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Chapter 7: Clinical Trials [7:13]

Jamie gets a second opinion about treatment, and talks with her father and brother. Should she join a clinical trial?

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Transcript: Chapter 7 - Clinical Trials

JAMIE KLAYMAN: Hi there.

JAMIE KLAYMAN: This is us, right? I almost forgot what room we were in.

ABBYE WARREN: Oh, you did?

DAVID RYAN: The clinical trials that we have available right now are all Phase I studies.

JAMIE KLAYMAN: Right.

DAVID RYAN: So just to recap what those are: the clinical trials, they come in three phases, essentially. When something looks good in the lab and you're taking it into the clinic for the first time, that's called a Phase I study. And Phase I studies can, um, be the first time or first several times that we're trying it out...

JAMIE KLAYMAN: Right, yep.

DAVID RYAN: ...for patients. Now of course we wouldn't...

JAMIE KLAYMAN: It could, right, we wouldn't keep it if it, if it's uncomfortable, and if it's bad, we stop it, and it couldn't actually work, so that's why we...

DAVID RYAN: Right. Most the time they aren't too toxic...

DAVID RYAN: Jamie's thinking about whether or not to try a clinical trial, in terms of trying to slow this pancreatic cancer down. The problem that's often felt between the doctor and the patient is that the primary objective of these studies is to find out whether or not they're tolerated, and to find the right dose, and the right schedule. It's a secondary objective to see if it works.

DAVID RYAN: Unfortunately, most of the time, Phase I studies, the responses that you see, you know, how effective they are...

JAMIE KLAYMAN: Right.

DAVID RYAN: ...pretty limited.

JAMIE KLAYMAN: Right.

DAVID RYAN: Um, it doesn't mean that we don't ever see great responses.

JAMIE KLAYMAN: Right.

DAVID RYAN: We don't ever see home runs.

JAMIE KLAYMAN: Yep.

DAVID RYAN: But they are pretty limited.

JAMIE KLAYMAN: Yeah.

DAVID RYAN: On the other hand, no good drug that we have today wasn't a Phase I study at some point. And so, what you're really doing is trying to see if you can latch onto that next great drug, um, but you have no idea whether the drug you're trying is, is gonna be that one.

DAVID RYAN: Alright, so you'll get these appointments and then we'll just go from there.

JAMIE KLAYMAN: Okay, great.

DAVID RYAN: If your dad wants to talk to me directly, it's fine; I know he's having a hard time.

JAMIE KLAYMAN: Okay...Yeah.

ABBYE WARREN: Yeah.

DAVID RYAN: Um...

JAMIE KLAYMAN: It's yeah, he, I mean he's - it's just har... You know, he's, it's hard for him to think that the fact that there's just nothing to - you know, nothing to do, is what he has the hardest time with. I... But...

DAVID RYAN: Well...

JAMIE KLAYMAN: I mean, you know, it's the way ...you can't always - you don't always get to hear what you want to hear, is unfortunately the way it goes.

DAVID RYAN: Right.

JAMIE KLAYMAN: I think the fact that I'm not going to win this struggle is hard enough for my dad to, you know, even think about, but then to kind of hear that the only option is a clinical trial, he just can't really come to terms with that; that there's not an infinite number of possibilities. So I think it's a hard thing for him to kind of - to come to terms with the fact that there are, are limited options, and I think that that's something that he's really struggling with.

*

JAMIE KLAYMAN: It's as almost like there's a pressure to survive, and it - it is almost like you feel that pressure of your letting people down just because your treatment isn't working.

NORMAN KLAYMAN: No, I have water.

JAMIE KLAYMAN: No, I've got it right here.

JAMIE KLAYMAN: I don't think people mean to put that pressure, but there is that mentality of, yes, you can fight this, or you can overcome this, or you can do this.

NORMAN KLAYMAN: The important thing here was to have you--before you made a decision, you know-- talk to another one.

JAMIE KLAYMAN: You see, I don't know, I think you and I get a different read on, on Dr. Ryan to begin with, but that's--we're allowed to disagree. I think that...

NORMAN KLAYMAN: Mmm, nah. Maybe I don't like his ties.

JAMIE KLAYMAN: You think Ryan's a showman?

NORMAN KLAYMAN: I think he is. I think he is.

JAMIE KLAYMAN: And what does he do that's showy?

NORMAN KLAYMAN: I think he is.

JAMIE KLAYMAN: I don't think he could be more low-key.

NORMAN KLAYMAN: Nah.

NORMAN KLAYMAN: The Comprehensive Cancer Center?

JAMIE KLAYMAN: Yeah, that's where we're going.

NORMAN KLAYMAN: That's where we're going.

JAMIE KLAYMAN: Yeah.

EDDIE KLAYMAN: So Jame, how'd the meeting go?

JAMIE KLAYMAN: It was good. The guy was, um...he had, you know, didn't have a ton to say, but I thought it...what'd you think?

NORMAN KLAYMAN: I thought he was, he was great.

NORMAN KLAYMAN: The impression I get with Ryan was that the liver is really bad, and yet this guy says, "It's not that bad."

JAMIE KLAYMAN: Yeah.

