Clinical Trials - Your Questions Answered

Meet Dr. George Sledge - Our March/April Expert

George W. Sledge, Jr., MD, is Professor, Departments of Medicine and Pathology, the Ballve-Lantero Professor of Oncology at Indiana University School of Medicine, and the Co-Director of the Breast Cancer Program at Indiana University Hospital. He received his medical degree from Tulane University and completed a residency in Internal Medicine at St. Louis University. Dr. Sledge then completed a fellowship in Medical Oncology at the University of Texas in San Antonio. He is currently the Chair of the ECOG Breast Cancer Committee and the ECOG Study Chair for several major studies. Dr. Sledge is also Editor-in-Chief of "Clinical Breast Cancer" and sits on the editorial boards of "The Breast Journal" and "Clinical Cancer Research". He is the author of more than 125 peer-reviewed articles and has been the recipient of many grants, fellowships and awards. He is also on the Young Survival Coalition Medical Advisory Board.

What tools are available to help patients find trials that are appropriate to participate in?

Dr. Sledge:

The National Cancer Institute's web site (http://www.cancer.gov/clinicaltrials/search) is definitely the best place to start looking. It allows you to search for clinical trials based on cancer type, stage, type of trial, and geographic location. In addition, all NCI-designated cancer centers are charged with helping patients, and most have a contact number that is obtainable through their web site. Drug companies will frequently have contact information for patients on their web sites.

Question Two:

Why is it that most studies seem to be "after the fact" (i.e. I read about a surgical study after I have had surgery) and I can't find studies to enroll in to look at things in my life "now" (that is- 6 years out) such as bone health, hot flashes, etc.?

Dr. Sledge:

Early breast cancer studies focused on questions such as response to new treatments and survival following treatment. It is only in recent years that investigators have begun to devote significant time to what we now call survivorship issues such as bone health, hot flashes, sexuality, and related quality of life issues. The Eastern Cooperative Oncology Group ( a nation-wide cancer study group) has a large ongoing trial that will eventually involve over 1000 women focusing on the survivorship issues of young women, and the Southwest Oncology Group has a separate trial looking at fertility issues associated with chemotherapy.

[Quality of Life in Female Breast Cancer Survivors and Their Spouse, Partner, or Acquaintance]

[Goserelin in Preventing Ovarian Failure in Women Receiving Chemotherapy for Breast Cancer]

I'm a patient at a prominent Breast Care Center and have a question about the politics of participating in trials at other centers. Do I have to completely switch my care over to the hospital doing the trial or would my doctors work in tandem?

Dr. Sledge:

It is not so much a political issue as a practical one. When a physician prescribes a medication on a clinical trial, he is required to administer or distribute that agent in a specific way by the trial's sponsor, so many new agents may only be administered at the hospital or cancer center where the trial is open. In contrast, many of the diagnostic tests associated with such trials (e.g., blood tests and standard scans and X-Rays) can be ordered closer to home, and physicians are generally willing to help out on this. If they are unwilling to collaborate, or are uncomfortable with a patient obtaining a second opinion, the patient is probably best served by getting another phsyician.

View other previous Ask the Expert features on the Ask the Expert Archive Page.