It’s getting better all the time

Well, it certainly appears to be, if you are lucky enough to be a clinician treating childhood cancers. That’s not to say that childhood cancer is in any way a ‘good’ thing to have, and not to understate in the slightest the unpleasantness of therapy. But things are getting better, and an extensive review by Charles Stiller shows how the benefits that are seen in clinical trials are mirrored in the whole population.

This may seem like an statement of the obvious, but there have been significant doubts cast on how trial results actually play out in ‘real life practice’ and complaints that the restrictive policies of trial inclusion and exclusions make extrapolations meaningless. The benefits here may be through the highly pragmatic nature of most cancer trials, and the increasing advancement of multi-professional, multi-disciplinary networked care.

We’re never satisfied though, and want to get more trials done. Even ‘good risk’ malignancies – perhaps having a 95% survival rate – can be made better, or less toxic to treat, or less disabling. (And spare a thought that 95% survival, if translated to your average ward establishment of nursing staff, means that one of your colleagues would die.)

Evidence based medicine is using the best available evidence to treat individuals and their families. Developing that evidence and using it makes it immediate and effective. Which of your patients would benefit from clinical trials?



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