Because not all treatments work in all patients with non-Hodgkin's lymphoma, the search is always on for new, better treatments and for better ways of combining existing treatments. A treatment may prove to be better because it has more effect against the lymphoma or because it causes fewer or less dangerous side effects - or a combination of both.
Part of this ongoing search for better treatments involves clinical trials. If early research and experiments have suggested that a new treatment may be better than the current standard treatment, then a trial is conducted for the new treatment to be compared with the current treatment. The comparison with an existing treatment, whose effectiveness is already known, acts as a 'control' - hence the trial is a 'controlled trial'.
Usually, about half the patients in a controlled trial receive the standard treatment and about half receive the new treatment. So that the comparison can be truly objective, the decision over which treatment each individual patient in the trial is given is taken at random, usually by computer, and not by the doctor who is treating the patient or by the doctors who are running the trial. Hence the trial is a 'randomised trial'
Therefore, these clinical trials are often referred to as 'randomised controlled trials'. Such trials are the only way that new treatments for a condition such as non-Hodgkin's lymphoma can be scientifically verified as being effective and worthwhile treatments. Clinical trials are therefore very important for improving management of the condition, both for patients today and in the future.
All clinical trials will have been examined and approved by an ethics committee and will have met rigorous governmental and medical criteria. The new treatment that is being assessed will have been the subject of very careful research before it reaches the clinical trial stage. Because the trial is randomised, however, there can be no guarantee that any particular patient will receive the new treatment..
Any patient who takes part in a clinical trial must give informed consent. No one can be forced to take part in a trial or be put under pressure to do so. And, once in a trial, a patient can leave the trial at any time, without having to give any reason for this decision. A patient who chooses not to take part in a trial, or who leaves a trial, will still receive the best current standard treatment - it will not have any affect on the attitude of the doctor and other health professionals to the patient.
For patients who would like to find out more about clinical trials, local lymphoma support groups can often provide information on clinical trials in your country. For more information, see Finding support.
The table describes the types of clinical trial that can be performed to help in the search for new treatments