[quote]Clinical trials: NCCN believes that the best management of any cancer patient is in a clinical trial. Participation in clinical trials is especially encouraged[/quote]

HiJames

the above quote was taken from the National Comprehensive Cancer Network (NCCN) guidelines which is THE authority on cancer in the US. It is generally accepted by the medical fraternity that patients on clinical trials fare better than those who are not. One of the reasons is that the protocol is VERY strict and tests and follow ups are often more comprehensive than normal practice. A patient on a trial is less likely to slip through the cracks and more likely to have side effects uncovered and treated quickly than those who are not participating in clinical trials.

Being on a clinical trial does NOT mean that you are stuck with a treatment if it is not working or causing problems. Clinical trial protocols always allow for discontinuation for lack of efficacy or intolerable side effects.

People underestimate how toxic cisplatin can be because they have it at the same time as radiation and assume that they are the side effects of radiation. The side effects have been shown to occur more often and be more severe by using the two treatments together. Effects such as mucositis, dysphagia and taste disturbance are caused by cisplatin AND radiation. The payoff is a better survival rate. Patients are monitored very carefully on cisplatin because potentially fatal adverse events such as renal failure, cardiac arrest and anemia are not uncommon. On these boards, people regularly miss their last dose of cisplatin because their blood work has signalled the development anaemia which is serious and fatal if allowed to progress.

Cetuximab (Erbitux) has been trialled in head and neck cancer and found to be more efficacious than radiation alone. Google Bonner and 2006 and the trial will pop up for you.

cisplatin has also been trialled in head and neck cancer and found to be more efficacious than radiation alone. The trials are quite old and numerous so this has become more an accepted "known". As a result, current standard of care tends to be cisplatin plus radiation where chemoradiation is indicated.

What we DON'T know is which is more effective - cisplatin or cetuximab ... trials are in progress now (which sounds like the one you are being offered).

The doctors continue to search for better drugs and cetuximab which has been well studied in other cancers is being trialled in head and neck cancer mostly because they are hoping that it is as efficacious but the side effects won't be so severe.