My daughter, age 26, has stage 3b small cell cervical cancer. She is undergoing a second round of chemo with radiation. First round, no radiation. With the first round they shrunk the tumor from 9cm to less than an inch in size (could not be detected at all on CT scan) and decided to do a radical hysterectomy. Upon entering the pelvic cavity, the surgeon saw that the tumor had attached to the small intestine and had been larger than they thought. Only about two inches of small intestine involved and only a layer of cells on the outside.She aborted surgery and only separated the attachment. We were referred to another doctor and he is starting the second round of chemo with external radiation for 5-6 weeks and internal radiation for 4 weeks after that. New CT scans of brain and body are clear.
I know this treatment will not cure her and odds are that it will come back in the first year. I read about research and clinical trails and have no medical knowledge to make an informed decision. This is her life, she is not a statistic. What treatment has the most promise for a cure? Clinical trials or not. She is insured and we make a good living. Please explain the safety measures taken to protect the patient in a clinical trial. I have read horror stories about side effects, mostly in phase I trails. Is it possible to be an MD Anderson patient and stay near home? My daughter has expressed a desire to stay near all her family if her time is limited. I have impressed upon her the reputation of MD Anderson, but she feels now is not the time to go. If she relapses after this treatment, is it too late to come to MD Anderson or participate in a clinical trial? Do you know of any complete cures or remissions with 3b small cell cervical cancer? Thank you
Posted: 26 Sep 2005 04:30 PM Originally Posted: 26 Sep 2005 11:11 AM
Thank you for contacting us at The University of Texas M. D. Anderson Cancer Center.
As far as a cure is concerned, the word "cure" is not a word you hear often with cancer. This is because cancer always has the
potential to recur, so technically the term "cure" would be misleading. When dealing with cancer, the term "remission" is more
commonly used. According to the National Cancer Institute (NCI), remission is, "a decrease in or disappearance of signs and
symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete
remission, all signs and symptoms of cancer have disappeared, although cancer still may be in the body." Having said that,
there are in fact patients that are in remission after having a cancer diagnosis of cervical cancer.
According to M. D. Anderson, clinical trials are strictly controlled human studies of new and emerging therapies. Here, these trials
incorporate state-of-the-art patient care, while carefully evaluating how best to apply the most recent developments in cancer
medicine. The safety of study participants is our top priority. Clinical trials at M. D. Anderson must first be approved by an
Institutional Review Board (IRB), which includes doctors, administrators, ethicists and members of the general public. Before a treatment
can be tested in people, it must be shown to be safe and effective in laboratory and animal studies. Volunteers are fully informed of
possible risks and sign a consent form before being accepted into a clinical trial. Results of clinical trials that prove a new treatment
to be safe and effective are reviewed by the U. S. Food and Drug Administration (FDA). That agency determines if and when the
treatment can be marketed for use by all patients with a particular disease.
Extensive research is performed by our doctors and scientists before a clinical trial gets to the human testing phase. In addition, our
clinical trials are strictly monitored and the inclusion/exclusion criteria are set by the IRB.
Phase I trials typically involve a small number of people and the physicians are trying to determine what is the safest and best dosage
and application measures for patients.
In some cases we are able to coordinate a patient's treatment with a local physician. Many of our patients come from outside the Houston
area and we realize it is not always possible to relocate here. If our doctors feel that a standard treatment is most appropriate they would try
and work with your daughter's physician if this is her wish. It is possible that some treatments could prevent your daughter from receiving
future treatments. If your daughter does have a recurrence after her current treatment plans, it is still possible for her to come to M. D. Anderson.
Your daughter would have to have her records reviewed and be evaluated here before our doctors could recommend a treatment opinion. We
would only make an appointment for her if we felt we would have something to offer her.
CERVICAL CANCER CLINICAL TRIALS:
To view the clinical trials currently underway for cervical cancer at M. D. Anderson, please visit our website at http://www.mdanderson.org/site_map/
1. Click on "Clinical Trials at M. D. Anderson"
2. Click on "View studies by cancer type"
3. Click on "Cervix"
The enrollment eligibility should be discussed with a physician. Your daughter would have to become a patient here to participate in any of our
GETTING AN APPOINTMENT:
If your daughter is interested in coming to M. D. Anderson for a second opinion or treatment, the first step would be to complete the referral
process. To start this process, she can either submit a patient self referral form on our website at http://www.mdanderson.org/contact_us/
or if she has any questions about the process she can reach the Information Line at (800) 392-1611, option 3. Upon submitting a referral,
a patient access specialist (PAS) will assist in gathering insurance information and specific medical records to generate a referral.
NATIONAL CANCER INSTITUTE:
NCI, referenced above, is an excellent resource on cervical cancer, as well as having information about clinical trials going on throughout
the United States. Their web address is http://www.cancer.gov/cancertopics/types/cervical/ or you can call (800) 422-6237.
I hope that this information is helpful. If you would like any additional information about M. D. Anderson services, programs, or appointment information, do not hesitate to contact the M. D. Anderson Information Line at 1-800-392-1611, option 3.