According to the Singapore Cancer Registry Annual Report, cancer remains one of the leading causes of death in Singapore, with thousands of new cases diagnosed each year. Research conducted through cancer clinical trials has been central to improving five-year survival rates across many cancer types treated locally. Behind every improvement in survival statistics is a patient who once stood at the same crossroads many newly diagnosed individuals face today, weighing currently proven treatments against the option to take part in research that could shape future care.
A cancer diagnosis often comes with difficult decisions. Alongside discussions about surgery, chemotherapy, radiation therapy, immunotherapy, or targeted therapy, some patients may also hear about the possibility of participating in a cancer clinical trial.
At NCCS, we support cancer clinical trials as part of our commitment to advancing cancer care and Singapore cancer research. Clinical trials have played an important role in many of the treatment advances available today, helping researchers better understand cancer and evaluate new approaches that may improve patient outcomes.
Despite their importance, many people remain uncertain about what participation involves. Some worry they will be treated as "guinea pigs", while others assume that clinical trials are only offered when standard treatments have stopped working. These misconceptions can prevent patients from exploring options that may be appropriate for their condition.
Understanding how a cancer clinical trial works, what potential benefits and risks exist, and what questions to ask your healthcare team can help you make a more informed decision.
Advances in cancer treatment have shifted significantly from what they were several decades ago. These advances did not happen overnight. They were made possible through years of research and clinical trials.
A cancer clinical trial is a research study involving human participants that aims to answer specific scientific and medical questions. Researchers may investigate whether a new treatment is safe, whether it works better than current therapies, or whether it can reduce side effects while maintaining effectiveness.
Clinical trials may focus on:
Every treatment currently considered as standard care was once evaluated through clinical research. Participation in clinical trials helps generate the evidence needed to improve care for future patients.
Many patients are hesitant about joining a clinical trial because of misconceptions that have persisted for years. Understanding the facts can help patients have more productive conversations with their healthcare team.
This is one of the most common concerns among patients.
Modern clinical trials operate under strict ethical guidelines and regulatory requirements. Before a study can begin, researchers must undergo extensive review processes designed to protect participants. Every trial follows a detailed protocol that outlines safety monitoring procedures, eligibility criteria, and participant protection.
Patients are also required to go through an informed consent process before joining a study. This ensures they understand the purpose of the research, potential benefits, possible risks, and alternative treatment options.
Many patients worry they will receive a placebo instead of active treatment.
In cancer research, placebo-only treatment is generally uncommon when effective standard treatments already exist. Instead, researchers may compare a new treatment against the current standard of care, or add a new therapy to existing treatment approaches.
The exact study design varies, which is why discussing the details of a specific trial with your healthcare team is important.
While some studies focus on patients with advanced or recurrent cancers, many clinical trials involve patients at earlier stages of disease.
Some trials investigate:
Clinical trials can therefore be relevant at various points along a patient's cancer journey.
Understanding the safeguards in place may help reassure patients considering participation.
Clinical trials in Singapore are conducted under a framework designed to ensure participant safety, scientific integrity, and ethical conduct. Studies are subject to regulatory requirements and independent review processes before participants can be enrolled.
Several layers of checks and evaluation may be involved, including ethical review boards, institutional review committees, and regulatory authorities.
The purpose of these safeguards is to ensure:
Patients should feel comfortable asking their healthcare team how a specific trial is monitored and what safety measures are in place.
For many patients, one of the biggest uncertainties is understanding what participation involves. While every study is different, most follow a similar process.
| Stage | What Happens |
|---|---|
| Initial Discussion | Your oncologist discusses whether a study may be suitable for your condition. |
| Eligibility Screening | Tests and assessments determine whether you meet study criteria. |
| Informed Consent | Researchers explain the study, risks, benefits, and participant rights. |
| Baseline Assessments | Medical evaluations establish your condition before treatment begins. |
| Treatment Phase | You receive the study treatment according to the protocol. |
| Monitoring and Follow-Up | Researchers monitor treatment response, side effects, and outcomes. |
Not everyone will qualify for every study.
Researchers use eligibility criteria to ensure patient safety and improve the reliability of study results. Criteria may include:
These requirements help researchers answer scientific questions accurately while protecting participants.
Patients should have the opportunity to review study information carefully, discuss concerns with family members, and ask questions before making a decision and giving consent to participate in any clinical trial.
Participation is entirely voluntary.
Patients enrolled in clinical trials are typically monitored closely throughout the study.
This may involve:
Monitoring helps researchers assess effectiveness while identifying and managing potential side effects.
When discussing a cancer clinical trial, it is important to understand that every study is different. The potential benefits depend on factors such as the type of cancer, the treatment being investigated, the trial phase, and an individual's overall health.
While participation cannot guarantee a better outcome, some patients may find that joining a clinical trial aligns with their treatment goals and personal preferences.
