Clinical trials lift Santa Fe cancer patients' spirits

Sue Vorenberg | The New Mexican
6/19/2009

After being diagnosed with breast cancer, Knapp, despite her knowledge from working as a surgical nurse in Santa Fe, found herself feeling lost and helpless when it came to her illness, she said.

"When I came to talk about this with the doctor it was the scariest thing ever," Knapp said. "But then the doctor explained it to me so well, so carefully, that I felt a lot better about it. And what I decided was 'I'm just going to hit this thing with the biggest gun I've got.' "

Knapp, 62, sought treatment at New Mexico Cancer Care Associates, a Santa Fe oncology office on West Zia Road.

Her first option, surgical removal of the tumor, failed, and her tumor was found to be more aggressive than she'd hoped.

But after that, she steeled herself to the idea of chemotherapy and radiation therapy. And she decided to give back to the community and to help her fellow patients in the process, by participating in one of the cancer care center's clinical trials, a chemotherapy study with the potential to reduce heart strain on breast cancer patients in the future.

"I was comforted by the fact that I would be followed closely by all these wonderful professionals for five years as part of the clinical trial," Knapp said. "Also, breast cancer is huge, and this trial is going to help everybody."

Beyond giving patients access to new types of care, clinical trials are part of the mandatory process for drug companies to get medications approved, and they also help doctors and the medical community gather data on new ways to fight different types of cancer, said Dr. Scott Herbert, an oncologist at New Mexico Cancer Care Associates.

"They can also have a morale-boosting effect," Herbert said. "It's great to get a patient without a lot of hope and tell them 'we've got something new, and we think it will really help.' Hope is very important. Also patients love to give back and help others fighting their disease."

A clinical trial generally includes two groups of patients — one group gets traditional therapy and functions as a control and a second group gets the new drug combination or therapy.

In her trial, Knapp was picked to be part of the control group. But even though she didn't get to use the new therapy, she still feels that her contribution made a huge difference, she said.

"It's the only way we're going to fight this battle against cancer — the more information we have, the better," Knapp said.

Earlier this week, New Mexico Cancer Care celebrated the enrollment of its 100th clinical trial patient, Susan Hart, by presenting her with a cake and flowers and throwing a little party.

"She was really excited," said Melissa Garcia, clinical research coordinator. "We're really proud of our patients' level of participation in these trials."

Clinical trials are a focus of the center, which has about 6 percent of its patients enrolled, Herbert said.

"For a community practice, that's a very large portion of our patients," Herbert said.

The center has 29 open trials for a variety of types of cancer right now. To help patients participate in them, New Mexico Cancer Care Associates works with two groups, the New Mexico Cancer Care Alliance and U.S. Oncology.

Both of those groups work with doctors' offices and universities to fill spaces in statewide and national trials, said Dr. Karen LoRusso, who runs the center's clinical trials program.

"People think trials are only for the last stages of cancer, when things are terminal, but that's not true at all," LoRusso said. "We have patients participating in trials in many different stages. There are trials for early stages, trials to keep cancer from recurring. There's a lot out there."

Research institutions, such as The University of New Mexico, tend to run more experimental types of clinical trials. Christus St. Vincent Regional Medical Center also works with UNM and other groups to run trials.

But since it's more of an intimate office setting, Cancer Care Associates tries to focus more on trials that are treatment-related or quality-of-life-related, Herbert said.

"We're not a research institution, we're an oncology office that tries to bring in the latest research, so we tend to participate in things that aren't as experimental," Herbert said.

For the most part, the types of trials the center participates in look a lot like its patient mix. Many of the studies are for breast cancer, which is the most common type seen at New Mexico Cancer Care Associates, Herbert said.

Other trials focus on lung, colon and other types of cancer. And for patients that have really rare cancers, doctors have another clinical trial option with U.S. Oncology called the STARS program, which stands for Selected Trial for Accelerated Rollout.

"That program is really designed for smaller patient facilities without a huge number of patients with rare cancers," Garcia said. "We have a list of rare trials from them, and we can get patients enrolled in 24 to 48 hours, as opposed to normal trials which can take two months to open up."

And unusual cancer types, such as some aggressive forms of leukemia and gastrointestinal tumors, do crop up at the Santa Fe office more often than you'd think, Herbert said.

"We've certainly seen some strange things," Herbert said. "We're a community oncology clinic, though, so whoever walks through that door, we treat."

One of the bigger national trials the center is participating in is something dubbed "tic tac toe," which is looking at a novel drug that's been approved for terminal breast cancer patients to see if it's more effective in treating breast cancer in earlier stages.

"(The drug) is one of the newest ones out there for cancer," LoRusso said. "It's an antibody, and it cuts off the blood supply to the cancer and seems to have fewer side effects than other chemotherapy drugs."

Traditional chemotherapy affects every cell in the body and attempts to kill the tumor by interfering with DNA, Herbert explained.

"That's why people lose their hair and have effects all over their body," he said.

The new drug is more narrowly focused on the tumor, and tries to kill it by removing the blood supply, Herbert said.

New Mexico Cancer Care Associates had the first patient in the country enrolled in that trial, Herbert added proudly.

Now in remission, Knapp said she's still very happy that she was able to participate in her trial. It helped to know she was also helping other while going through her treatment, she said.

And she'd recommend that any patient look into doing the same thing she did, Knapp added.

"I felt I got everything that I needed," Knapp said. "And I think staying active, having the support of my friends and the people here also helped immensely. It sure puts things into perspective. Every day I wake up and think 'wow, I'm still here.' "

Contact Sue Vorenberg at svorenberg@sfnewmexican.com.