In cancer medicine, fewer than 5% of all patients in the US enter clinical trials

Wednesday, 31/03/2010  |   Others  |  no comments

In a recent article by John L Marshall, the Director of the Otto J Ruesch Centre at Georgetown University in The Weekly Guardian (5 March 2010) states that, “In cancer medicine, fewer than 5% of all patients in the US enter clinical trials. That means more than 95% are treated with the standard of care, a legal term denoting minimum level of care for an all or injured person… How did we end up here? The answer is simple: cancer patients are scared for their lives and will accept what is offered, and we oncologist want to offer improved outcomes and recommend the best treatments we can.” Dr Marshall goes on to say: “Insurance will pay for these treatments. A portion of fees collected by doctors and hospitals is based on how much chemotherapy we administer. So the more drugs we give, the more radiation we give, the more we collect from health insurance .”

Later Dr Marshall says, “A major focus of healthcare reform is for doctors to practice evidence-based medicine. The problem in cancer medicine is that we have very little evidence to support what we are doing. Because so few of our patients enter clinical trials, we have no way of tracking their outcomes collectively. Our understanding of cancer therapies comes from the 5% who enrol in trials…”

We know cancer patients facing death are desperate and accept toxic treatment after toxic treatment hoping to extend their lives, but do they? No one knows. There are no trials comparing older (and cheaper) forms of chemotherapy over the newest (and exceedingly expensive) new ‘breakthrough’ drugs. Doctors are under pressure to prescribe the latest and newest drugs but cannot get the simplest information on comparing life expectancy between these older and newer drugs. 

When I as a complementary oncologist get told I should show the RCTs for what I offer to patients, I only point our the painful truth, none of us, orthodox or complementary practitioners have the opportunity to track our outcomes collectively. This should change for the benefit of the patient and our only ethical concern should be their well being and not inter-disciplinary point scoring.

Leave a Reply

You must be logged in to post a comment.