Clincial trials are research studies that involve people. The main purpose of a clinical trial is to find a better way to prevent, diagnose, or treat a disease. Participants on a clinical trial receive drugs or procedures that have already been researched in successful lab and/or animal studies. All participants on a clinical trial are volunteers. They can chose to stop their participation in a clinical trial at any time. Because they are "trials", results are not assured. It must be understood that clinical trials provide the testing ground for tomorrow's effective treatments.

Understanding clinical trials
Clinical trials are not considered part of a standard course of cancer treatment, but are supported by some doctors for patients in certain situations. Clinical trials are important to develop new treatments for cancer. Many of today's standard cancer treatments - treatments that are accepted and widely used by medical experts - are based on the results of previous clinical trials. We may consider participating in a therapeutic clinical trial treatment if:

• No standard treatment course exists for our cancer
• Standard treatment hasn't worked, or longer works, on our cancer
• We've suffered a recurrence
• We've been diagnosed at a late stage of our cancer's growth

It is important to keep in mind that some clinical trials have eligibility requirements that bar patients from participating if they've already begun receiving a standard form of treatment. For this reason, where you first get treated for cancer can have important implications for your treatment plan, and potentially outcome of the disease. A comprehensive cancer center is more likely to offer diverse treatment options, including clinical trials, that may be appropriate for your particular cancer type and stage. As with choosing any cancer treatment, it is important to learn as much as you can about your options and consult with both your clinical care team and supportive care team (family/caregivers) to determine the best decision for you.

Types of clinical trials

• Prevention trials study how healthy people may prevent cancer from happening to them. People who currently do not have cancer, but who are at high risk of getting cancer, may benefit from participating in a prevention trial. An example of a prevention trial is STAR (Study of Tamoxifen and Raloxifene). The study showed that the use of the drug Raloxidene is as effective as the drug Tamoxifen, and has fewer risks. Both drugs are now used to reduce the risk of breast cancer in women who are post-menopausal and who are at higher risk for this disease.
  
• Early detection/screening trials discover ways to find early stage cancer. An example of an early detection trial is the National Lung Screening Trial, to find out whether screening current and former smokers for lung cancer before they have symptoms can reduce deaths from this disease.
• Diagnostic trials find new and better ways to determine if someone has cancer, and if so, where the cancer is located in the body, how much cancer is there, and if it has spread to other parts of the body.
• Quality of life/supportive care trials seek to improve the comfort and quality of life of patients and their families or caregivers.

Knowing the phases
Clinical trials are done in incremental phases. The later the phase, the more people the drug or treatment has been tested on. It's important to be familiar with what the phases mean when choosing a clinical trial to participate in.

According to the US National Institutes of Health, clinical trial phases are as follows:

• Phase I: Researchers test an experimental drug or treatment on a group of 20 to 80 people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
  
  
• Phase II: The experimental study drug or treatment is given to a group of 100 to 300 people to determine if it is effective and to further evaluate its safety.
  
  
• Phase III: The experimental study drug or treatment is given to groups of 1,000 to 3,000 people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the experimental drug or treatment to be used safely.

Patients in Phase III clinical trials are assigned to either a control group, which is given a standard treatment, or the experimental group, which tests out the experimental drug or treatment.

• Phase IV: This phase gathers more information about a new treatment that has already been approved for use in patients.

Risking side effects
Because clinical trials involve new treatments, there are potentially more side effects associated with them than with standard treatments. While some clinical trials have been successful in treating cancer, there is no guarantee experimental therapies will cure us.

Finding clinical trials
The institutes below may offer trials in your area. Try searching by disease type and hospital.

• The National Cancer Institute's page on clinical trials

• ClinicalTrials.gov is the US National Institute of Health's clinical trial website.

• The Dana-Farber Cancer Care Institute in Boston, MA

• Memorial Sloan-Kettering Cancer Center, New York, NY

• The Sidney Kimmel Comprehensive Cancer Center at John Hopkins in Baltimore, MD

• eCancerTrials.com allows you to search for clinical trials by cancer type and cancer stage.

• The University of Texas M. D. Anderson Cancer Center in Houston, TX

See also

• Latest cancer news and research
• Planning your treatment
• Choosing a doctor
• Choosing a cancer care facility