Searching for Clinical Trials

Looking for a clinical trial can be a daunting experience. It may be that you are doing this just to see what's out there, but it's more likely to be that you - or a friend or family member - have just had some bad news about treatment and you need to review options. At times like this you may not know where to turn. The aim of this article is to offer some guidance in what is likely to be a difficult time.

The first and most important thing to keep in mind is that clinical trials are conducted for different reasons - and this is normally indicated by the phase of the trial. The most important of these are Phase I, II and III trials.

Phase I trials are normally the first trials of candidate drugs or other treatments in humans. To get to Phase I a drug will have gone through 'pre-clinical' testing in the test tube (in vitro) or in animals (in vivo). Occasionally a drug might be tested in tiny amounts in humans before going into a proper Phase I trial. The key aim of the Phase I trial is to find the appropriate dosing of the drug. The effectiveness of a treatment is of secondary importance. The researchers are convinced by the pre-clinical evidence that the drug has some effect, but they need to establish a proper dosing schedule before they can focus on how good it is in practice. This is an important point to keep in mind. Also, Phase I trials tend to be on a small in scale (there are only a few patients, often based at a single hospital or clinic and with small research team).

Phase II trials take things a step further. At this point the drug or treatment has been through Phase I. The dose has been established and there are often some indications of effectiveness. There's still an element of looking at the dosing schedule or treatment protocol, but the emphasis is now on seeing whether the positive effects seen in the pre-clinical studies actually hold true in humans. Phase II studies are often larger in scale - more patients, more doctors, possible multiple locations.

Lines of Communication

An interesting little story caught my eye on one of the science web sites this week. It‘s a report of a recent study that found that ‘managing communication around cancer diagnosis gives patients sense of control in an otherwise uncontrollable situation’. The researchers found that:

...communication is an important factor in coping with cancer in that it enables people to exert control during a highly stressful and turbulent time. However, despite best efforts to structure and control that communication, cancer patients cannot always predict or control other people's reaction.

In our experience the need to communicate with friends and family simply became exhausting. Particularly when you’ve just had bad news, the need to relay it multiple times just makes you feel worse. The constant repetition of bad news is depressing, especially when you know that the person on the other end is going to react badly to it too. It means that not only do you have to deal with your own reactions, but you end up having to manage other people’s too. It increases the stress precisely when you’re most stressed out.