Access to clinical trials offers new options for cancer patients -- Gazette.Net


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For cancer patients such as Mike Kenney of Aspen Hill, clinical trials, now available at MedStar Montgomery Medical Center in Olney, offer new hope.

In May, Kenney, 52, began experiencing some gastrointestinal symptoms. An episode of dizziness and sweating in June landed him in the hospital’s emergency department. After testing, he was diagnosed with esophageal cancer, which has metastasized to his liver.

“Surgery is off the table,” he said. “Basically, I am on palliative care.”

Palliative care focuses on relieving and preventing the patient’s suffering.

Kenney said he was fortunate to receive all of his care at MedStar Montgomery, including participation in a clinical trial for patients with gastrointestinal cancer. He was directed to Michael J Pishvaian, a gastrointestinal oncologist at Georgetown University Hospital in Washington, D.C.

“I initially thought I would have to go to Georgetown, but since he has office hours in Olney, I am able to see him there,” he said. “I’ve also received my chemo at MedStar Montgomery.”

MedStar Montgomery recently expanded its services to offer selected clinical trials. So far, six patients have participated.

Kenney just completed a trial for gastrointestinal cancer patients that tries to tailor the drugs specifically to the patient, as determined through blood tests.

“It looked at how metabolism handles chemo. If someone has a slow metabolism, why give them a lot of chemo and have it sit there, or if they have a fast metabolism, maybe they could be given more,” he said.

Physicians and researchers use clinical trials to learn whether an experimental treatment is safe and effective. Participating cancer patients can benefit by receiving either the current standard of care, or a new and possibly more effective treatment.

“Clinical trials are relatively new to our treatment program in Olney,” said Mary Miller, a registered nurse and the hospital’s administrative oncology director. “They are offered all across the country, but usually they are part of a large university setting.”

Miller said that being a part of the MedStar Health system allows services that are normally offered in larger hospitals to be brought to smaller communities.

The first trial at MedStar Montgomery began in April, and Miller said she hopes that by offering clinical trials in Olney, cancer patients can have local access to any treatment they could get in a major city.

“Patients love the idea of not having to drive to Georgetown and having the same exact treatment available here,” she said.

Kenney said that receiving care at MedStar Montgomery has made it easier on family and friends upon whom he sometimes must rely for rides.

“I’ve had friends going through this that go to Johns Hopkins University Hospital in Baltimore,” Kenney said. “The facilities and physicians are top-notch, but it is a pain in the tuchis to drive there and park. Basically, it’s an entire day.”

In addition to the trial Kenney just finished, a second trial is underway at the hospital for patients with metastatic pancreatic cancer. The tumor is removed and analyzed to determine which combination of drugs will have the best effect on that specific patient, based on their molecular profile.

Trials usually originate with a physician who has determined a trend and wants to take that concept to the next level. Treatments and clinical trials have to be vetted through federal regulators. Patients who meet eligibility requirements must consent to the trial, although they can stop at any time.

Miller said there are lots of steps in getting a trial started at a hospital, including rules to safeguard patients, applications and training.

She said patients at MedStar Montgomery are very well read, and many have done their own research. Usually, physicians, cancer navigators or nurses share information on clinical trials with the patients.

“We are required to have some avenue to provide patients with the information on clinical trials,” she said. “The Commission on Cancer Accreditation requires us to offer information on clinical trials with the goal of raising awareness and availability. Patients rely on the doctors, and we are obligated to inform the doctors.”

Miller said that there is a tumor conference each week at MedStar, featuring oncologists, surgeons, radiologists, pathologists and nurses. Any newly diagnosed cancer case is presented and new clinical trials are discussed.

Health insurers don’t always pay for clinical trials, but Miller said many do, and it sounds as if all will after more provisions of the federal Affordable Care Act take effect in January. The two trials underway at MedStar Montgomery involve “standard of care drugs,” or specific drugs that are accepted by medical professionals for a particular disease or illness, which should be covered by insurance.

Miller said two or three additional clinical trials are expected to open at MedStar Montgomery this year, including one for prostate cancer and one for breast cancer.

Kenney was grateful for the chance to participate in the trial and plans to start another trial next month.

“Chemo will never cure me; it is just a matter of time,” he said. “The trials are a crapshoot, but they also offer a ray of hope and sunshine.”

thogan@gazette.net