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Clinical Trials FInder

Finding A Clinical Trial For You

Please answer ALL of the questions related to the patient's care. We will use this information to assist in finding a clinical trial suited to their needs. 

Please allow for 3-5 business days for us to search for the appropriate clinical trial information. 
1.What is the patient's full name ?
2.What is the name and email address of the person requesting the search?
3.What is the patient's phone number?
4.What province does the patient live in?
5.What is the patient's birth date?
6.What is the date of the patient's diagnosis?
Date
7.What is the distance that the patient is able to travel to participate in a clinical trial? 

NOTE:
-Keep in mind that clinical trials may require the patient to come in at least once a week. Each clinical trial is different. 
-Craig's Cause Pancreatic Cancer Society does have patient support grants to support travel to treatment.
8.Are you willing/able to travel to the US? If yes, is there preferential city or geographical area you would like to go?

NOTE:
Many American clinical trials have many locations with different contact information. This will allow us to give you the contact info that  best suits you.
9.Indicate if the patient is, ‘Interested in Phase I clinical trials’ or ‘Not interested in Phase I clinical trials.’

NOTE:
Phase I clinical trials test dosage and safety of the new treatment. These clinical trials are usually reserved for patients who have stopped responding to standard treatments.
10.What type of pancreatic cancer has the patient been diagnosed with?

NOTE:
Is it adenocarcinoma (the most common type of pancreatic cancer), neuroendocrine (islet cell carcinoma), or something else?
11.What is the patient's current stage of pancreatic cancer?
12.If the patient's pancreatic cancer has spread, which organs has it spread to?
13.Did the patient receive a surgical consult referral with a Hepato-Pancreato-Biliary (HPB) surgeon?
14.Did the patient attend a surgical consult with a Hepato-Pancreato-Biliary surgeon?
15.Did the patient receive a referral to a medical oncologist who specializes in pancreatic cancer treatment?
16.Did the patient attend a medical oncologist appointment, with a medical oncologist who specializes in pancreatic cancer?
17.List past and current treatments received and general time line/dates of treatment.

NOTE:
Include the names of all chemotherapy drugs, surgeries and other treatments received. If known, did your cancer progress on treatment?
18.Has the patient undergone molecular profiling (analysis to identify specific genetic mutations or biomarkers) of their tumor? If so, please provide information regarding the results.
19.Is the patient currently in treatment: Yes or No
20.Has the pancreatic cancer caused any other health concerns (i.e. jaundice, venous thrombosis)?
21.Was there any previous medical conditions prior to the cancer diagnoses?
22.Anything else you would like to add?
Current Progress,
0 of 22 answered