Join Clinical Trials for Bone Cancer
There are a number of primary bone cancers, including osteosarcoma, Ewing sarcoma, malignant fibrous histiocytoma, and chondrosarcoma. If you are one of the nearly 3,000 people in the United States who will be diagnosed with bone cancer in 2012, clinical trials for bone cancer may be of interest to you.
Many trials are currently investigating new types of chemotherapy to treat bone cancer, while others are looking at combining various surgical methods with radiation therapy and chemotherapy.
In addition, some studies are focused on genetic testing of bone tumors in the hopes of gaining a better understanding of how DNA changes lead to the development of bone cancer. Finally, some studies are looking at new drugs to better control the pain and other side effects associated with bone cancer.
What Will Clinical Trials for Bone Cancer Be Like?
When participating in a bone cancer clinical trial, there are a few basic tests and procedures you may receive; however, the ultimate design of the particular study will determine which specific procedures you will undergo. The following tests and procedures are often used during clinical trials for bone cancer:
- Physical exam
- Monitoring of physical signs and symptoms, including pain, swelling, fractures, weight loss, and fatigue.
- Blood tests
- Common imaging tests, such as x-rays, computed tomography (CT scan, or “CAT scan”), and magnetic resonance imaging (MRI). CT scans and MRI enable doctors to view more detailed pictures of areas inside your body than X-rays can reveal.
- Radionuclide scans involve the use of a small amount of radioactive material that is injected into the body through a vein in your arm. The material then attaches itself to cancerous bone cells in the body, allowing doctors to see if and where your bone cancer has spread.
- Positron emission tomography (PET) scans also use radioactive material that is visible inside the body through the use of a specialized camera, and are often used in combination with CT scans to better identify areas of cancer.
- Quality of life assessments that evaluate how much of an impact your cancer is having on your daily life
Typical Protocol for Clinical Trials for Bone Cancer:
Clinical trials for bone cancer, and cancer in general, are investigating a number of research topics. Examples include:
- Trials that use “targeted therapy.” Targeted therapies involve the use of certain chemotherapy or immunotherapy drugs to block specific activities in cancer cells and keep them from growing.
- A trial involving the use of the drug denosumab, which is used to treat osteoporosis, to see if it can effectively treat bone tumors that cannot be surgically removed.
- A trial designed to compare standard surgical procedures for removing bone tumors with a newly developed, investigational surgical method.
- A study designed to assess the effects of nutritional supplements on fatigue and pain in patients with bone cancer.
- A trial comparing the use of conventional pain medication with a newly-developed pain medication to see which is more effective, and has fewer side effects, when used to treat the pain associated with bone cancer.
A brief word about randomized trials and placebos:
Many clinical trials involve the comparison of an investigational treatment to an existing or “standard” treatment for the cancer. The exact therapy (i.e., investigational or standard) that each patient receives in such a trial is usually determined through a process known as randomization, in which patients are randomly assigned to receive either the investigational treatment or the standard treatment.
Sometimes, a trial will investigate the use of a standard treatment plus a new drug compared to standard treatment plus a placebo. Placebos are inactive or sham treatments that are identical to the active treatment; however they have no therapeutic value.
The purpose for using a placebo is to be certain that any adverse effects that occur during the clinical trial are actually the result of the investigational treatment and not some other factor. In these types of trials, all patients receive the standard treatment, while those randomized to the investigational treatment receive the additional drug.
In rare instances where no standard therapy exists, or when a new drug is being evaluated for the first time in a specific cancer, the investigational treatment might be compared to a placebo alone. In these types of trials, those patients who are randomized to the placebo group do not receive an active treatment.
This is rarely done in cancer clinical trials, however, and is only done when it is necessary from a scientific standpoint, is ethically appropriate, and when patients have been adequately informed that they may receive the placebo. Therefore, it is important to understand that if you are interested in participating in a trial that involves the use of a placebo alone (i.e., without standard treatment because none exists), you may end up receiving the placebo rather than the active treatment being investigated.
Often times, patients are reluctant to join a trial that involves the use of a placebo for fear that they will not receive an active treatment. While that may occasionally be the case, individuals who receive placebos are necessary to clinical research because their responses during the study allow researchers to better measure the effects of the active treatment being studied, and help the researchers observe what would have happened without the active treatment.
It is also important to understand that it is not appropriate for an individual to participate in a placebo-controlled trial when there is a widely available and highly effective standard treatment already in existence for their cancer.
Trial Eligibility and Medical Information Needed:
The type of clinical trial you may be eligible for often depends on whether you have been newly diagnosed with cancer, or if you have already received treatment. In addition, eligibility may also be determined based on the stage of your cancer.
Therefore, it is important to know the exact details of your cancer diagnosis when searching for clinical trials of potential interest. Specific details you will want to make note of and have on hand include the following:
- The official name of your cancer (e.g., chondrosarcoma)
- Knowledge of where your cancer first started. For example, if you have bone cancer that spread to the brain, it is still considered bone cancer.
- Know your cancer’s cell type. This information can be located in your pathology report.
- Know the size and location of your tumor.
- Know the locations of any and all metastases that have been diagnosed.
- Know the stage of your cancer. This describes the extent of your cancer, and whether it has spread to other sites in the body. Each individual cancer has its own staging system, so be sure to know and understand the staging system specific to bone cancer.
- Know your prior history of cancer (e.g., if you were diagnosed with breast cancer prior to your diagnosis of bone cancer, be sure to have all the details pertaining to that diagnosis as well).
- Know your current performance status, which is an assessment performed by your doctor to determine how well you are able to perform normal activities of daily living. Two common scales used to evaluate the performance of cancer patients include the Karnofsky Performance Scale (KPS) and the ECOG scale.
- Know what treatments you have already received for your cancer. Examples might include chemotherapy, radiation therapy, immunotherapy, and/or surgery.
- Know your bone marrow function test results, including your white blood cell count, platelet count, and hemoglobin/hematocrit.
- Know your liver function test results, including bilirubin and transaminases.
- Know your kidney function (also referred to as renal function) test result, which includes serum creatinine.
Suggested Bone Cancer Search Terms:
“bone cancer chemotherapy,” “bone cancer surgery,” “metastatic bone cancer,” “bone cancer surgery,” “bone cancer pain,” and “bone cancer treatment.”
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