Hani Gabra

Clinical trials are important for cancer research and important for individual cancer patients. There are different Phases of clinical trials. The most common is Phase 3 when a new agent is added to the gold standard therapy. Patients are rarely disadvantaged by participating in a Phase 3 clinical trial because they receive the gold standard therapy plus the new added agent.  For some patients earlier clinical trials maybe more appropriate, but because Phase 1 trials do not include standard therapy it is important for patients to have detailed discussions with their consultant before deciding to participate in early clinical trials. Here are 10 questions you might consider asking your consultant:

1. What phase is the trial in?
2. Will I be able to continue any other treatment?
3. What have been the results of the earlier phases of the trial?
4. Have there been any fatalities?
5. Who is sponsoring this trial?
6. Will I know what I'm getting?
7. If my cancer progresses, will I have the option of getting the other treatment?
8. How do you evaluate whether the trial is working or not?
9. How many participants do you need before you move on to the next phase?
10. How long will you follow the participants?

There are many effective strategies for the treatment of cancer for drugs derived from natural products. Nature and evolution have provided us with excellent strategies for cancer from compounds that have developed naturally. Sixty per cent of drugs approved for cancer treatment have a natural origin. Drugs such as taxol, irinotecan and trebetacan and many others have found their way into mainstream treatment for cancer. Just because these drugs are derived from natural compounds does not mean that they are not less toxic. Some of them do have significant side effects, which is a feature that renders them potent for cancer treatment.

Taxol is a plant derived drug used in chemotherapy across a wide range of cancers including: breast, ovarian, lung, bladder, prostrate. Side effects include: hair loss, diarrhea, low blood count, peripheral neuropathy, and nausea and mouth ulcers.  

Irinotecan is an example of a plant derived compound, which is a chemotherapy drug mainly treating cancer of the colon and rectum. Side effect include: diarrhea and extreme suppression of the immune system.

Trabectedin is a relatively new drug, which has not yet been widely approved, for the treatment of advanced sarcomas in patients who have failed on conventional therapy

Cervical cancer is an unusual and exceptional disease. The human papilloma virus (HPV) is extremely common in the human population and is impossible to entirely irradicate.  The UK cervical vaccine program holds great promise for preventing cervical infections caused by the papilloma virus. Infections by the papilloma virus are not cervical cancer. Many people have cervical infections caused by the papilloma virus, but they do not have cervical cancer. Although the papilloma virus is a necessary pre-requisite for cervical cancer, it is not the only factor in the disease. With the cervical vaccination program we can look forward to a time when the incidence of cervical cancer will be very low.  

• The human papilloma virus is transmitted through genital contact, most often during vaginal and anal sex. Also, HPV may be transmitted during oral sex and genital-to-genital contact.
• At some point in their lives, nearly 50 per cent of all men and more than 75 per cent of all women are infected with HPV. Most HPV infections in young females are temporary and have little long-term significance. Currently, approximately 20 million Americans are infected with HPV and another six million become newly infected each year.
• HPV tests on the market are only used to help screen women at certain ages.
• Each year worldwide, there are an estimated 0.5 million cases of cervical cancer diagnosed and 270,000 deaths from the disease.
• The US Center for Disease Control and Prevention recommends the use of three shots of the HPV vaccine in females aged between nine and 26 years.