You have CANCER for the first time: What is expected of you or your choices for clinical trials.

You have CANCER for the first time:

What is expected of you and your choices for clinical trials.

If you ever become a Cancer patient in Victoria, from your first diagnosis, you need to make some very serious decisions, whilst suffering from complete shock and disbelief at the diagnosis.


                                                                                      Doctor and patient, National Cancer Institute Wikimedia commons


Decision 1

Do you want to fight the cancer? The choice is yours. If you decide not to, the understanding is that you will receive standard care and pain management, for whatever time is left. Another choice, that can be decided at any stage beyond the first diagnosis, is to sign a “no resuscitation” statement, insisting ta=hat no further action must be taken to revive you.

If you decide to fight, the next action is needed immediately.


Decision 2

Speaking from my experiences, you must sign a binding contract to allow your oncologist (the specialist cancer doctor) to place you in at least one clinical trial. There is no real treatment option without a clinical trial. No patients, public or private, can get experimental cancer therapy without this consent.

Some have said to me they chose to be treated by their own specialist. That doctor will offer an established treatment and care, which may or may not work. If you want to receive new experimental therapy, the doctor will direct you towards a clinical trial. The doctor of your choice may attend to (weekly and hospital) visits, but the treatment will not vary from that set by the clinical trial.


Decision 3  

If you accept and apply for a clinical trial (it is by no means a sure thing), then the next difficult decision must be made. Do you want to enter the treatment as a private or public patient? The public hospital administrators are relentless. Their argument is that the treatment is the same, private or public. It makes no difference, but if you sign as a private patient, then you are lessening the burden to the State. If your answer is public cover, with private insurance, the administrators will return to you again and again throughout most of your treatment to get you to sign across to private insurance.

Of course, if you do not have private health insurance, there are no further decisions to be made and you need to accept the treatment given.

I am not sure if a billionaire is given the same option of a doctor, private hospital facility and the type of care and treatment. I suspect they may search worldwide for the best therapy, rather than a clinical trial. For the normal Victorian, I believe the choices are very limited and the choice of treatment even less, during such a tough time.

Based on my past experiences, your treatment has already been decided by the consulting doctors and the specialist oncologist selected. This was made according to the laboratory results, preliminary examinations and assessments made prior to any talks with you, about your diagnosis and condition.

As a private patient, upon hearing the therapist selected, you can seek further opinions if you prefer a specific specialist, but this does not necessarily mean a new therapy. For new cancer treatments and therapy, in Victoria, there should be no difference whether you are a public or private patient. I suspect there is.

The thing is, you have no idea what you have signed up for. You might expect the most up-to-date treatment, with the possibility of success or life, but this is less likely. No other reasonable new therapy will be considered whilst you are in a contracted trial, regardless of its published success.