Jenni Scarlet is a research nurse and clinical trial coordinator at Waikato Hospital in Auckland, New Zealand. Her role involves coordinating clinical trials from their setup stage, obtaining ethics approvals, enrolling and following up patients, and the reporting and analysis of trial information.
During her career of more than 25 years, she has seen vast improvements to patient care and outcomes due to Breast Cancer Trials research. We spoke to Jenny about her experiences in cancer care and why she supports Breast Cancer Trials.
“I’ve specialized in breast cancer clinical trials for the past 25 years, initially part time going to full time. And I’ve been involved in coordinating a range of clinical trials right from surgical to radiotherapy trials, to a variety of drug treatment trials.”
“I’ve also been involved in clinical trials for the prevention of breast cancer, treatment of early and advanced breast cancer, and also trials for reducing side effects, improving quality of life, and also improving communication.”
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During her career of more than 25 years, she has seen vast improvements to patient care and outcomes due to Breast Cancer Trials research. We spoke to Jenny about her experiences in cancer care and why she supports Breast Cancer Trials.
What are some common fears that you hear from breast cancer patients?
“So, sometimes patients can worry about potential side effects, particularly if it’s a drug trial. So, part of our role is to educate women about potential side effects and talk about ways of alleviating side effects and managing side effects.”
“Women also often worry about their breast cancer coming back, and so it’s ensuring that they continue having breast cancer follow up through mammograms and through appointments with their doctor over a long period of time.”
“Sometimes there’s a lot of other worries in relation to breast cancer side effects and their ability to carry out their ordinary activities of daily life. Caring for children, for example, or being able to work, and so it’s supporting women through their other worries about life in general, and sometimes referring women on to other support staff like psychologists.”
“So, over the 25 years of my involvement coordinating clinical trials, I’ve been involved in the introduction of modern-day endocrine treatments, for example, the aromatase inhibitors. So I was involved in coordinating the original ATTACK trial, introducing an anastrozole. And the intergroup exemestane study with exemestane, and the BIG 1-98 trial introducing letrozole, and later on, we were a site for the SOFT, the suppression of ovarian function trial, introducing ovarian function suppression to premenopausal women and using exemestane.”
“So, with more effective what we call endocrine therapies or hormonal treatments, this has extended the lives of women. Waikato Hospital was also a site for ALTO, and the ALTO and Affinity Trials introduced other anti-HER2 drug treatments. So HER2-positive breast cancer is a more aggressive breast cancer, and better anti-HER2 drugs have, again, extended lives over time.”
“And over the past 20 years, we’ve been introducing sentinel node biopsy to breast cancer surgery. This has been compared with the standard surgery of axillary node dissection, and it’s de-escalating axillary surgery to reduce side effects of surgery.”
“I coordinated the International Breast Cancer Intervention Study, Tamoxifen Prevention Trial. It’s something that I related to with a family history of breast cancer and was very keen to give other women with a family history of breast cancer the opportunity to take part in a prevention trial. Often for these women, the options for managing their risk are regular screening, and some women opt for preventative surgery, which is radical and takes a lot of thought and discussion to make that decision.”
“So, I was keen to make the IBIS-1 trial available to women in our area, so that medical prevention was another option for managing risk.”
“So, if women do have better outcomes as part of participating in a clinical trial that’s very satisfying for my colleagues and I, that’s what we want. We want to improve outcomes for women with a diagnosis of breast cancer. We want her to go on and live her best life.”
Is it a difficult thing to see as a Nurse, when there isn’t a treatment for a patient?
“Yes, particularly for advanced breast cancer patients. While some woman’s disease can be controlled for quite a number of years with modern drug treatments, often there is a point where a woman’s advanced breast cancer does progress. We are able to switch treatment with more options these days and continue to extend that woman’s life and allow her more time with her family, but as she deteriorates and heads into the palliative and eventually the end stage of her life, that’s very sad for us staff journeying alongside her, with her treatment.”
“For me personally, it’s an inspiration and a motivation to keep being involved in clinical trials to find better drugs for women living with advanced breast cancer.”
“Without clinical trials research, and other research, we would never be able to improve on what we currently do in terms of care and treatment of patients with breast cancer. It’s important for the future that we continue researching to find better treatments, and that we continue to find drugs that have fewer side effects in terms of quality of life, and eventually, one day, find a cure for all breast cancers and ideally prevent all breast cancers, if that’s ever possible.”
Are there opportunities for patients in New Zealand to participate in clinical trials?
“So most centers in New Zealand, including oncology centers, such as, Dunedin Hospital, Christchurch, Wellington, Palmerston North, Waikato, Auckland, North Shore and Whangarei hospitals, all participate in different clinical trials.”
“So, if a patient is interested in taking part in a clinical trial it’s a good idea if they ask their treating surgeon or treating oncologist if there is a clinical trial available for their situation.”
“Often the doctor who offers a clinical trial is somebody who’s wanting to improve care of their patients, and knowledge gained through clinical trials research today is then used for future generations.”
What are your hopes for the future?
“My hopes for the future of breast cancer research would be to find a cure for all cancers and to have drugs with no side effects. And to one day eventually prevent breast cancer.”