NORMAN KLAYMAN: "There's an awful lot left of it." Everything that he said was well thought out, well articulated...and I think, I think he's, he's, I think he's, he's a great guy.

EDDIE KLAYMAN: Okay so, he's got some good i -- he's, he's, he's a good speaker. Does he have, like..?

JAMIE KLAYMAN: He's got nothing different.... we were meeting with him for a while, he was looking at the scans...

NORMAN KLAYMAN: But he really had a command of pancreatic cancer. Everything that he said was positive.

EDDIE KLAYMAN: Yeah, but was it the same thing?

NORMAN KLAYMAN: What did he, what did, what did Ryan say on the first day we met him? What did he say to us?

EDDIE KLAYMAN: He said that he can't predict how long someone could, could live, some people live very long. Uh, it's a very aggressive type of a cancer.

NORMAN KLAYMAN: And what did he, what else did he say?

EDDIE KLAYMAN: He said we're gonna do the best job we can to try to treat you. That's what I remember, what do you remember?

NORMAN KLAYMAN: I remember him saying that she had like five months to two years.

JAMIE KLAYMAN: No, I don't remember saying that.

EDDIE KLAYMAN: He didn't, he didn't say that.

JAMIE KLAYMAN: That's what I said, I don't, no he didn't...

NORMAN KLAYMAN: Yes he did. Guaranteed. Ask Abbye, she'll remember it.

JAMIE KLAYMAN: I don't remember him giving any kind of time frames.

EDDIE KLAYMAN: He said "I can't tell you how long you could live."

JAMIE KLAYMAN: Yeah, he said...

EDDIE KLAYMAN: He said, "I have a patient, today, that has been living for ten years."

JAMIE KLAYMAN: Right, well no, it was four years, he said.

NORMAN KLAYMAN: No, yeah, four yea--, four, four years, four years.

JAMIE KLAYMAN: He didn't give any kind of time frame. Right.

EDDIE KLAYMAN: Who told you, you know, we'd be looking up at the daisies in sixty days? I don't, no one told us that.

NORMAN KLAYMAN: Oh, they did, of course they did, and no one ever told you anything different.

JAMIE KLAYMAN: No one ever told...

NORMAN KLAYMAN: No one ever told you anything different.

JAMIE KLAYMAN: Sure they did but no one...

EDDIE KLAYMAN: Yeah but that, that's your mind running, that's not, you know...

JAMIE KLAYMAN: No one's - no one's ever given us any kind of time frame.

NORMAN KLAYMAN: No. You're wrong, you're wrong.

JAMIE KLAYMAN: I think, I think you're wrong.

NORMAN KLAYMAN: You're wrong. When I go to the meetings he doesn't say a thing. I talked to Ryan the other night. Don't tell me, "Go to a meeting."

EDDIE KLAYMAN: You talked to him for like...

NORMAN KLAYMAN: I talked to him the other night for a half hour...

EDDIE KLAYMAN: Yeah?

NORMAN KLAYMAN: And I asked him ten questions and I never got one answer.

JAMIE KLAYMAN: Well what questions did you ask him?

NORMAN KLAYMAN: He always sk...

EDDIE KLAYMAN: What'd you ask him?

NORMAN KLAYMAN: It doesn't matter.

JAMIE KLAYMAN: It does matter.

NORMAN KLAYMAN: The answer is he doesn't get answers. I don't have to compare, I'm not gonna go over it with you, or, or, or anyone. Those are, I...questions I asked him...

JAMIE KLAYMAN: Well, what did...what did you ask?

NORMAN KLAYMAN: That are personal questions that I, questions about...

EDDIE KLAYMAN: Are they questions that, that, that can't be answered?

NORMAN KLAYMAN: Obviously, they weren't answered.

EDDIE KLAYMAN: Okay, well maybe they're questions that can't be answered...

NORMAN KLAYMAN: Because I got "I don't know...I don't...I don't know. I don't want to give you an opinion."

JAMIE KLAYMAN: Well, what did you? Well did you...

NORMAN KLAYMAN: Three times, "I don't want to give you an opinion."

JAMIE KLAYMAN: And what was that a ques...an answer to?

NORMAN KLAYMAN: It doesn't matter.

JAMIE KLAYMAN: It does matter. You're talking about me, so what were your questions about?

NORMAN KLAYMAN: No it doesn't matter, doesn't matter.

JAMIE KLAYMAN: Okay, I think we're done.

EDDIE KLAYMAN: Well, if you say, "How long will someone live?" they're gonna say "I don't know."

NORMAN KLAYMAN: No. That wasn't the question.

EDDIE KLAYMAN: Well, I'm just saying, if you ask that, you know...

JAMIE KLAYMAN: Okay. Alright, I think we're, I think we're done. I think we're done.

NORMAN KLAYMAN: Yeah.

JAMIE KLAYMAN: That was great.

JAMIE KLAYMAN: Cancer isn't a disease that fights fair. It doesn't care how strong you are, or what you look like, or how much money you have, or how dedicated you are; you could be the most upbeat, and the strongest person, and you know, unfortunately, if you have an aggressive cancer, there may be nothing you can do.

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