The Emperor of All Maladies and clinical trials – #cancerfilm
I am glad to have learned that the PBS mini-series Cancer: The Emperor of All Maladies (based on the book – The Emperor of All Maladies: A Biography of Cancer) – is available to watch at http://cancerfilms.org/media-gallery/?media=cancer-the-emperor-of-all-maladies—episode-
I wasn’t certain that I would want to watch it. I had learned about the book when I was first diagnosed, but the whole idea of reading about cancer was overwhelming. As it is, I cannot read about cancer too near to bed-time, otherwise I have difficulty sleeping. So, it was with trepidation that I clicked the link and started watching. Several of my blogger friends have commented on their inability or ability to watch the mini-series. As a survivor, it cannot be viewed without some emotion.
I really enjoyed the first episode. It is facilitating to learn not just about the disease itself, but also about how clinical trials were first established. Throughout the first episode, I found myself listening and trying to figure out how this or that innovation led to the treatment that I received. It helped me better appreciate the role of surgery as a first line of defense in some cancer treatment. As I watched, I found that I was a bit sad about not being able to participate in clinical trials. The bilateral nature of my disease excluded me from the only trial that qualified for. I have read through various blogs that many breast cancer clinical trials fail to find enough participants (although I haven’t been able to find a good reference for that fact – if any of my readers have a good source, please let me know). At the time of diagnosis, I was more interested in getting into treatment quickly, then I was at finding a clinical trial. It is one aspect of diagnosis that is quite odd really – before I had cancer, I had not even considered clinical trials.
When I was first trying to decide on which chemotherapy regime to take – my oncologist gave me two choices – AC-T (A-Adriamycin, C-Cytoxan, T-Taxol) or TC (Taxotere and Cytoxan) – I made my choice based upon the side effects of the two regimes, but also based upon what I understood to be the standard of care in Canada – because I’m Canadian, and it was something I could trust. What I didn’t understand at the time, was that the AC-T treatment was an older treatment than the TC treatment. This meant that a lot more is known about the AC-T regime – however, it doesn’t mean that the regime is better – just that it has been around longer and therefore more is known about the longer term side effects. It is always going to be the case that the older regime is going to be better understood, because it will have been studied for longer. It doesn’t necessarily mean that it is better (or worse) than the alternate regime. There is a nuisance there that I didn’t completely appreciate when I made my decision. I might have given TC more of a thought had I appreciated that because it was newer, less is published about it. That being said, the potential side effects for TC were things that I knew my body was both prone to, but also things that my body would have a harder time coping with – so the decision for AC-T was the right one for me. I also do wondering about my decision for neo-adjuvant chemotherapy. Again this is an area where the standard of practice is changing – there is not nearly as much written about it as there is adjuvant chemotherapy. In some ways, I am sad that I’m not directly part of a study that looks at the long term effectiveness of neo-adjuvant chemotherapy as opposed to adjuvant chemo.
Watching the first episode has me wanting to go out in search of clinical trials – if for no other reason, then to validate that I don’t actually qualify for any right now. On one hand, it would be great to be part of new treatments which have such promise, but on the other hand, an unknown drug with unknown side effects isn’t exactly something I feel I can deal with right now. I have participated in a couple of studies that involve me giving my blood for the sake of science. For me, those are easy trials to agree to. I can spare a couple of vials of blood now and then – and if my blood can help further breast cancer research, then I’m happy to comply.
I’m looking forward to Episode 2 of Cancer: The Emperor of All Maladies.