Ch. 12 Case Study: A Patient Offered New Cancer Treatment
Harriet Abeline had faced bad news before. She was diagnosed with breast cancer five years ago and underwent a lumpectomy and radiation treatment. Two years later, a routine mammogram revealed another lump. She used similar treatment for this tumor.
Harriet understood medicine. For years she had worked as a recruiter for a major drug company interviewing and hiring scientists and physicians. The company was a reputable and honest business and developed drugs that were used all over the world.
With each recurrence of cancer, she researched her situation and the available drugs being used for treatment. She also discovered that some cases of breast cancer are caused by a genetic predisposition. With each google search, she read about the experimental treatments that were available for end-stage breast cancer, keeping them in the back of her mind.
Her doctor told her that the cancer had spread to her bones. Harriet was frightened. Dr. Hill understood her fear. Harriet had been working with cancer patients for years and had recently been using some of the newer treatments available for late-stage cancers.
1. What should Harriet do? Should she be tested to see if she carries mutant alleles BRCA1 and BRCA2?
2. If Dr. Hill told Harriet that no other treatment could help her, might that make a difference in her decision to participate in the trial? Why or why not?
3. Many trials need end-stage patients to see how a drug might affect individuals who are very sick or dying. Can these patients really understand what the trials are about and give consent?
4. What should Dr. Hill tell Harriet about the proposed treatment before she agrees? List 5 items.
5. Is there anything that a researcher or physician shouldn’t tell a patient?
6. One serious problem in clinical trials is that researchers often cannot persuade patients to participate. Why do you think that is?
