Oncology Research

Three Questions to Ask Your Oncologist About Clinical Trials

By Caesar K. Tin-U, M.D., Texas Oncology

When it comes to cancer, advancements in clinical trials and research are our greatest hopes for eliminating the disease. Discoveries like new drug therapies or combinations of drugs, innovations in radiation therapy, and better screening and diagnosing methods come from clinical trials – research studies that examine the safety and effectiveness of different cancer treatments and reveal insights into the disease and ways to deliver better care.

Breakthroughs that advance prevention and treatment of cancer are made possible by the courageous patients who volunteer to participate in clinical trials. Yet less than 5% of adult cancer patients participate in clinical trials, according to the National Center for Biotechnology Information. Clinical trials follow strict compliance with federal, state, and local regulatory requirements. Each patient is carefully evaluated to ensure the patient is a strong fit for a particular clinical trial. Here are three questions to ask your oncologist about participating in a clinical trial. What types of clinical trials are available? Patients are encouraged to play an active role in their cancer care. This includes being informed of all treatment options available. Ask your oncologist about clinical trial availability. At any given time, there are hundreds of active clinical trials at various stages of evaluation. For example, prevention trials focus on preventing cancer or the recurrence of cancer, and might focus on diet and nutrition or the use of different medications or vitamins to determine if risk of developing cancer is lowered. Similarly, treatment trials are designed to answer questions about new treatments, vaccines, therapies, or surgical procedures. What are the benefits and risks of participating in a clinical trial? The benefits and risks of clinical trials vary by trial. And, just as every patient experiences symptoms and side effects differently, this is true for clinical trial participants as well. Some of the benefits of participating in a clinical trial include treatment that may be more effective than other available treatment options and access to treatments often not available to the public. Patients enrolled in clinical trials also receive the same standard of treatment and care as those not participating in trials. While there are inherent risks with participating in research, the benefits often outweigh them. For example, in some cases, the risks include side effects that are not dissimilar from those experienced with traditional forms of treatment like chemotherapy and radiation therapy. Am I eligible for a clinical trial? Not all patients are eligible for clinical trials, even when it seems like you may be a good fit. Factors considered before approving a cancer patient for a clinical trial depend on such criteria as age and sex, cancer type, stage of cancer, previous treatments, and medical history. If you’re interested in a trial but not eligible for trials currently available, discuss your interest in participating with your oncologist. New clinical trials open regularly.

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Mental Health

Latinx Young Adults Who Worry About Heart Conditions at Higher Risk for Mental Health Disorders Heart-Focused Anxiety a Significant Predictor of Depression

By Laurie Fickman

For coffee drinkers, a common scenario might involve drinking an extra cup only to end up with a racing heart and a subtle reminder to themselves to cut down the caffeine. But for those who have a different thinking pattern, one that includes heart-focused anxiety, the racing heart might conclude with the fear of a heart attack and a trip to the emergency room. It turns out young Latinx adults who experience heart-focused anxiety could be at greater risk for mental health disorders. “We have empirical evidence that individual differences in heart-focused anxiety are related to more severe co-occurring anxiety and depressive symptomatology among a particularly at-risk segment of the Latinx population,” reports Michael Zvolensky, Hugh Roy and Lillie Cranz Cullen Distinguished University Professor of psychology at the University of Houston, in the Journal of Racial and Ethnic Health Disparities. The population segment to which Zvolensky refers is Latinx young adults with previous trauma who were born in the United States. Their trauma might include racism related and transgenerational stress. This is only the second study on heart-related anxiety in the Latinx community, both conducted by Zvolensky. “In our first study, we assessed middle aged adults, presumably more concerned about their health. This study is unique, however, because even among a group generally too young to experience mounting health concerns, we are seeing a similar pattern, which tells us it’s probably relevant to the whole Latinx population,” said Zvolensky. According to previous research, the Latinx population can somaticize mental health problems, meaning they don’t view them as mental health issues, but rather turn them into physical symptoms and report them as such. As examples, anxiety might be reported as a headache or a problem with breathing. “This population also struggles with a lot of chronic physical health co-morbidities including heart disease and obesity, so this research is a good fit for a population who tends to blame mental health issues on physical ailments, which generates greater mental health risk,” said Zvolensky, who is also director of the Anxiety and Health Research Laboratory/Substance Use Treatment Clinic at UH. To make matters worse, treatment for mental health conditions among Latinx populations is often limited or nonexistent. “Latinx persons underutilize mental health services compared to non-Latinx whites and are more likely to use primary care for the delivery of mental health services which are often inadequate for successfully addressing mental health problems,” said Zvolensky, who created and assessed reports from 169 college aged, Latinx college students who had been exposed to trauma. “Results indicated that heart-focused anxiety was a statistically significant predictor for general depression and overall anxiety,” said Zvolensky. Clinically, the results of the study could ultimately guide the development of specialized intervention strategies. “We can screen for heart-focused anxiety and that’s much more efficient and precise than screening for a whole range of mental health problems,” said Zvolensky. “If you reduce heart-focused anxiety, you do that person a great service because you’re likely decreasing their risk for a whole range of mental health problems. And that’s called precision medicine.”