Judith – Interview 24
Judith agreed to take part in a randomised trial comparing different intervals of chemotherapy treatment for non-Hodgkin’s lymphoma. She was allocated to the standard treatment and responded well.
Judith was diagnosed with non-Hodgkin’s lymphoma in 2008. When she had a lymph excision operation she agreed to take part in an experimental study of a new technique in anaesthetics, which involved using a fibre-optic camera down the throat. The aim is to get a better view of the larynx and reduce the incidence of sore throats after anaethesia.
The week after her diagnosis by the surgeon, she saw the oncologist who asked her if she would be willing to take part in a randomised trial. One group would receive the standard chemotherapy treatment (rituximab) every 3 weeks for 21 weeks, and the other group would receive it every 2 weeks for 14 weeks. Both groups would have 8 treatments, and PET scans would be used to monitor the effectiveness of the different treatment regimes.
Judith felt it was not a major decision to take part, as she had to have the chemotherapy anyway, so she agreed on the spot. She was hoping she might be allocated to the group having the shorter course, so she could get it over and done with by the summer, when her step-daughter was getting married. However, she was allocated to the standard treatment group, which is what she would have received anyway if she had not agreed to the trial. At the time of the interview, she was still in the middle of treatment. She has tolerated it well, and in fact it seems to have had the side effect of improving the symptoms of another condition she has, systemic lupus erythematosus. She feels she would have tolerated the every 2-week regime well, and at the time was a bit upset to be allocated to the standard treatment group, but now she does not mind.
Judith feels research is very important, and if the trial shows that every 2 weeks is better she feels she will have helped save other people from several weeks of treatment, and perhaps reduced their chances of having a relapse. Although at the time of making her decision she felt she had enough information and understood it well, some questions have now started to occur to her, which she plans to ask the consultant next time she has an appointment. For example, she knows that the information talks about the impact on survival but she is not sure whether this means she will be followed up for many years to come. She is also interested in the way different individuals respond to chemotherapy. She herself seems to have responded very quickly – a lump in her neck which had grown 50% in a week before treatment had disappeared by her third treatment. She wonders if she were not on the trial whether she would have continued to have the full 8 treatments or would have been taken off it earlier.
Judith feels confident she can trust staff running a trial within the NHS, and she believes her care would have been just as good if she were not in a trial. She would be more wary of a trial funded by the pharmaceutical industry, because she would be worried about the financial incentive to make money out of a particular drug.