One of the most recognised benefits of clinical trial participation is the opportunity to access treatments that are not yet widely available.
Researchers continue to investigate innovative approaches to cancer care, including:
For some patients, these therapies may represent additional treatment options beyond current standards of care. However, because these treatments are still being studied, their effectiveness may not yet be fully understood.
Many patients are motivated by the opportunity to help future generations of cancer patients.
Every advance in cancer treatment has been made possible because individuals chose to join clinical trials regulated by the Health Sciences Authority. By contributing data and experiences, participants help researchers answer important questions that may influence future standards of care.
Cancer research continues to evolve rapidly, particularly in areas such as genomics, precision oncology, and immunotherapy.
Participation in clinical trials helps strengthen Singapore cancer research efforts by providing valuable information that may improve the understanding, diagnosis, and treatment of cancer in local and regional populations.
While there are potential benefits, patients should also understand the possible challenges associated with participation.
A balanced discussion with the healthcare team is essential before making a decision.
One of the most important aspects of clinical research is uncertainty.
Researchers conduct clinical trials because they do not yet know whether a new treatment will be more effective than existing options. Some investigational therapies may ultimately prove beneficial, while others may not provide additional advantages.
Patients should therefore avoid viewing clinical trials as guaranteed access to superior treatment.
Although clinical trials undergo extensive review before they begin, new treatments may still have side effects that researchers are continuing to evaluate.
Some side effects may be expected based on earlier studies, while others may emerge as more patients receive the treatment.
This is why ongoing monitoring is a critical component of every study.
Clinical trial participation often requires more frequent visits compared to routine care.
Patients may need to attend additional appointments for:
For some individuals, these requirements may affect work schedules, family responsibilities, or travel arrangements.
Meeting initial eligibility criteria does not always mean a patient will ultimately participate in a study.
Researchers may need to consider multiple factors before confirming enrolment, including:
Patients should understand that screening is designed to protect the safety of participants and ensure accurate research results.
The decision to participate should be based on individual circumstances, treatment goals, and discussions with the healthcare team.
The following table highlights situations where a clinical trial may be considered.
| Situation | Why a Clinical Trial May Be Considered |
|---|---|
| Newly diagnosed cancer | Researchers may be evaluating new first-line treatment approaches. |
| Cancer has returned after treatment | Additional treatment options may be available through research studies. |
| Rare cancers | Clinical trials may provide access to specialised therapies being investigated. |
| Limited standard treatment options | Research studies may offer alternative approaches under evaluation. |
| Interest in advancing medical knowledge | Participation contributes to future improvements in cancer care. |
It is important to remember that participation is a personal decision. What may be appropriate for one patient may not be suitable for another.
Before making a decision, patients should feel comfortable asking detailed questions about the study.
Understanding the purpose, expectations, and potential implications of participation can help ensure that the decision is well informed.
Consider discussing the following questions with your doctor:
Understanding why a particular study may be suitable can help patients appreciate how the trial relates to their diagnosis and treatment goals.
Patients should ask about both the potential advantages and limitations of participation.
A balanced discussion helps set realistic expectations.
Clinical trials are often one of several options available.
Patients should understand how participation compares with standard treatment approaches.
Patients may wish to ask about:
Participation in clinical research is voluntary.
Patients have the right to withdraw from a study at any time, although researchers may discuss the safest way to discontinue participation if treatment has already begun.
Cancer research is increasingly focused on delivering more personalised and effective care.
Researchers today are not only studying whether treatments work, but also why they work for some patients and not others. Advances in molecular biology, genetics, and precision medicine are helping scientists better understand the complex nature of cancer.
Clinical trials are a critical component of this progress.
Through Singapore cancer research initiatives, researchers continue to investigate:
Research conducted in Asian populations is particularly valuable because genetic, environmental, and lifestyle factors may differ from those observed in Western populations.
By participating in clinical trials, patients contribute to knowledge that may help researchers develop more effective and personalised treatment strategies for future generations.
Many patients worry about losing control after enrolling in a clinical trial. In reality, patient rights remain central throughout the research process.
Participants have the right to:
The informed consent process exists to support these rights and ensure that patients understand what participation involves before making a decision.
Protecting patient welfare remains a fundamental principle of clinical research.
Joining a cancer clinical trial is a personal decision that should be based on careful consideration of the potential benefits, risks, and commitments involved. While clinical trials have contributed to many of the advances seen in modern cancer treatment, participation may not be the right choice for everyone.
The most important step is having an open discussion with your healthcare team. Understanding the purpose of the study, available alternatives, expected commitments, and potential outcomes can help you make a decision that aligns with your goals and preferences.
At NCCS, we are committed to advancing cancer care through research, innovation, and patient-centred care. Through our involvement in cancer clinical trials and Singapore cancer research, we continue to support efforts that improve treatment options and deepen our understanding of cancer. If you would like to learn more about available clinical trials in Singapore, speak with your oncologist or contact our team for further information.