunct to the care provided.
Dr. Cohen encourages most patients to participate in clinical trials if they have the opportunity. He says, “Clinical trials are the only way we can make progress in cancer treatment. These studies are sanctioned by the National Cancer Institute and they’ve already been extensively reviewed so we know they are reasonable approaches to treating a specific type of cancer. Then there is always the satisfaction for patients of knowing that by participating in a trial they will be helping future cancer patients.”
Dr. Cohen continues, “We believe that clinical trials make us better physicians and give our patients more and better options for treatment. Being at an institution where clinical trials are conducted is even beneficial for those patients who do not participate because their physicians are at the forefront of knowledge concerning cancer treatment.”
“By conducting clinical trials,” says Dr. Cohen, “we are always at the leading edge of cancer treatment. We continually try to move beyond the standard treatment and on to treatments that are more effective and have fewer side effects.”
