Expert Analysis Highlights:

• Clinical trials serve two purposes: Offering patients the newest treatment options and advancing scientific knowledge for future patients
• Below are some useful questions you should ask when deciding whether or not to participate in a clinical trial
• To find out if there is a trial in the area you need treatment, check out clinicaltrials.gov where all trials are registered
• For more information about clinical trials, click on the following link to patientresource.net

The phrase “Clinical Trials” means one of two things to most people: An opportunity to get the latest and greatest new treatment, or a futile human experiment with no major benefit to them.  The truth is somewhere in between.  The bottom line is that it depends on the trial and its design.

To review, a clinical trial is a program offered by some hospitals which assigns you randomly to receive standard treatment or a new treatment for which the potential benefit is not yet proven.  Some trials have 3 “arms” or treatment paths.  The key to a good research study from a design standpoint is that patients are randomly assigned to a treatment path and then the outcomes are compared.  This is the most scientifically valid way of assessing how good the treatments work.

Here are some useful questions you should ask when deciding whether or not to participate in a clinical trial:

• What is the benefit seen in previous studies of the new treatment being studied in the trial?
• Does the new treatment being studied work by a different mechanism (i.e. a novel treatment) compared to the standard treatment?
• Where did the idea for the clinical trial come from?
• What are the quality of life and survival differences likely if I do not participate in the trial?

For some trials the new treatment may be very promising, while for other trials, the benefit may be marginal or even negligible based on prior studies.

For your protection, all clinical trials are governed by rules which hospitals are ethically and legally obliged to follow.  The rules are: 1) If the benefit of one of the treatment options is clearly apparent during the course of the study, the study must be ended early so that the results can be disseminated and patients do not have to continue a course of treatment which is known to be inferior, 2) You must be informed of every aspect of the design of the study, 3) You can opt out of the trial at any time, and 4) You are entitled to see the results of the study once completed.

Clinical trials serve two purposes: Offering patients the newest treatment options and advancing scientific knowledge for future patients.  Consider it not just a way of getting a new treatment, but also a way of helping inform future patients with a similar cancer.  In general, clinical trials provide hope for patients whose treatment options might otherwise be limited.  Many trials are managed on a multi-institution level, making the trials available on a local level for many patients.

To find out if there is a trial in the area you need treatment, check out clinical trials.gov where all trials are registered.  There you will be able to find out what the treatment arms are, whether the trial is open of closed to new patients, and where to go to see if you’re a candidate.

This video has a compelling story told by a young English couple talking about their sexual relations and experience with in vitro fertilization after the woman’s treatment for cervical cancer. It’s nice to know that some couples are brave enough to talk about sex after cancer treatment. Sexuality affects many cancer patients and their spouses. It is important to talk about this aspect of your cancer treatment with your doctor.

Here’s more information from our companion website that you may find helpful:

There are a wide range of reasons for changes in sexuality during cancer treatment, and the reasons relate to the treatments themselves as well as to other side effects of treatment.

Surgery has a variety of effects on sexuality. Removal of all or part of a reproductive organ decreases hormone levels, which can lead to overall loss of sexual desire. Such surgery can lead to premature menopause in younger women, and may make sexual intercourse painful or difficult for younger and older women. Surgery in the pelvic area in men can damage the nerves leading to the penis, causing erectile dysfunction. Lastly, surgery that changes body appearance, as with removal of a breast or a testicle, can affect how a person feels about his or her body image. A negative body image can change how you feel about your sexual desirability.

Chemotherapy or radiation therapy to the pelvis may damage the ovaries in women or the testicles in men, both of which can reduce the amount of hormones produced. This loss of hormones may cause a loss of sexual desire in men and women, premature menopause in younger women, and erectile dysfunction in men.

The side effects of cancer treatments also play an important role in sexuality. Side effects such as fatigue, nausea and vomiting, pain, diarrhea, and mouth sores can substantially reduce a person’s interest in sex and his or her feelings of desirability.

Some treatments are available for physical sexual issues. For example, vaginal dryness can be treated with vaginal moisturizers and lubricants. Several drugs are available for erectile dysfunction, including sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). These drugs may not be appropriate for every man, and men should talk to their doctors about the risks and benefits. Hot flashes in both women and men have been relieved with low doses of antidepressants such as fluoxetine (Prozac), venlafaxine (Effexor), duloxetine (Cymbalta), and paroxetine (Paxil).

Open communication with your spouse or significant other is key to maintaining a good intimate relationship. You and your partner should share concerns and fears. Talk about ways to be intimate other than with sexual intercourse. You should both understand that it is safe to have sex during cancer treatment (unless your doctor tells you otherwise). Counseling (individual, couples, and/or sex therapy) may be helpful.