Dana Rathkopf, a medical oncologist at Memorial Sloan Kettering who specializes in caring for men with prostate cancer, addresses common questions and misconceptions about participating in clinical trials. Because of their potential to improve the standard of cancer care across the entire spectrum of the disease, she emphasizes that clinical trials aren’t just for people with an advanced stage of cancer.
People who are considering a clinical trial, she says, should carefully read the informed consent document, which discloses important details about the study. She also addresses questions about the potential benefits and risks to the participant, the duration and organization of trials, and any costs that are or are not covered by the trial.
Joining us now is Dr. Dana Rathkopf, a medical oncologist at Memorial Sloan Kettering Cancer Center specializing in caring for men with prostate cancer. Thanks for being here, doctor. You've led several clinical trials. Why are clinical trials so important in the development of new cancer treatments?
We're constantly striving to improve upon the standard of care, and to do that, we need to run clinical trials. Clinical trials are typically a study where a patient volunteers to participate so that we can test a new treatment or a new device or a new question or concept and see if it's better than what we currently have available.
A lot of patients and families would wonder about this: Are clinical trials only appropriate for the patients who have exhausted all other treatment options?
Absolutely not.
That's good news, right?
Yeah, you know, clinical trials as we understand more about cancer and the disease biology behind it, we're realizing that there's room for improvement on the standard of care across all states of disease. I think it's always appropriate to think about a clinical trial when you're meeting a physician for the first time to always ask: Are there clinical trials available? What's the standard of care? What other options are available for me?
A lot of people worry about cost, of course. Do patients have an increase in out-of-pocket expenses if they do enroll in a trial?
Typically, in a clinical trial, if it's a research drug for example, the cost of the research tests are covered by the clinical trial. But the best way for a patient to inform themselves about what is and is not covered is to look at something called the informed consent. Before you sign up for any clinical trial or before you even think about enrolling in a clinical trial, your doctor will give you an informed consent that clearly outlines what is and is not covered in that trial. And then you can always ask questions of course of your insurance company or the institution that's performing the study as well.
And Ellen talked about placebos in her report. Can you explain a little bit more to us who may not fully understand what a placebo is and how it works?
Oh absolutely. So I think placebos are a common fear for patients approaching a clinical trial, that they'll receive a placebo or that they won't get the active drug. If we use a placebo, we use a placebo in combination with the standard of care. So for example, if you have patients receiving the standard of care and you want to test a new drug, half the patients or some proportion of the patients will receive the new drug plus the standard of care, and the other proportion of patients will receive just the standard of care with a placebo. A patient will always be informed if there's a placebo involved in a study, and again that returns to the informed consent and discussion with the physician.
Alright, doctor, thank you so much for being with us and explaining all of this to us.