Ensuring Our Youngest Cancer Patients Receive State-of-the-art Care Close to Home

By Douglas Scothorn, MD, and Ginna Priola, MD

Mission Children's Hospital cancer clinical trials Asheville, NC

In most people’s lives, September represents the changing of the leaves, pumpkin spice lattes and yellow school buses picking up excited kids returning to school. However, for our families at Mission Children’s Hospital, it’s a month to recognize the courageous battles being fought by their children. September is Childhood Cancer and Sickle Cell Awareness Month.

Roughly 15,600 children are diagnosed with cancer every year (that’s 43 children per day) and 1 out of every 9 will lose their battle. As in adults, childhood cancer does not discriminate: diagnoses cross all ethnic groups, socioeconomic classes and geographic regions. Cancer remains one of the leading causes of death in children. Currently, we have 429,000 childhood cancer survivors in the US, of which 95 percent will have at least one significant health related-issues due to their original diagnosis or their treatment.

Over the past 40 years, the survival rates for childhood cancer have increased from less than 60 percent to almost 85 percent. In large part, this is a result of research and clinical trials run by the Children’s Oncology Group (COG). COG is made up of over 200 hospitals that treat children and adolescents with cancer in the US, Canada, Australia, New Zealand and Europe. These hospitals work together to develop treatment approaches for all types of childhood cancer. This ensures that children can receive the same state-of-the-art cancer treatment, regardless of where they live. Mission Children’s Hospital has been a member of the COG for almost 25 years.

Since 1980, only three drugs have been approved to treat children with cancer, and four drugs have been approved for use in both adults and children. Many childhood cancer treatments haven’t changed since the 1970s. On average, the five-year survival has improved from about 50 percent in 1975 to greater than 80 percent in 2010. However, there is still a long way to go. Although there are numerous nonprofits focused on providing funding for childhood cancer research, the National Cancer Institute currently only designates 4 percent of its annual budget toward childhood cancer research.

Clinical trials for childhood cancer typically compare the current best known treatments (called the “Standard of Care”) with treatments that are hoped to be more effective and/or have fewer side effects than the standard of care treatments (known as the “Experimental Treatment”). After each clinical trial, the treatment with the best outcomes becomes the new standard of care.

As of September 2019, Mission Children’s Hospital has over 60 active clinical trials designed to treat more than 90 percent of children with cancer. This means that children in western North Carolina can be assured of receiving the best available treatment for their cancer without having to leave their friends, family or community.

Here at Mission Children’s Hospital, in our pediatric hematology/oncology clinic housed in the SECU Cancer Center, we diagnose about 20 new patients a year in western North Carolina and continue to care for them throughout their diagnosis and for many years following.

As staff and providers at Mission Children’s Hospital, we understand the tremendous opportunity and responsibility we harbor to help these kids and their families … FIGHT LIKE A KID.

To learn more about the specialty services at Mission Children’s Hospital, visit missionchildrens.org.

Douglas Scothorn, MD, is a pediatric oncologist at Mission Children’s Hospital.

Ginna Priola, MD, is a pediatric oncologist at Mission Children’s Hospital.

Why You Shouldn’t Fear Clinical Trials when Faced with Cancer

September 23, 2016
By Dr. Rachel Raab, Director Mission Breast Program

For many cancer patients, the idea of participating in a clinical trial brings hope. They see it as an opportunity to receive a treatment that Mission Health patients participate cancer clinical trials may be better than the standard of care, to advance science, and to help future cancer patients. For many patients, however, the thought of participating in a clinical trial is frightening. I often hear patients say that they do not want to be a “guinea pig” and fear receiving treatment that is “experimental.”

For an individual with cancer, it can be difficult to know if a clinical trial is the right treatment option. It is a myth that clinical trials are only for people who have advanced cancer that is not responding to treatment. Here is some basic information about clinical trials.

What are clinical trials?

Clinical trials are research studies that involve people and help doctors to find ways to improve treatments and the quality of life for cancer patients. Some clinical trials are done to treat cancer, some for prevention of cancer, others to find ways to manage symptoms of cancer and side effects from cancer treatments.

By the time a clinical trial reaches a patient in the clinic, it has gone through steps in order to ensure that the drugs being used are safe and effective. Scientists, or researchers, work in a lab for many years to understand how drugs affect cancer cells before these drugs are ever used to treat people.

Every clinical trial has a person in charge. This is usually a doctor who is called the principal investigator. Research nurses and other individuals are also involved in the trial to ensure that the trial is being run appropriately.

If a clinical trial is discussed with you or your loved one, this conversation should include information on why the trial is being done, who can join the trial, what drugs are being used, how often treatment is given, what side effects can occur, what medical tests will be done and how often, the type of information that will collected from the trial and what this information will be used for.

What are the phases of clinical trials?

Phase I clinical trials are used to show that people can safely use a new drug or treatment. In phase I clinical trials, the dose of the drug being studied is slowly increased with the goal of finding the dose that works best without causing severe side effects. People who join phase I clinical trials are often the first to get a new therapy or combination of therapies.

Phase II clinical trials give information about a treatment’s safety and how well it works. Before a treatment can move into the next phase of a clinical trial, the phase II clinical trial needs to show that the treatment is as safe as standard treatment.

Phase III clinical trials compare the new treatment that has shown to be effective in a phase II trial with the standard of care for that particular type of cancer. Patients are randomized to one of the treatments. These trials include a large number of patients and take years to finish.

Why are clinical trials important?

Clinical trials help doctors find new and better cancer treatments that can help patients live longer. They help doctors better understand side effects from treatment and how to prevent and manage them. They help improve quality of life for cancer patients. People are living longer, better lives because of clinical trials.

(From Mission Health Blog; Mission Health has served Western NC since 1885)