ABC Show Brothers&Sisters

For those of you that don’t know the show, lead character Kitty was diagnosed with Lymphoma in last week’s episode. This week, Kitty’s story line highlighted her struggle to choose a treatment course: standard of care available locally vs. a clinical trial available out of town; and her family’s fierce fight amongst one another to guide Kitty’s decision. I compliment the writers on their sensitivity to the cancer population and applaud them for making cancer a mainstream discussion.

I am upset with one small aspect of last night’s episode – the discussion of clinical trials. Kitty’s mother Nora (played by Sally Fields – love her!) was against the idea of a clinical trial for a few reasons (1) distance to treatment, (2) lack of support system for Kitty, and (3) potential side effects of treatment – all extremely valid reasons. During an argument with Kitty’s husband Robert, (Robert is for the clinical trial, Nora is against a clinical trial) she stated something to the effect of “I started a cancer center and understand the politics of clinical trials.” The scene and the dialogue left me with a negative impression of clinical trials which disturbed me enough to write this post.

As an oncology nurse with years of clinical trial management experience, I want to state that clinical trials are a critical component of the drug development process. Without the generosity of clinical trial patients – yes, I said generosity – there would be no standard of care for the entire cancer population.

There are numerous misconceptions about clinical trials and I have heard them all! So let me take a moment to clear up some of the misconceptions. The following is available on the NIH website:

A Survey on Clinical Trial Barriers

A survey of almost 6,000 people with cancer conducted in 2000 took a look at why so few adults participate in cancer clinical trials. Some of the highlights included:

• About 85 percent of people with cancer were either unaware or unsure that participation in clinical trials was an option, though about 75 percent of these people said they would have been willing to enroll had they known it was possible.

Of those who were aware of the clinical trial option, most declined to participate because they believed common myths about clinical trials. They either thought that:

• The medical treatment they would receive in a clinical trial would be less effective than standard care
• They might get a placebo
• They would be treated like a "guinea pig"
• Their insurance company would not cover costs

People who received treatment through a clinical trial found it to be a very positive experience:

•  Ninety-seven percent said they were treated with dignity and respect and that the quality of care they received was "excellent" or "good"
• Eighty-six percent said their treatment was covered by insurance

 Source: Harris Interactive. Health Care News 1(3) [Poll]. (Available from www.harrisinteractive.com/harris_poll/

My profession takes great care when presenting a clinical trial to a patient and the management of the patient within the context of a clinical trial. Participating in a clinical trial does not mean we take away your rights to high quality care, nor does it mean that we treat you like a “guinea pig” or any other type of animal. It does not mean you will receive substandard treatment for your disease.

The decision to participate in a clinical trial is a personal decision involving many factors. Speak with your physician, your nurse, the social worker, your religious leader, or anyone else that helps you make treatment decisions - but first and foremost, get the facts!

I applaud Brothers & Sisters for including the clinical trial process in Kitty’s dialogue however, I ask the writers to be more informed about the clinical trial process before casting a negative light on the one pathway that leads to new treatment options.