Research into new ways of treating ovarian cancer is going on all the time. All drugs used to treat ovarian cancer have been evaluated in clinical trials. If early research suggests that a new treatment might be better than the standard treatment, cancer doctors will compare it with the most effective standard ones in clinical trials. These ‘randomised clinical trials’ are the only reliable way of testing a new treatment.
One woman we talked to was invited to go on a trial comparing different combinations of carboplatin and paclitaxel (Taxol) chemotherapy treatments before and after surgery to remove the cancer (tumour) and affected organs. She took time to consider the invitation before accepting, and explained that she did so mainly to help improve treatments for future patients.
Was invited into a clinical trial and describes her decision to take part.
This trial has now been completed and as a result of the study a combination of using carboplatin and paclitaxel in ovarian cancer is now considered standard treatment.
When asked how she felt about her treatment being selected by computer, one woman explained that she had been so ill that she would have accepted any treatment that made her feel better. Another woman who took part in a trial was pleased to discover later that she had been allocated the treatment her hospital would have used anyway. Another woman who wanted the new drug but got the standard treatment considered this ‘unfortunate’ but recognised it was the only fair way to conduct a trial.
Was happy that her treatment in a clinical trial was the hospitals standard treatment.
Several women had been invited to take part in a trial comparing carboplatin alone with the combination of carboplatin + paclitaxel (Taxol). Paclitaxel can cause worse side effects than carboplatin and always causes hair loss. Some women declined the offer because they did not want to risk getting the combination treatment with its worse side effects or because it might have involved extra hospital visits. One woman did not take part in a trial comparing cisplatin and carboplatin because she wanted her oncologist to choose the optimum treatment for her.
Decided against going in a clinical trial because she wanted to avoid the severe side effects of…
The decision about whether or not to take part in research should be made without pressure and without any effect on the medical care the person receives. However, sometimes this had to be decided soon after diagnosis, when a woman and her family have hardly had time to take it in. A woman who had been a nurse had felt uncomfortable about her decision not to take part in a trial, since she knew that the doctors would have liked her to agree.
Felt uncomfortable about her decision not to take part in a clinical trial.
Women whose cancer has recurred are sometimes offered experimental drugs. In the early stages of development drugs are often investigated on their own, not compared with other drugs. A few women asked their doctors if there were any trials they could join. Some were not suitable candidates for any trial being run at that time, and one woman decided against a trial after talking it over with her GP.
A recurrence of her cancer was treated with new experimental chemotherapy drugs.
Another trial that women were invited to join in was one to determine the best time to treat women whose tumour recurs. In this trial, called OV05, all women in remission received regular CA125 blood tests (see ‘Treatment outcomes and follow up’), and if the level of the tumour marker rose patients were randomised either to be told the result and receive chemotherapy straight away or to have the result withheld and wait until their symptoms recurred or scans showed that the tumour had regrown. One woman decided this trial was not for her because she would want to know if her CA125 level was rising.
Describes a trial where a rise in women’s CA125 prompts randomisation to further treatment or to…
Refused to take part in a follow-up trial in which she would not know if her CA125 level rose.
The OV05 trial has also now been completed and the results were published in 2010 (Lancet 2010) they showed that treating women as soon as their CA125 levels go up does not help women with ovarian cancer to live longer. Treatment can safely be delayed until it is clear that the cancer has recurred based on examination, scan results or symptoms.
A woman whose cancer recurred after her initial treatment was invited to take part in a trial in which a sample of her tumour was tested in the laboratory to find out which drug combinations it would respond to, but she wanted to know the test results and used her medical insurance to find out.
Used her medical insurance to find out the results of tests taken as part of a clinical trial.
People who take part in trials appear to do better. This may be a result of the extra attention and careful monitoring they receive or because the types of patients who are eligible to enter trials would do better anyway. One woman mentioned that the only way she could have a new chemotherapy was by being in a trial. Another commented that being in a trial meant she had more regular check-ups.