The treatment plan depends mainly on the type of cancer and the stage of the disease. Doctors also consider the patient’s age and general health. Often, the goal of treatment is to cure the cancer. In other cases, the goal is to control the disease or to reduce symptoms for as long as possible. The treatment plan may change over time.
Your doctor can describe your treatment choices and the expected results. You and your doctor can work together to decide on a treatment plan that is best for you.
Clinical trials are used to determine the most effective and safest treatment for a disease. Each trial is aimed at improving survival rates or reducing side effects or late effects of treatment.
It is also important to understand that clinical trials are standard practice in cancer treatment for children, adolescents and young adults. While less than five percent of adults with cancer are enrolled in clinical trials, 60 percent of patients under age 29 diagnosed with cancer are enrolled in trials. Participation in clinical trials spans an average of two to three years and requires a lifetime of follow-up care. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
Because cancer in children is rare, taking part in a clinical trial should be considered. Some clinical trials are open only to patients who have not started treatment.
Clinical trials are one of three types, called “phases”, as defined below.
Phase I. Studies brand new drugs. In other words, they really don’t know whether or not the drugs will kill people or cancer first. In this phase, they are trying to figure out what doses of drugs or therapies can be given to humans, extrapolating from animal trials.
Phase I studies are true experiments. Laboratory tests have suggested that the new drugs might be effective against cancer, but the researchers do not know if they will help, and the doses that children will tolerate are unknown. Parents often enroll their children in these trials in the hope that a new and untried drug will be effective, but they need to recognize that the chances are low.
Phase II. Studies drugs that graduated from Phase I studies, and the trial is testing if the drug is active against a specific cancer. They try them on a few more people and a few different doses. The drugs probably won’t kill the patient.
Phase II trials are sometimes chosen by parents when their child has relapsed. Occasionally, Phase II trials are designed to test an exceptionally promising agent against a tumor for which other effective therapies exist. While the treatments are experimental, there is usually reason to believe that patients enrolled may benefit.
Phase III. Studies the standard protocol – the one most often currently used for a particular type of cancer – with drugs that have graduated from Phase II studies. This doesn’t mean that they throw out the whole standard protocol and use the new drugs, it means that they “tweak” the current combination of drugs used by slipping in some new ones and/or changing the doses or combinations of current drugs and/or the length of drug treatment. Often the researchers are trying to maintain survival rates while lowering the toxicity of the treatment.
Pediatric Oncology. Clinical Trials. Retrieved October 30, 2011, from http://www.ped-onc.org/treatment/clintrial.html
National Institute of Health. How to Find a Cancer Treatment Trial: A 10-Step Guide. Retrieved September 13, 2011 from http://www.cancer.gov/clinicaltrials/learningabout/treatment-trial-guide http://www.cancer.gov/clinicaltrials
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