'Why I decided to take part in a clinical trial' - Breast cancer survivor Esther Galvin
Every successful cancer treatment we have, we owe to the people who participated in clinical trials to test it. After surviving breast cancer, Esther Galvin wanted to help others the way she was helped, she tells our reporter
When special needs assistant Esther Galvin noticed that one of her nipples looked a bit odd, she checked her breast - and found a lump.
The mother-of-two consulted her GP and was referred to her local Breast Clinic, which carried out a mammogram, a biopsy and an ultrasound.
"I had noticed that the nipple on my left breast was indented or inverted. It looked a bit odd, although there was no pain," she recalls, adding that shortly afterwards, in February 2016, she was diagnosed with an oestrogen-based tumour in her left breast and another under her left arm.
She was referred to an oncologist, who explained that she would require a course of chemotherapy, a lumpectomy for the removal of the lump and radiotherapy.
Then he asked an unusual question - if, following these treatments, Esther was deemed suitable to participate, would she be willing to take part in a clinical drugs trial?
Significant strides have been made in cancer treatment over the decades, primarily as a result of clinical trials.
Every medicine that is available now is available because of the people who have participated in the necessary trials that preceded its launch on the market.
Although she didn't know anybody who'd ever participated in a drugs trial - in fact, only about 650 cancer patients participate in such experiments in Ireland annually - the 52-year-old Cork city resident decided to give it a go.
Over the following months, Esther, from Rochestown, progressed through the recommended chemotherapy, followed by surgery and radiotherapy, and was put on an oestrogen-suppressing medication.
Once everything was over, she started the drugs trial in September/October 2016.
"I wanted to give it a go. I really wanted to do it because I felt it could be of benefit to me and other cancer patients," she says.
The programme required her to take a tablet for 21 days and then go without the tablet for seven more days.
"I meet the consultant once a month for a physical examination and a number of tests, including blood tests. I haven't noticed a huge difference since I started it.
"I'm living a normal life," she says, adding, however, that she does notice that she is no longer as interested in a glass of wine at the weekend - something she used to look forward to.
She's scheduled to continue the treatment until next autumn and after that will still be reviewed and tested every year for the next eight years on top of the normal check-ups she would get as a cancer survivor.
In the meantime, she says, she's planning to return soon to her job as a special needs assistant in an autism unit.
We need many more cancer patients to sign up for clinical trials, says cancer specialist Professor Bryan Hennessy, a senior lecturer at the RCSI and consultant medical oncologist at Beaumont Hospital, Dublin and Our Lady of Lourdes Hospital, Drogheda.
Trials have several benefits, both for individual patients and for the ongoing fight against cancer, he asserts.
"Clinical trials take us closer to functioning treatment that stops people dying from cancer," he explains, adding that participating in such research either offers a patient the chance of novel treatments or provides patients with no more options access to potentially new treatments that they could not otherwise avail of.
"I've seen patients derive significant benefits in the control of their cancer through trials," he says.
Furthermore, he emphasises, trials are now highly regulated, and constitute very specific and carefully targeted investigations.
Given our far better understanding now of what makes a cancer grow in a patient at molecular level, he says, the treatments designed to block the gene abnormalities that make cancer grow are usually highly sophisticated and very specifically targeted.
In many cases, he adds, the drug in question will already have been through a number of trials, and will have been shown to block cancer growth.
Added to this, he continues, there is a better public awareness and understanding of the benefits of trials and new treatments.
"Members of the public are more aware of the fact that trials are beneficial for the patient on trials," Dr Hennessy says, adding that there is growing awareness of the fact that patients on clinical drug trials get better outcomes than they would have on standard treatment. "These drugs have been extensively tested before they get to human trials and their side effects have already been well defined," he says.
However, it's important to increase awareness of this, he says, pointing to the Just Ask campaign by Cancer Trials Ireland to mark International Clinical Trials Day, which began last month.
The campaign encourages people living with cancer to ask their consultant oncologist if there is a relevant cancer trial that they can join to enhance their treatment options
"When people are aware of the potential benefits of such trials, they are more open to the idea of it," explains Professor Hennessy, who says trials have been running in Ireland for about 20 years.
"In recent years, people have started to ask about trials much more so than in the past, and we are trying to encourage that."
If a trial might not be available in your cancer centre or hospital, it's important to understand that a suitable trial may be available elsewhere in the country so just ask, he emphasises.
"I know of one patient who specifically asked to be referred to a trial in another hospital in a different part of the country so as to be included in it.
"Just because a trial is not available in your hospital, it doesn't mean it may not be available elsewhere.
"We feel strongly about the benefits of these trials. We are trying to encourage people and their doctors to look into the availability of trials elsewhere in the country," he says, adding that trials also have a potential benefit for the State - they save the HSE millions every year in drug costs.
"When a patient is on a trial, treatment is provided to them," he says. It is estimated that last year alone cancer drug trials saved the HSE more than €6m.
There is a growing belief that cancer trials should be an integral part of cancer care and not just an add-on, Professor Hennessy says.
Currently, only about 3pc of Irish cancer patients are participating in clinical trials - and this figure is something the group would like to see significantly increased.
"We'd like to double this to 6pc, or approximately 1,300 patients, in line with the proposed new National Cancer Strategy," Professor Hennessy says, adding that a good infrastructure for cancer trials needs to be put in place.
To this end, he says, the Government must increase funding to cancer trials. "We're asking for an extra €2.5m or €3m a year - which is about half the drug costs saved."
* For more information on cancer trials in Ireland, visit www.cancertrials.ie
Health & Living