Health Report presents Science Friction: the trials and tribulations of experimental drug trials

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Health Report 28 min 2 speakers 8 chapters transcribed 1 day ago

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What is the ethical dilemma behind enrolling in experimental cancer drug trials?

Natasha Mitchell 0:01

This is an ABC podcast.

Dr. Norman Swan 0:06

Hello, Norman Swan here from The Health Report. I'd like to give you a taste of another great podcast from us here at RN. Science Friction with Natasha Mitchell looks at the intersection of science and society. And recently, the show dived into the murky waters of experimental drug trials. It can feel like Russian roulette when people turn to new experimental options for fatal diseases. You can subscribe to the Science Friction podcast, hear it on the ABC Listen app or on RN, Fridays at 11.30 in the morning or Sundays at 1. Not many

Rod Burrows 0:45

people out there

Natasha Mitchell 0:45

that share that interest. This is Rod Burrows, a science teacher who loves his punk. I share that interest, actually.

Rod Burrows 0:58

You're off of punk bands, but you're off of a rather broad taste in music. Seems to be stuck in a 70s time warp, though.

Natasha Mitchell 1:06

I'll just get you to do a few P words for me. Pepper, policewoman.

Karen Van Gorp 1:10

Peter

Natasha Mitchell 1:10

Piper. And this is Karen Van

Karen Van Gorp 1:12

Gogh.

Natasha Mitchell 1:12

It's sounding great.

Chris Christensen 1:14

And this. We're a V-dub family, so we do Volkswagen things. Is Chris Christensen. Volkswagen things. Volkswagen things. Do tell. I'm part of a club and they do runs and people all wave and smile because Volkswagen seem to make people happy.

Natasha Mitchell 1:40

For Chris, Karen and Rod, the stakes are about as high as they get right now. It's become a question of survival. Hello, Natasha Mitchell joining you. Welcome to A Science Friction on the ethics of drug trials. And I've been thinking of two dear friends as we've made this episode, both in their prime when they were taken by terminal cancer. They'd put their hands up to be human guinea pigs. And their experience has raised a whole lot of interesting questions for me about the game of Russian roulette that is signing onto a drug trial. It starts with those words, you've got cancer.

Karen Van Gorp 2:25

You sit there and there's that super cold, very hot feeling that goes through your whole body. And there's a huge amount going through your head. Your adrenaline's pumping. My response is, what can we do about it?

Rod Burrows 2:41

You've got a terminal condition. If you don't get treatment, you're going to die. And die fairly quickly. Yeah, definitely felt vulnerable because you're signing with a gun to your head to a certain degree. You just do it. That's what you have to do.

Karen Van Gorp 2:57

That's not necessarily everybody's response, but mine was, I need to do something, I need to gain control, this is out of my control.

Natasha Mitchell 3:06

Clinical trials come in various colours. A Phase 3 trial is a large-scale trial designed to test a drug's efficacy. And the gold standard is what's called a double-blind, randomised, placebo-controlled trial, which means means you don't know whether you'll get the trial drug or not. So you are playing a game of luck just when your luck is running out. And if you do happen to get the drug, its side effects might be worse than the cancer itself. But you'll put up with a lot when you feel like your options are limited.

How do patients like Rod, Karen and Chris decide to join a clinical trial?

Ian Olver 3:40

They are vulnerable. They participate in clinical trials when there is no other active anti-cancer therapy available to them. And that's the situation where you can offer that choice.

Natasha Mitchell 3:54

Professor Ian Olver from the University of South Australia has a really interesting combination career going on. A long-time medical oncologist, he's also a renowned cancer researcher and a bioethicist concerned about the ethics of treatment.

Ian Olver 4:08

But there's always been a power relationship between a doctor and a patient that can't be exploited in the situation of wanting to recruit them to trials. And some people... have a separation between the people running the trial and the people who are actually looking after the patients for that reason. But you've got to make sure that they understand absolutely that they're going into a trial, that there's a lot of unknowns and that they're not being offered something where we can even sometimes give them a percentage idea of how they'll benefit. And that's the nature of a trial. If you knew the answer, you wouldn't be doing the trial.

Natasha Mitchell 4:45

Even so, you can't help but hope that a trial might beat your cancer. And that's the message from Big Pharma too.