My sister has advanced breast cancer. Should she consider joining a clinical trial?

Q. My sister has advanced breast cancer. Should she consider joining a clinical trial? What are the risks and benefits?

A. The question of whether to join a clinical trial typically arises if the established therapies for a par-ticular cancer or an individual case are not very successful. In such a circum-stance, looking into an appropriate clini-cal trial makes sense. But it’s important myth no. 1: There’s nothing you can do to prevent cancer. That’s both untrue and potentially dangerous. Examine your lifestyle—chances are there are aspects of it that increase your risk of developing cancer. Take smoking. It contributes to about one third of all cancer deaths, especially from lung cancer. But smokers who quit before age 50 can halve their elevated risk of dying from cancer during the next 15 years. Other cancer-risky behaviors are eating a poor diet and not being physi-cally active. Being overweight is another negative factor that should be cor-rected. These risk factors—poor diet, inactivity, and overweight—are behind one third of all cancer deaths. myth no. 2: Stress can lead to cancer. Despite considerable research, no good evidence supports the idea that stress causes cancer, reduces the chance of survival if you have the disease, or brings about a recurrence.

Scientists are constantly trying to translate basic research into new cancer therapies. To determine if an experi-mental drug is safe and effective, it must be tested in human volunteers in a clinical trial. Such drugs have come through preliminary lab and ani-mal studies and appear promising. So, depending on the stage of testing, your sister could be one of the first people to benefit. In addition, trial participants typically receive top-notch care.

Now for the other side of the coin. Because the drugs in clinical trials are new, their side effects and risks are relatively unknown. Also, the drugs may turn out to be less effective than existing therapies. In addition, some trials are randomized, meaning that some of the participants end up receiv-ing standard therapy rather than the experimental one. The close monitoring required in some trials may also mean more time and expense than your sister can afford.

Your sister should discuss the mat-ter with her doctor. If her doctor is not aware of any relevant clinical trials, she can check with the National Cancer Institute’s Cancer Information Service (800-4-CANCER) or she can visit www. centerwatch.com.