How to Overcome Barriers to Clinical Trial Participation
Joining a cancer clinical trial may present challenges, but you can work with your care team to find solutions.
What Should I Expect as a Clinical Trial Participant?
While purpose and protocol vary across trials, participants may experience the same logistical challenges. Luckily, care teams work with participants to overcome roadblocks.
There are more ways to diagnose and treat various types of cancer than ever before. This is in large part due to clinical trials, says David Nguyen, MD, a medical oncologist at Lowell General Hospital Cancer Center in Lowell, Massachusetts.
Clinical trials are research studies that test new treatment options, which means they’re crucial for advancing cancer care. And participation among people with cancer is increasing: Research suggests that one in five people who have cancer participate in one or more cancer research studies.
Many obstacles can get in the way of clinical trial participation, though, from eligibility requirements to travel limitations. The good news is, there are ways to overcome these obstacles. Keep reading to learn how.
Common Challenges and Solutions to Joining a Cancer Clinical Trial
Here are some common barriers to clinical trial participation — and potential work-arounds you may be able to implement with the help of your care team.
Challenge 1: Strict Eligibility Criteria
Every clinical trial has what’s known as eligibility criteria — a specific set of characteristics or requirements you must meet to be considered for a given trial. This can include factors such as:
Age
Sex
Cancer stage
Overall health
Previous treatment
If you don’t meet a trial’s eligibility criteria, you won’t be considered for participation.
Solution: You can work with your oncologist to determine what kinds of trials may be right for you. The National Cancer Institute’s How to Join a Clinical Trial: Cancer Details Checklist can help you work through common eligibility criteria, so you’ll have your information handy when exploring trial options.
Challenge 2: Geographic Limitations
Most clinical trial sites are in urban areas with a high concentration of academic research institutions, hospital networks, and other services. If you live in a rural area, you may face a long commute, as well as the financial burden of traveling.
Solution: “We found out during the pandemic — when clinics were more open to remote care — that you can participate in trials from a distance,” says Dr. Nguyen. This may involve electronic monitoring devices to collect data and virtual check-ins with healthcare providers. And if you do need to travel, many trial teams provide compensation for travel and accommodations.
Challenge 3: High Demands on Participants
Trials that ask for a lot from participants, such as frequent, lengthy appointments, can feel overwhelming and be a deterrent, research shows.
Solution: Work with your oncologist to find a trial that best suits your needs, says Nguyen. You can also make a demanding trial more manageable by finding work-arounds, such as using electronic communication in place of some trial site visits. Keep in mind that cancer treatment, in general, is time intensive, even if you don’t participate in a trial.
Challenge 4: Costs Associated With Participation
Participating in a clinical trial can sometimes pose a financial burden if you need to take time off from work, hire childcare, or travel to the trial site.
Solution: At most academic centers conducting trials, social workers are available to help connect you with free resources you may not know are available to you.
“When you start to seek out clinical trials, you should work with a financial adviser or coordinator,” Nguyen advises. “Oftentimes, they can be creative in finding ways to help you travel to trials, too, like offering rideshare credits.”
Challenge 5: Misconceptions About Participation
Research shows that the idea of participating in a clinical trial makes some people who have cancer feel like they’re signing up to be experimented on like a lab rat.
Solution: Don’t think of yourself as a guinea pig. Trials don’t exist for experimentation’s sake. Clinical trials are necessary to advance cancer care, and the primary goal is to enhance treatment options for people. “Clinical trial participation is really the engine that allows us to bring great therapies to the front line,” says Nguyen. And participating in a clinical trial can even help you gain access to the latest treatment advances before they’re more widely available.
The Takeaway
Clinical trials are essential for advancing cancer treatment, yet many people face barriers to participation, such as strict eligibility criteria, geographic limitations, and financial concerns.
Support is available to help overcome these obstacles, including remote trial options, financial assistance, and guidance from oncologists to identify the best trial options.
Dispelling myths about clinical trials can empower more people to enroll, which contributes to the development of more effective and personalized cancer treatment.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Unger JM et al. National Estimates of the Participation of Patients With Cancer in Clinical Research Studies Based on Commission on Cancer Accreditation Data. Journal of Clinical Oncology. June 20, 2024.
Briel M et al. Exploring Reasons for Recruitment Failure in Clinical Trials: A Qualitative Study With Clinical Trial Stakeholders in Switzerland, Germany, and Canada. Trials. November 25, 2021.
Rodríguez-Torres E et al. Barriers and Facilitators to the Participation of Subjects in Clinical Trials: An Overview of Reviews. Contemporary Clinical Trials Communications. September 2021.
Wong AR et al. Barriers to Participation in Therapeutic Clinical Trials as Perceived by Community Oncologists. JCO Oncology Practice. September 2020.
Tawee Tanvetyanon, MD, MPH, is a professor of oncologic sciences and senior member at H. Lee Moffitt Cancer Center and Morsani College of Medicine at the University of South Florida in Tampa. He is a practicing medical oncologist specializing in lung cancer, thymic malignancy, and mesothelioma.
A physician manager of lung cancer screening program, he also serves as a faculty panelist for NCCN (National Comprehensive Cancer Network) guidelines in non-small cell lung cancer, mesothelioma, thymoma, and smoking cessation. To date, he has authored or coauthored over 100 biomedical publications indexed by Pubmed.
Kerry Weiss is a New York–based freelance writer, editor, and content strategist specializing in health and wellness. She has contributed to a variety of online publications, including Healthline, WebMD, Sharecare, Twill Care, and What to Expect.
