Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans
Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans from Patient Empowerment Network on Vimeo.
How can veterans with lung cancer access support services for clinical trials? Expert Dr. Michael Kelley from Duke University School of Medicine discusses clinical trials at VA locations, support services to help access clinical trials, and proactive patient advice for transportation costs to clinical trials.
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“So sometimes the clinical trial will pay for transportation costs. Sometimes the clinical study will pay, and sometimes no one will pay. So you do have to ask whether that is provided, and if not, are there other resources that could be used to help pay for any transportation that would be needed?”
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Transcript:
Lisa Hatfield:
So if a patient finds a clinical trial that’s outside of the VA, will the VA help coordinate that being a part of that clinical trial if it’s outside of the VA? And the other question I would have about that, are clinical trials done at all of the VA facilities or if a person sees one that’s done, maybe they go to a smaller facility, they have to go somewhere else, can they go to that larger facility for the clinical trial?
Dr. Michael Kelley:
Yeah, great questions. So several different answers to that. So there are…some VAs do clinical trials and some don’t. And any clinical trial is not open at every VA. So if it’s open at some VAs, it may not be open at other VAs. So if the veteran finds a clinical trial at another VA and they’re willing to travel to that other location, there are generally no barriers to doing that and to enrolling in that clinical trial at the other VA.
But let me start with the first part of your question is, well, how do I find a clinical trial? So this is, I think, a barrier that we’ve all realized, and we’ve set up a service that is called the Clinical Trial Navigation Service. So a provider can ask this service to talk with the veteran and to help find a clinical trial that might be appropriate for them and then to report that back to the provider. So they can talk about what geographic area would be appropriate for the veteran and then other characteristics of the veteran and their medical care that would help inform if there’s a clinical trial available.
In the VA or outside the VA, we’ve initially partnered a lot with the National Cancer Institute at the NIH Clinical Center in Bethesda, Maryland where they will actually provide transportation for people to enroll in clinical trials at that center.
So that’s one of the areas we’ve been working with and then a few other organizations or systems. So that is one thing is you have to find the clinical trial. And the other part of your question was, you know, will VA help the patient get there? Okay. So sometimes the clinical trial will pay for transportation costs. Sometimes the clinical study will pay, and sometimes no one will pay. So you do have to ask whether that is provided, and if not, are there other resources that could be used to help pay for any transportation that would be needed.
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Are There Lung Cancer Clinical Trials Studying Veterans?
Are There Lung Cancer Clinical Trials Studying Veterans? from Patient Empowerment Network on Vimeo.
Are veterans with lung cancer under study in clinical trials? Expert Dr. Michael Kelley from Duke University School of Medicine discusses benefits of clinical trials, an early stage non-small cell lung cancer clinical trial, and proactive patient advice about clinical trial access.
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“…if you have a diagnosis of cancer you’re facing and you’re getting your care from the VA, please ask your provider if there’s a clinical trial that might be appropriate for you. That might be at the VA, or that might be somewhere else and both of those would be appropriate to consider to understand what the advantages and disadvantages would be for you, including being able to improve the knowledge that would help future people who also face the same diagnosis.”
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Transcript:
Lisa Hatifeld:
Dr. Kelley, can you speak to ongoing clinical trials and research specifically for veterans, or are there any clinical trials or research studies that are available that focus on lung cancer treatments specifically tailored to veterans?
Dr. Michael Kelley:
Yes. So we’re very interested in ensuring that veterans have access to all components of clinical care. And for many individuals who have a diagnosis of cancer and enrollment in a clinical trial is considered appropriate and part of standard clinical care to consider. So there are some studies which are designed by VA for veterans. There’s one ongoing now that is comparing surgery with radiation for early stage non-small cell lung cancer. That study is going to, I think, inform the entire country and maybe the entire world about what the differences are in terms of the outcomes and tolerability of those two treatments.
They’ve both been around quite some time now, and they’re used extensively throughout the world, but they’ve never been compared directly. So the veteran population is helping to answer a very important question, and it is designed specifically for veterans. The population of veterans who have cancer, in particular lung cancer, who are enrolled in VA, tend to have more other diseases in addition to the lung cancer, so more diabetes, hypertension, heart disease.
And when initial drugs or other treatments get approved, they’re oftentimes used in a very select population that don’t have any other diseases. They’re healthy people with cancer, and that means that we don’t know necessarily whether it’s safe or effective to use those treatments in people that have what are called comorbidities or other diseases.
And so veterans can oftentimes not have their treatment informed by the medical studies that have been completed to an exacting degree. So what we’ve done is to design some studies that are specifically for veterans to expand on that knowledge and make sure that we understand what is safe and effective in veterans. So my activation tip is that, if you have a diagnosis of cancer that you’re facing and you’re getting your care from the VA, please ask your provider if there’s a clinical trial that might be appropriate for you.
That might be at the VA, or that might be somewhere else and both of those would be appropriate to consider to understand what the advantages and disadvantages would be for you, including being able to improve the knowledge that would help future people who also face the same diagnosis.
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Advancements in Lung Cancer Clinical Trials | Updates for Veterans
Advancements in Lung Cancer Clinical Trials: Updates for Veterans from Patient Empowerment Network on Vimeo.
How can veterans help move lung cancer clinical trial advancements forward? Expert Dr. Drew Moghanaki from UCLA Health explains clinical trial groups that need more participants, available support resources for veterans, and patient advice.
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“…speak up and ask if there is a clinical trial that you may be eligible for to help another veteran. And, of course, when you enroll in a trial, you’ll be getting basically the best treatments that we think are available at this time.”
