Tennessee Oncology

When it comes to cutting edge cancer treatments, most of us would assume that participating in a clinical trial would involve a trip to Atlanta or some other big city. Today, cancer clinical trials are taking place close to home at Tennessee Oncology's Lebanon office.

One of the people heading the trials is Dr. James Peyton. He is board-certified in medical oncology and has been with the practice since 2003. He has worked with patients who have colon, breast and lung cancers, as well as learning about new advances in cancer therapy — that's where clinical trials come into play.

At Tennessee Oncology clinical trials are ongoing. "We have trials for many different kinds of cancer," he said. "Pretty much any kind of cancer you can think of. When you look at the criteria for treating patients with incurable cancers one of the most common recommendations is enrollment in a clinical trial."

What is the most important criteria for choosing someone for a clinical trial?  "If they are healthy enough to go through it," Peyton said. Clinical trials are studies that evaluate the effectiveness of new drugs or treatments. The development of more effective cancer treatments requires that new therapies be evaluated by testing them on cancer patients. In oncology, clinical trials are especially important because, in the absence of high cure rates, nearly all therapeutic approaches are evaluated over time.

Patients who participate in clinical trials benefit from a new drug or treatment procedure, to improve management of symptoms resulting from treatment or cancer and/or for the opportunity to directly contribute to the understanding of how to treat a cancer which will ultimately benefit other patients.

Participants in clinical trials receive either a promising new treatment or the best available conventional treatment. If a new treatment option is proven to work, patients who are participating in the clinical trial will be among the first to benefit. While there is no guarantee that any treatment will be successful, clinical trials have been proven to offer some of the most effective cancer treatments currently available today. The abundance of clinical trials across the country has yielded results.

"The research protocol facilitates the ability to explore new options for treatment," he added. "We've had a lot of exciting new drugs. We've seen an explosion of the options available for patients because of research." Currently, there are hundreds of ongoing clinical trials in the United States.   Although clinical trials are an important component of cancer care and are crucial for improving cancer treatment, fewer than five percent of cancer patients currently participate them. The number is so low because some patients are uninterested or unaware that they exist, have difficulty finding an appropriate clinical trial that may benefit them or they are ineligible to participate in a clinical trial because of prior treatments.

"Some refuse because of their comfort level. You don't always understand why people don't want to do it, but I'm a big proponent for it," Peyton said, adding that all he can do is give patients the options and let them make the decision. "I tell them what the traditional information is and what the results are."  Success in cancer research comes in small increments, because there are no shortcuts in the search for a cure. Peyton said it depends on whether or not a patient is using the new drug exclusively or in combination with a traditional course of treatment. "If you have a combination of chemo therapy with a drug, you won't know for sure until they collect all the data," he said.

Peyton said the goal may not be to cure cancer, but to tame it. "If you can turn cancer into a chronic problem, if you can manage it and have a good quality of life with a medication that keeps the disease in check for a long period of time, you could turn it into a disease process like diabetes," he said.

A drug is a success if it is more effective than the traditional treatment. "You have to compare the new drug versus the standard," he said. "You look at overall survival as an end point to judge its effectiveness.  If people live longer on this drug that deems it an effective therapy. A lot of the drugs are looking at different toxicity. A lot are becoming easier to handle by patients. We're trying to see if they have the same benefits. People are more likely to go through a less toxic therapy."

Doctors and researchers are having some success. "I think the drugs have improved the survival rate of patients," he said. "What we're seeing is that people are surviving longer with incurable disease and that's a testament to the drugs themselves.  And we have newer drugs which have been able to prevent cancer from coming back. I feel we've made a significant contribution, because there are patients who 10 years ago wouldn't be alive."

Even with new drugs and therapies, the war against cancer is still raging. The difference is what victory may look like. "I don't think we've succeeded. I think it's still a battle. It will depend on how much control you can achieve. That's the most important thing. The goal is to keep them with a good quality of life for a longer period of time," Peyton concluded. "We're probably going to try to control cancer as opposed to actually trying to cure it. You can end up improving their quality of life and they could live to see their grandchildren grow up."