New clinical trials the key to beating cancer

The value of clinical trials has been highlighted with the announcement that terminally-ill cancer patients could be “effectively cured” using a new combination of drugs heralded by scientists as a once-in-a-generation breakthrough.

The results of the trial have been described as “spectacular” with nearly 60% of patients with advanced melanoma having their tumours shrunk or brought under control by the use of the immunotherapy, which uses the body’s own immune system to attack cancerous cells.

Professor Roy Herbst of the Yale Cancer Centre in the US said immunotherapy could replace chemotherapy as the standard cancer treatment within the next five years and the potential for long-term survival or “effective cure was definitely there”.

In the international trial, 945 patients with advanced melanoma were given the drugs ipilimumab and nivolumab. The treatments stopped cancer advancing for nearly a year in 58% of cases, with tumours stable or shrinking for an average of over eleven months.

Mary Higgins from Annaghdown is one of 13,000 Irish patients who have taken part in a clinical trial.

In 2013, there were 16 Irish hospital sites participating in 102 clinical trials affiliated with The All-Ireland Cooperative Oncology Research Group (ICORG) – a 30% hike on the previous year.

Clinical trials get access to medicines not yet available in pharmacies but which have in the main been approved by overseas drug authorities.

It is now thirteen years since Mary was diagnosed with breast cancer as she was about to turn 41. She underwent a mastectomy and had her ovaries removed. She had chemotherapy in Galway and radiotherapy in St Luke’s Hospital in Dublin and was given the all-clear.

Eight years later a metastatic tumour was discovered in her hip. She had a pin inserted into the bone to reinforce the hip and underwent radiotherapy.

Last year she woke up with a horrific pain in her ribs overnight.

An x-ray revealed the cancer had returned, this time in her spine and ribs.

“When I say horrific pain, I mean really excruciating, I was barely able to get out of bed. They decided to treat the most severe areas with radiotherapy and that gave me some relief. I had scan after scan, check up after check up and my consultant Prof Maccon Keane who’ve I’ve been under from the beginning, said to me I’d be a great candidate for a clinical trial,” explains Mary.

“He said I’d have a one-to-one nurse, more checkups, very regular assessments and the chemotherapy was less severe.”

The clinical trial involved the chemotherapy drug Capecitabine, which is given orally instead of intravenously every day. After a year Mary and her medical team are extremely happy with the results.

“I have very little symptoms. I’m not sick. I haven’t lost my hair which is a huge factor. I’m able to function. I don’t look sick. I do it at home, I go in every six weeks for a scan and a check up and come home with my bag of tricks, which has the medicine for six weeks. It’s brilliant,” she says.

“I don’t want to count my chickens but it’s certainly working for me. This time last year I felt as if my ribs were broken. Now not a bother. I’m back walking again, I can do all my housework, baking, meet friends for coffee. I couldn’t paint the house now, but right now is Mary time so that’s fine.”

Mary took redundancy a year ago from an office job at O’Connor’s TV and Electronic Repair Services after 34 very happy years. She has the support of a “wonderful” husband Michael, three children, who are now aged between 23 and 17 and her sisters, which she describes as “class acts”.

“It’s been horrific on them. My youngest son was only four when I was diagnosed. They have more questions now, I can’t fob them off, I didn’t want to be using the word cancer, but now I tell them everything. They’re a great help,” she muses.

The main source of complaint from Mary is the financial burden of the disease – up until March she had to pay €144 a month for medication after being continuously refused a medical card but she still has to cough up for consultants (at one stage she was under three different ones) and hospital parking.

“There’s no point in lying down and crying about things. I take every day as it comes. You just get up and go. I had a privileged life except for the illnesses. I had the world travelled. I had wonderful holidays, a wonderful job. I’ve always been a positive person.”

Mary advises anybody going through cancer treatment to enquire about the possibility of a clinical trial.

“I still have a lot to go through myself, but I would encourage anyone who is considering treatment options to ask your doctor about clinical trials to see if they are an option for you. A clinical trial can offer you the best treatment and there is something nice about knowing that you are helping patients who are coming after you.”

Oncologist Dr Ray McDermott, interim head of the Ireland Cooperative Oncology Research Group (ICORG), said significant strides had been made in cancer treatment which is largely as a result of clinical trials.

“Every medicine that is available now is available because of the people who have participated in the trials that preceeded.,” he stated.

“Participating in clinical trials is not something to fear and our research demonstrated that almost 50 per cent of people participated in order to get access to medicines that are not currently available and at the same time contribute to the treatment options that will be made available to other people living with cancer in the future.”