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Transcript:
Lisa Hatfield:
Dr. Moghanaki, can you speak to ongoing clinical trials and research specifically for veterans? And are there any clinical trials or research studies available that focus on lung cancer treatments specifically tailored to veterans from underrepresented communities?
Dr. Drew Moghanaki:
Yeah. So we want to focus on the people we care about the most, which for many of us are veterans, but at the end of the day, partnering nationally and globally in clinical trials is probably the best thing that we can do. We don’t really think that the lung cancer is…that our veterans are dealing with is necessarily different than what a civilian may be. So by partnering, we have bigger scale to tackle these problems and get these studies done as quickly as possible.
When it comes to underserved communities, same thing. We do the VA and VA researchers definitely make a point of trying to get more underrepresented communities access to clinical trials. But again, we just usually geographic challenges are our biggest barrier. Someone wants to live in this beautiful part of the country up in a mountainside near a lake, but they’re two-and-a-half hours away from a city. That can be challenging for us.
But the good news is that the VA does provide a lot of housing. So for those veterans who live far away, if they want to come, we’ll take care of them. We’ll provide, if they’re eligible for your VA healthcare, we’ll provide them housing. We can even provide them with their meals. And so, and get them access to the best care. So basically my activation tip here is to be aware that clinical trials are really critical.
It’s how we’ve moved forward. It’s a tremendous opportunity to help other veterans behind themselves who will get lung cancer in the future. There’s nothing we can do at this time to stop the number of people getting lung cancer. And so the more research we can do, the better this world can be. And my activation tip is to speak up and ask if there is a clinical trial that you may be eligible for to help another veteran. And, of course, when you enroll in a trial, you’ll be getting basically the best treatments that we think are available at this time.
Lisa Hatfield: Great. Thank you. Thank you so much. Those activation tips were really great and patient-centered. And I think that’s what, at least me as a patient, watching that in the audience, that’s what I want to hear is what can I do to help advocate for myself? So thank you for those responses.
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Lung Cancer Care for Veterans: Advancements in Radiation Oncology
Lung Cancer Care for Veterans: Advancements in Radiation Oncology from Patient Empowerment Network on Vimeo.
What should veterans with lung cancer know about radiation oncology advancements? Expert Dr. Drew Moghanaki from UCLA Health explains recent advancements in radiation oncology and radiotherapy, where the advanced therapies are accessible, and proactive patient advice.
[ACT]IVATION TIP
“…make sure you do your homework and try to make sure that the department of radiation oncology you’re going to really does have the best technologies. And there’s lots of different ways to look at this, including going online and reading more about what the quality of care might be in the community.”
Download Resource Guide | Descargar guía de recursos
See More from [ACT]IVATED NSCLC Veterans
Related Resources:
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Combating Disparities: Veterans’ Healthcare Access and Quality |
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Advancements in Lung Cancer Clinical Trials Updates for Veterans |
Transcript:
Lisa Hatfield:
Dr. Moghanaki, are there any promising advancements or techniques in radiation oncology that could potentially improve outcomes for veterans with lung cancer?
Dr. Drew Moghanaki:
Yeah, there really are. So back in the old days, radiotherapy was just an open beam that we would shine towards a general area of the body. And they did a good job of getting control of the cancer, but, unfortunately, it would injure a lot of normal tissues. Today, radiotherapy is much more precise and targeted. In fact, our precision is within less than a millimeter of what we aim at. And so military analogy is this is like your best sharpshooter that can hit a small, less than a one-inch target from a 1,000 yards away.That’s basically what we’re able to do. We’re not a 1,000 yards away. The machine’s right there. We can see inside the human body. We can see the tumor, especially if it’s moving, and we can deliver highly concentrated high dose X-rays specifically to the tumor with a very little amount of exposure to the area around it.
So we’re just not seeing our patients getting injured from radiotherapy, and we’re seeing sometimes some situations up to 100 percent complete tumor control with no further growth. So it’s really important for veterans to know. So my activation tip is if surgery is on the table, you might want to check in with a radiation oncology team as well to see, well, is radiotherapy an option as an alternative? It might be safer and just as good and maybe better. So a lot of people don’t know about this because this is not taught as much, but radiotherapy is really one of the major forms of curative therapy for lung cancer.
Lisa Hatfield:
Okay, thank you. As a patient, I always have follow-up questions to clarify a couple of things. So I have another follow-up question to this, the question you just answered. So I know that not all veterans are seen at VA hospitals or VA facilities. If they are being seen at a VA facility, will they have access to the latest and greatest radiation radiotherapy services, or do only some centers have these special types of therapies?
Dr. Drew Moghanaki:
Yeah, well, when it comes to the VA’s commitment to provide the best care for every single veteran who’s eligible, there’s a logistical challenge in that it’s hard to deliver care to veterans everywhere, especially super sub-specialty care like thoracic surgery or radiation therapy. The equipment’s expensive. There’s a lot of staff that has to be hired. You can just look at airports. We don’t have a major commercial airport in every town and city in the U.S. They’re in major towns, major cities.
And that’s kind of how things are with the VA medical centers. And even when you look at the network of 130 VA medical centers in the 50 states of the U.S. only just more than 40 of them actually have radiotherapy on site at that VA medical center. So a lot of veterans who actually need radiation therapy are going to be getting that through the VA referred out to the community providers.
And so it’s important to if you’re at the VA, you’re very likely to get high-quality radiation therapy because a lot of oversight, the federal government’s watching. In fact, it’s the most regulated radiation oncology service in this country at this time. But if you’re going out into the community, make sure you do your homework. And my activation tip would be then make sure you do your homework and try to make sure that the department of radiation oncology you’re going to really does have the best technologies. And there’s lots of different ways to look at this, including going online and reading more about what the quality of care might be in the community.
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