No Trials for the Aging
Why are seniors being left out of clinical studies?
Why the Lack of Seniors?
Many seniors may miss out on clinical trials because their oncologists are
simply reluctant to refer them. A study published in the Journal of Clinical
Oncology in 1991 found that 80% of oncologists surveyed thought that
patients have better outcomes when they get clinical trial treatments, but half
added that they had sometimes declared patients unsuitable for the trials on
the basis of age alone.
Economics may also play a role. The rules about Medicare reimbursement for
patients participating in clinical trials are ambiguous, according to a recent
report from the federal Institute of Medicine. The institute recently urged the
Health Care Financing Administration, which administers Medicare, to issue
clear rules on reimbursement for participation in trials.
Because clinical trials require additional medical visits, lack of
transportation, or its cost, may be another obstacle.
Looking for Solutions
A variety of approaches -- such as paid advertisements to seek seniors, and
clearer Medicare rules -- will probably be needed to draw more older patients
to clinical trials, says Hutchins. For now, the scarcity of elderly patients in
cancer treatment trials is reminiscent of the former under-representation of
women and African-Americans in clinical trials. In the late 1980s and early
1990s, federal agencies established requirements that women and minorities must
be adequately represented in clinical trials of cancer treatments.
A Senior's Story
Despite these obstacles, Ted Simms, like Opal Addison, did get into a trial,
and he's glad he did. And that's another argument for including more seniors in
clinical trials: Doing so can offer measurable benefits to the participants
themselves. Four years ago, Simms (not his real name), at the age of 73, found
a lump in a lymph node that turned out to be cancerous. Three weeks later, the
Texas resident started receiving intravenous taxol every 21 days as part of a
6-month clinical trial.
He bore the cost of traveling 150 miles and staying in a motel the night
before each treatment. The drug caused mouth blisters, weight loss, and sapped
his energy. His fingertips and feet still feel numb from the treatment -- but
the cancer is gone. "I was a guinea pig," he admits, "but I didn't
mind. It was the best option available.''
Carol Potera is a journalist from Great Falls, Mont., who writes for WebMD,
Shape magazine, and other publications.