Bridging the Gap Between Community Hospitals and Academic Medical Center Care

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Topics include: Treatments and Understanding

Dr. Maen Hussein, hematologist and oncologist at the Florida Cancer Specialists & Research Institute, sits down with Tamara Lobban-Jones at the World Conference on Lung Cancer (WCLC) in Denver, Colorado to take a hard look at the viability of clinical trials from the patient's point of view.  Dr. Hussein readily acknowledges patient fears of placebos and becoming a guinea pig, but quickly points out that patients have the right to end the trial with options for other trials.  He encourages patients to find an oncologist they trust, and then trust that oncologist to find, leadand treat them through the best, most appropriate clinical trial. 

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Tamara Lobban-Jones:

Some patients are surviving off of clinical trials, and, you know, it could be—that can be something that they feel good about, others might not feel so good about.  What do you have to say to those patients? 

Dr. Hussein:

Clinical trials, I'm pro clinical trial.  I'm not from clinical practice.  Our practice has been involved in many trials that changed the standard of care.  We were part, for instance, of the paclitaxel (Abraxane) trial in lung cancer, got it approved for lung cancer.  We are now part of immune therapy trial.  And, you know, I think the fear that patients have about clinical trials they feel, oh, maybe I'm getting a placebo.  I'm, you know, a drug rat. 

Tamara Lobban-Jones:

Right. 

Dr. Hussein:

I don't want to be a lab… 

Tamara Lobban-Jones:

A guinea pig. 

Dr. Hussein:

…a guinea pig.  And I think, you know what?  Guinea pigs don't have a choice.  You do have a choice.  You can always stop a trial if you don't feel this is the one for you.  And I think it's the presentation of how you present the trial to the patient. 

The reason we are better in treating cancer, the reason why people are living longer with cancer, even with stage IV lung cancer—I have patients who are five years and still alive with stage IV lung cancer—is because of those trials, because we learn from the trials.  So I actually encourage my patients to look for the trials.  I would send them to other practices if they have trials that I don't have.  

Fortunately, in our practice we have many trials, and that's the new thing or the good thing about community oncology in general.  A lot of community oncology practices have trials that you can find in academic, and sometimes we even have trials that they don't have in academic centers.  So the community oncology clinical trials are kind of more real time, because this is really the patient that you see in real life.  Academic may have more, the more refined, more complicated and maybe more perfect patients, and it's always nice to ask around and look and see what clinical trials are there.  Because, again, that could be the drug that maybe will help you fight your cancer and live those years. 

Tamara Lobban-Jones:

Some patients are saying, okay, so you've got these flurry of treatments in different things on the landscape here, and sometimes they feel like the gap is widening, but you feel like it's actually coming—we're coming closer, or the gap is being bridged. 

Dr. Hussein:

So you're right about that.  The gap is being bridged.  I think academics are realizing that it is important also for community practices.  We are partnering with academic centers, so we are becoming sites of their trials, so they might have background academic, but they are allowing our patients to have it in our office instead of driving the distance to go to academic centers. 

And we're apparently doing a good job because they are asking us to do more, so I think that's kind of bridging the gap.  So patients have to trust their oncologist if they have that research.  It doesn't—I mean, it doesn't hurt to go for a second opinion, but I can tell you most of those doctors will say go back to your doctor and get your trial there, because you're going to get the same care that we would have given you in academic center, but you're closer to home.  The people you see in the office are people you see in your community, so you might have more rapport with them.  So that's where the patients just have to trust their doctors, and if they have the trial to go there. 

I mean, I'm presenting data today about a community-based clinical trial, and in our practice we have doctors who presented in other meetings like ASCO and even ASH.  They have oral poster presentations, so there's more community oncology presentation in those big, you know, conferences where in the past it was mostly academic physicians.  So that tells you that the gap is getting smaller.        

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on September 21, 2015