When to do a Clinical Trial Search
All too often I get e-mail from patients who are interested in clinical
trials, but who don't qualify for any right now because they've rushed into
standard treatment before thinking about trials. If you are interested in the
clinical trial option, it is critically important that you investigate trials
at the appropriate times, and usually that's sooner rather than later! Often,
there are several possible times when you might be able to get into a trial, so
if you have already missed an opportunity, don't despair. Instead, learn how
the system works and when to search, so you'll be prepared for the next window
of opportunity. Of course, a trial may not turn out to be your best option, but
you may not have a chance to find out unless you search, and search at the
Specific Situations in Which Searching for Trials is Urgent
- If you have just been diagnosed with apparently localized cancer
- Often the treatment for early or localized cancer seems medically routine
and clinical trials aren't considered at all. But in localized cancer
additional treatment to prevent recurrence called, adjuvant therapy, can
increase your odds. There may be clinical trials which aim to improve adjuvant
therapy even when some form of adjuvant therapy is standard. For some cancers
there is no proven adjuvant therapy, but there may be promising trials of
adjuvant therapy. For an introduction to adjuvant therapy, see Dr. Kevin Murphy's article on adjuvant therapy on
Some clinical trials of adjuvant, and especially neoadjuvant therapy, require
that you sign up before your surgery or primary treatment. If you rush
into surgery without doing a trial search, you may count yourself out of
valuable trials! Some trials use the primary tumor to make a vaccine which is
then administered as adjuvant therapy. If your primary tumor is gone, obviously
it's too late! Neoadjuvant trials involve giving treatment such as drug or
radiation therapy before the surgery. Again, if you've already had the
surgery it's too late.
- If you have just had surgery for apparently localized cancer
- Many adjuvant trials do not require that you sign up before surgery, but
almost all adjuvant trials require that you enroll within a few
months of surgery. If you wait too long, you won't qualify! Also if you
start an adjuvant therapy outside of a clinical trial, you will disqualify
yourself for any trials of newer adjuvant therapies. Note that in some cases
the primary treatment is something other than surgery, such as radiation
therapy, but the basic considerations for when to search are the same.
- If you have just had a recurrence or have just been diagnosed with
- It's especially important to search for trials before starting treatment if
standard treatment is not terribly effective, as is the case with many advanced
cancers. If you are on treatment you will be disqualified from trials as long
as you are on treatment and as long as your cancer hasn't gotten worse. Merely
having had treatment for your recurrence or advanced cancer can disqualify you
from some trials which may require that you haven't tried any other treatment
for the recurrence, or which may require that you haven't used certain drugs.
Note that if there is a somewhat effective treatment for your cancer, you may
actually be required to have tried that before qualifying for trials. If this
is the case for your cancer you will discover it when you do your search.
- If you have just learned that your treatment for advanced cancer
- You'll want to look into trials before starting another treatment. You
usually can't start a trial until several weeks after completing your last
treatment and recovering from its side effects, so you should have a little
time to investigate now.
Situations in Which Searching for Trials is Less Urgent
While doing a clinical trial search may not be urgent, you may still want to
keep tabs on what's out there in case you need it. If you are currently disease
free, and don't qualify for trials of additional treatment, you might want to
see what's out there for patients who have a recurrence. The risk of recurrence
after the initial treatment varies from close to zero to nearly 100%, depending
on the situation. If your risk is high, you will probably be more motivated to
keep tabs on new developments than if it's low!
- If you have a clinical emergency
- Many people believe that after a diagnosis of cancer there is not a day to
lose in starting treatment. The truth is cancer is usually a relatively slow
process, and in most cases delaying cancer treatment for a short time in order
to investigate your options isn't a problem. But there are real exceptions, and
if it's truly an emergency, you can't wait to investigate trials. You need to
act on your doctors advice now!
- If you are on treatment now
- You normally won't qualify for a trial until after you complete your
- If you have started or completed adjuvant therapy
- Then you probably won't qualify for a trial unless you have a recurrence.
While you may want to look into what the most promising options would be in
case do you have a recurrence, it isn't urgent.
- If you've been disease free for some time
- If your primary therapy has worked and it's been more than a few months
since you finished treatment, you probably don't qualify for any adjuvant
trials since these usually require registration within a few months of
completing the primary therapy. Again you may want to keep tabs on what's out
there for advanced disease in case you do have a recurrence.
This CancerGuide Page By
Steve Dunn. © Steve Dunn
Page Created: 2001,
Last Updated: November 23, 2001