A new project is hoping to tackle a long-standing health inequity by opening up access to more clinical trials in rural and regional communities.
For some patients, a clinical trial can be the best chance for improved health, but most take place in metropolitan settings in large hospitals.
Stephen Wadey, 34, was diagnosed with melanoma seven years ago. After surgery to remove the cancer, he decided to join a clinical trial.
"I didn't really like the idea of just sitting around and waiting to see if it would come back or not," he said.
"Once we spoke with the oncologist about other options he mentioned that though there's no tablet or drug we can just give you to eradicate the cancer, we have these things called trials."
The trial he was a part of helped prove the immunotherapy worked well for many people, and it's now used in clinical settings.
'Major challenge for regional people'
Although his cancer has returned several times, Stephen Wadey is confident the trial helped fight it in each instance.
And while he's grateful to have participated in the trial, it took a toll on him and his young family.
They live in East Gippsland, Victoria — 270 kilometres from the hospital offering the treatment, so the commitment included seven years of many road trips backwards and forwards to Melbourne.
"To go there for routine scans, follow up appointments, surgery, treatments sometimes weekly, sometimes fortnightly … it was a lot of backwards and forwards, which means a lot of time off work," he said.
"You've just been diagnosed with a terrible illness and to have to face the challenges of travel and costs and time off work … it represents a major challenge for regional people."
The father of one is an advocate for opening up access to clinical trials and the work of the TrialHub project.
The project has partnered the Alfred Hospital in Melbourne with rural and regional hospitals to improve their clinical trial offerings and set up new trials.
It's a federally funded pilot that, if successful, will expand to other states and territories.
The initial stages of the project focused on getting the infrastructure right, and recently it started to recruit patients to trials.
There are now 165 patients in trials for melanoma, prostate cancer and rare cancers.
"We know people in regional and rural areas have poorer outcomes than people in metropolitan health services," Anne Woollett, the director of the project, told ABC's current affairs program PM.
"So, we really need to look at why … and a lot of the time it's because people can't access the same level of treatment."
Making life-saving therapies accessible
While the best hopes for outcomes from the treatments in clinical trials don't always pan out, many life-saving therapies have been found this way.
"Many years ago people with testicular cancer, for example, had very poor outcomes, but as result of trials now there are very high cure rates for testicular cancer," Dr Woollett said.
"And there's a number of cancers that now have similar statistics and that's the result of clinical trials that have been conducted in the past, providing the evidence to guide care now into the future."
Bendigo Health is one of the health services that's involved.
While prior to the project they were already running trials, Robert Blum, the clinical director of cancer services, said they've been able to improve what they can offer.
"Some of these patients already travel an hour and a half or two hours to get to this site. The travel to Melbourne for a clinical study is so great they just decide they can't do it," Dr Blum said.
"These people will sometimes be working, will have farms to run. At the end of the day it becomes so onerous they just decide I'm not going to do it.
"Not only are clinical trials important, it's important to make them accessible to everyone and historically people in regional and rural areas have been at a disadvantage."
There are 150,000 Australians that will be newly diagnosed with cancer each year.
Dr Blum wants to see those in rural and regional communities eligible and wishing to be in a trial, to have equal access.
"Our ideal goal is to develop our regional cancer centre research units to the point that patients will have the same opportunities they might have if they lived in metropolitan city," he said.
