25. Being a “Change Agent” with Clinical Trials

Lori Marx-Rubiner is a social worker, writer and breast cancer coach. On the national level, she is involved in advocacy and serves on peer review for the Department of Defense Breast Cancer Research Project (a Congressionally Directed Medical Research Program). Locally she coaches women through their diagnoses and into treatment, and has led in-treatment support groups. She is particularly interested in working with young mothers who are parenting through cancer. Lori was first diagnosed with lobular carcinoma in 2002, at the age of 35, and nearly ten years later was diagnosed with metastatic breast cancer. She writes and speaks on issues from “The Pinking of America” and the marketing of breast cancer, to the importance of science-based evidence in treatment decision-making, to what we can each do to make a difference. She lives in Los Angeles with her amazing support team: her husband John and her 13-year-old son Zach. Lori’s blog can be found at www.regrounding.wordpress.com.

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How does working the night shift impact your breast cancer risk?

Would the early detection of DNA damage help determine future breast cancer risk?

Can breast milk be screened for breast cancer, or to determine breast cancer risk?

Does one’s breath contain biomarkers for the early detection of ovarian cancer?

Might acupuncture improve the sleep of breast cancer survivors?

Clinical trials. This is how we will find the cure to breast cancer. However, the only way to complete and assess the outcomes and potential of new therapy is to conduct and complete a clinical trial. And as frustrated as we can be with the pace of trials, and finding a cure, we hold the key — we can be the change agent….

There are a number of reasons that researchers struggle to enroll sufficient participants in their trials, but until they do, the research can’t move forward. However, there are many preconceived notions about what it means to participate in a trial, and many of them hamper participation. They are mostly about how the trial participant is protected.

How is the patient protected?

• Treatment Protocols – Many people fear that in a trial they will be put into a “placebo” group or a “treatment” group. When it comes to breast cancer research, potential treatments are evaluated as compared to the existing standard of care. In other words, you will either receive they “usual” treatment or the “new” treatment.
• Informed consent – Before participating in a trial all of the key information about the study is disclosed. The purpose, duration, requirements, and potential risks and benefits are explained. There are also opportunities to ask questions of the research team. If a patient changes her mind about participation at any point, even after the trial has begun, she may withdraw. Period.
• Ethics Review – Every trial in the United States is overseen by an Institutional Review Board (IRB). This board is charged with the responsiblity for minimizing risks to and protecting participants, as well as the maintenance of ethical standards. Research is subject to ongoing review by the IRB.
• Worse Than Standard Care? Many patients fear that clinical trials will only make things worse. The truth is, anything is possible. However we are typically comparing the “current” treatment with ones that researchers believe could be better. And nothing, nothing, nothing arrives in human trials without being thoroughly tested in the lab first.

The subject of trials has been on my mind for some time, but is particularly poignant just now. Over the next two weeks I will conclude a process of peer review for breast cancer research. Along with a team of about 20 individuals, both scientists and consumers, we will have reviewed nearly 50 studies. As a peer reviewer my primary job is to evaluate the impact and innovation of these studies from the perspective of the breast cancer community – patients, survivors and caregivers. Tonight I submitted the last of my eight critiques, and my head is still spinning. With the AMAZING support provided by a team of people, I got it all done. How well I understood the content remains to be seen, but the very idea that *I* could be involved, on any level, to discovering a cure is AWEsome.

Here’s the good news…you can get involved too!

1. Number one, most exciting thing you can do: JOIN THE ARMY! If you haven’t already heard, Dr. Susan Love & the Avon Foundation have teamed up to create Army of Women. This is an incredible opportunity, especially for our supporters who have not been diagnosed with breast cancer, to get involved!

2. To learn more about clinical trials in America, check out US Clinical Trials.

3. For more on breast cancer trials in particular, check out Breast Cancer Trials.

And most of all, know that your participation in clinical trials can lead us to a cure!

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Post Script: I failed to mention that not all trials are for new or newly-applied medications, either. For example, I just received a blood sample collection kit for a trial looking at heredity and cancer. My involvement in the trial: a few vials of blood given at my next doctor appointment and a survey about my family…so simple!

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