BY UNA HOPKINS
What a great world it would be if we knew how to prevent, or even cure, all types of cancer. Medical providers do all we can with conventional surgery, chemotherapy and radiation therapy, but to treat the most aggressive cancers, we must also incorporate innovative therapies beyond the standard of care. Since nearly all of today”™s cancer treatments began with breakthrough discoveries emanating from clinical trials, providing cancer patients with access to these trials can significantly improve their prospects and is, therefore, a crucial component of a comprehensive cancer care program.
Although several institutions conduct clinical trials in Westchester, our population benefits every time an additional study is launched. With a population of nearly 1 million residents in the county, and an additional 700,000 people living in Rockland, Putnam, and Dutchess counties, this region has a large pool of potential patients eager to participate in clinical trials locally.
Whether patients receive a placebo or the therapy being tested, they are likely to perform better than patients receiving conventional care because of the extra attention they get. As part of the trial protocol, clinical trial patients are seen more frequently, receive regular extensive evaluations, and in the case of patients involved in clinical trials at White Plains Hospital, are repeatedly evaluated for several years to measure the effectiveness of the tested therapy. There”™s a psychological benefit, too; just knowing they are part of a clinical trial improves the mental outlook of patients struggling with serious illness.
The community also gains something when a local institution engages in clinical trials. Local trials often progress faster than trials conducted on a national or global scale. The best and the brightest minds in medicine are drawn to institutions where they can conduct clinical research; their skill and knowledge benefit all patients, not just those participating in clinical trials.
White Plains Hospital started a robust clinical trial program in 2011. Three years later, the program has grown to 19 clinical trials and a patient enrollment of 450. Already, some trials are beginning to extend and save lives.
Clinical trials in action
Lung cancer kills more people than the next three deadliest cancers (colon, breast and pancreatic) combined. One reason is that symptoms don”™t manifest themselves until the cancer has progressed too far to be treated through surgical removal. Yet, if tumors are found and removed early, recovery is nearly universal. Two hospital-associated thoracic surgeons, Dr. Todd Weiser and Dr. Cynthia Chin, started a clinical trial two years ago to see if early screening to detect early-stage lung cancer could potentially save lives.
It turned out that the first life likely saved was one of White Plains Hospital”™s own ”“ Robert Linscott, a 14-year hospital employee. A low-dose CT scan revealed a mass in his right lung, which Weiser and Chin removed using video-assisted thoracic surgery. No further treatment was needed, and as part of the trial, Linscott was enrolled in a smoking cessation program. Six weeks later, Linscott returned to work at the hospital, and one year later, he remains cancer-free. He will continue to receive a yearly CT scan for the next five years to be sure the cancer doesn”™t return.
In addition to several national studies, multiple patient registries have been launched at White Plains Hospital, including a registry for patients who had undergone nipple-sparing mastectomies. Breast surgeon Sunny Mitchell started the registry to measure how such patients will fare compared to patients who received conventional mastectomies. A far-reaching study, funded by the National Cancer Institute, examined the effect of using a certain chemotherapy drug to initially treat men with newly diagnosed, metastatic, hormone-sensitive prostate cancer. The conclusion: Men who received the drug gained more than an extra year of life. As a result of this study, the use of the drug has become the new standard of treatment, extending lives for cancer patients a long way from White Plains.
Clinical trials require an institutional commitment to advance medical care and to cover the cost of many of the trials. Many White Plains Hospital clinical trials are not funded by pharmaceutical companies; in general, insurers do not consider trials to be a reimbursable service. So White Plains Hospital covers the cost itself. A robust clinical trial program also needs a robust administration system. The hospital hired a clinical trials manager who recruits patients, manages the paperwork, and assists providers to ensure they meet all trial protocols.
One of the attractions in affiliating with Montefiore Medical Center is that White Plains Hospital patients will have access to hundreds of more clinical trials. It will help us continue to deliver on our promise to provide world-class care in the communities where we live.
Una Hopkins is the administrative director of the Dickstein Cancer Center at White Plains Hospital.
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