Dr. Beer interviewed about clinical trials

A few weeks ago, at the 2012 ASCO meeting, I had the privilage of being interviewed about about clinical trials by Andrew Schorr, Founder of Patient Power.


You may also wish to visit the Patient Power website, which is a wonderful resource.


To put a smile on your face see Larry's latest cartoon.

To learn more about clinical trials, take a look at our book.
(c) 2012 Tom Beer and Larry Axmaker

Lower income reduces participation in cancer clinical trials

In a carefully documented study, sponsored and funded by the National Cancer Institute and NexCura, researchers found a surprising gap in participation in clinical trials between cancer patients with higher incomes and those with lower incomes. Nearly 5,500 cancer patients were interviewed for the study that concludes:

• Cancer patients with annual incomes under $50,000 were 27% less likely to participate in a clinical trial than those with an annual income of more than $50,000.
• Cancer patients with an annual income under $20,000 (such as many living on Social Security) were 44% less likely to participate in a clinical trial than those with an annual income of more than $50,000. Concern over possible costs was given a major factor in their decision not to participate (including co-pays, time off work, etc.).

Does this matter from a scientific/research point of view?

Researchers say yes.

• Lower participation rates in the lower income groups results in lower overall participation rates and slows the rate of completing trials and ultimately getting FDA approval for new and better treatments.
• With lower participation rates from large segments of the population trial results may not be as reliable, their results may not be fully applicable to all populations.

Does it matter from a patient point of view?

• Clinical trials can provide many benefits to participants, including access to new drugs, excellent medical treatment, and close monitoring of their health status.
• According to the study leader, Dr. Joseph M. Unger, lower income individuals already have more medical conditions and less access to healthcare than their higher income peers. Having less access to cancer clinical trials adds to this treatment gap.

Solutions?

The study recommended:

• Increased and improved education for lower income cancer patients, making sure they knew what the costs were and that costs associated with clinical trials were not significantly different from regular care.
• Increased and improved education for lower income cancer patients about the possible benefits of participating in cancer clinical trials.

Other possibilities…

• Providing transportation or transportation costs for low income participants.
• Providing the trial treatment in the participant’s home (going to them).
• Finding ways to include (more) lower income individuals who do not have health insurance coverage.

In an ideal world, all patients would have equal access to cancer clinical trials. 

To put a smile on your face see Larry's latest cartoon.

To learn more about clinical trials, take a look at our book.
(c) 2012 Tom Beer and Larry Axmaker

Our book has made it into the 21st century!

In addition to the print edition, we are now an eBook!  We've had a number of folks ask us if we will be on Kindle and, as of today, we are.  We should be coming to the Nook and the Apple iBookstore soon as well.


If you've been waiting for the electronic version, it's here now!  We are excited about another milestone in our book journey.

To put a smile on your face see Larry's latest cartoon.

To learn more about clinical trials, take a look at our book.
(c) 2012 Tom Beer and Larry Axmaker

Video: the personalized medicine revolution in cancer care

Cancer care is changing to become more individualized and personalized.  Detailed biologic analyses of individual cancers are increasingly enabling treatment to be tailored to match each cancer's unique vulnerabilities.  We wrote about this in a  prior blog post.  


Now, you can watch a great show about personalized cancer care from the OHSU Knight Cancer Institute.  Click here to see the show.  Some aspects are specific to the Knight Institute, but most of the program will help you learn about personalized and targeted therapy for cancer.


The call-in lines, by the way, are no longer open.  Folks could call in with questions on the day the show ran on KOIN-TV in Portland.


To put a smile on your face see Larry's latest cartoon.

To learn more about clinical trials, take a look at our book.
(c) 2012 Tom Beer and Larry Axmaker

ASCO 2012 Update on advanced prostate cancer treatment

ASCO is the world's largest oncology meeting.  Important new data about abiraterone and MDV-3100 were presented at the meeting.  Both of these drugs have been shown to have a significant benefit for patients with metastatic prostate cancer that is resistant to standard hormonal therapy.


I had the privilege of reviewing the latest developments in treatment of advanced prostate cancer.  The slides for my talk are available here.  It's a large file, so be sure you have a broad band connection to download.  The slides are fairly technical at times, but do include "current status" summary slides that provide a succinct summary of the status of each of the new agents discussed.


To put a smile on your face see Larry's latest cartoon.

To learn more about clinical trials, take a look at our book.
(c) 2012 Tom Beer and Larry Axmaker

It’s all about the numbers—or is it?

12 million individual Americans have cancer. That’s a lot. Of course not all cancers are equal. Some grow very slowly, others very quickly. Some are nearly always fatal, some are sometimes fatal, and some are almost never fatal.

There are always new drugs in the clinical trials chain that have the promise of cure (not often enough), prolonging life, or improving quality of life. There are also ongoing controversies about the high costs of trials and drugs, and whether or not regular testing should actually occur (remember the recent discussions about breast cancer and prostate cancer testing). There are published statistics about survival advantage, incontinence, harm vs. benefit, waiting vs. not waiting, and on and on. It never ends--which is probably a good thing in the long run.

But for anyone with incurable cancer it’s a very, very individual thing. For example, I know a lot of guys with long term prostate cancer and no two of us are getting exactly the same treatment (unless we’re in a trial). Individual cancer treatment depends on factors such as age, overall physical condition, speed of cancer growth, resistance to certain drugs, allergies, tolerance of side effects, health insurance coverage, and some other things most of us have probably never heard of.

Regardless of national or international statistics about cancer and cancer treatments, your best interests lie in focusing on your needs, talking and listening to your medical team, and looking for the things that might help you. Whatever the ‘statistics’ and ‘experts’ say, you are not just a number—OK, you’re actually number ONE (remember that)!

Any given drug or treatment will either help (100% effective) or not help (0% effective) you. All those statistics might or might not have anything to do with what’s best for you!

To put a smile on your face see Larry's latest cartoon.

To learn more about clinical trials, take a look at our book.
(c) 2012 Tom Beer and Larry Axmaker