Clinical trials are often understood through fragments, brief mentions during consultations, second-hand accounts, or assumptions formed over time. For many patients and caregivers, what they know is shaped less by direct explanation and more by what they have heard along the way. By the time clinical trials enter the conversation more clearly, treatment options may already be narrowing, and decisions feel more urgent
Yet clinical trials aren’t a last step in care. They are part of how modern medicine is developed and, in some cases, accessed. Across Asia, this pathway remains under-discussed and often misunderstood.
What a clinical trial actually is
A clinical trial is a controlled study designed to answer a clear question: is this treatment safe, and how does it compare with what’s already available? Before any human involvement, treatments undergo years of laboratory and preclinical testing. Only when sufficient evidence is established do trials move into human studies, progressing through defined phases that build evidence step by step.
- Phase 1: Safety and dosage
- Phase 2: Effectiveness in a specific condition
- Phase 3: Comparison against current standard treatments
- Phase 4: Ongoing monitoring after approval
This progression is deliberate. Each phase reduces uncertainty step by step, so by the time a treatment reaches wider use, clinicians already understand how it behaves in real patients.
Why clinical trials matter more than most people realise
Every treatment in use today exists because people took part in clinical trials. Beyond advancing science, these trials also shape individual care pathways. For someone managing a long-term condition, or navigating a treatment that’s no longer delivering expected results, a clinical trial can offer access to emerging therapies, closer monitoring and an additional option within the broader care plan. Clinical trials can be considered alongside standard treatment rather than after it.
Patients choose to participate in clinical trials for several reasons. According to Dr Khoo, a Medical Oncologist, many are motivated by the opportunity to access new treatments that aren’t yet widely available, particularly when standard therapies have limited effectiveness. Others take part because they want to contribute to medical research and help future patients benefit from improved treatments.
He adds that even for patients who feel well or are already undergoing treatment, it may still be worth considering a clinical trial. Some studies offer access to innovative therapies, new drug combinations, or refined treatment strategies that could potentially lead to better outcomes. In certain cases, trials are designed to determine whether a new approach may be more effective or better tolerated than current standard care.
Importantly, patients enrolled in clinical trials are typically closely monitored by a dedicated research team, providing an additional layer of medical oversight throughout the process.
However, deciding whether to participate requires a clear and realistic understanding of what’s involved. Participation often represents a choice between the current “gold standard” of care and an investigational approach that may or may not offer additional benefit. Patients should take the time to understand what’s already known about the experimental treatment, alongside the uncertainties and potential risks involved.
Practical considerations also matter. Clinical trials usually require closer monitoring, including more frequent reviews, blood tests, and radiological examinations. These demands can affect time, travel, and daily routines, making it important to weigh the potential benefits against both medical and personal realities.
The reality of participation
Clinical trials are often associated with uncertainty, and a common concern is straightforward: what if something goes wrong? For many patients and families, the concern also extends to whether participation will disrupt existing care or introduce uncertainty into an already difficult situation, especially when stability is already hard to maintain.
Trials are designed to manage uncertainty in a controlled and transparent way. Before enrolment, participants go through an informed consent process that outlines the purpose of the study, what participation involves, potential risks and available alternatives.
Participation remains voluntary, and individuals can withdraw at any time. What participation involves depends on the study, but it typically includes scheduled clinic visits, additional assessments and a clearly defined treatment protocol. In some studies, participants may receive standard treatment for comparison. Outcomes are measured carefully within a structured system, allowing clinicians to understand both benefits and risks in real patients. In many cases, patients return to standard care after a trial ends, although some studies include follow-up access to treatment or continued monitoring.
Patients often have concerns or misconceptions about clinical trials, and as Dr Khoo explains, one of the most common is the belief that participants are treated as “guinea pigs.” In reality, clinical trials follow strict ethical and regulatory standards to ensure patient safety, with every study reviewed and approved by regulatory authorities and ethics committees before it begins.
Another frequent concern is the possibility of receiving no treatment or only a placebo. In oncology trials, patients almost always receive either the current standard treatment or the new treatment being studied, and placebos are rarely used on their own when an effective therapy already exists.
Patients may also worry about unknown side effects or additional burdens, such as more frequent hospital visits. These concerns are typically addressed by explaining how safety monitoring is carried out, how side effects are managed, and what additional commitments participation may involve.
Addressing these concerns is only one part of the process. Helping patients weigh them against potential benefits requires more than presenting clinical data. Dr Khoo shares that he often takes on the role of both a scientific investigator and a compassionate advisor, guiding patients through the decision-making process by explaining what the trial is studying and how it may benefit the patient or contribute to medical progress, while discussing the impact participation may have on lifestyle, logistics, and finances.
The aim is to move beyond technical details and support patients in aligning the trial’s requirements with their personal values and quality-of-life priorities, so the decision feels informed, realistic, and appropriate for their individual circumstances.
Why awareness remains low
Many patients never hear about clinical trials during routine care. Consultations are often time-limited, with focus placed on immediate treatment decisions. Trial availability varies across institutions and isn’t always visible across healthcare systems, while information remains fragmented and difficult to interpret. Language and health literacy barriers further limit access.
In practice, many patients aren’t told about clinical trials not because they’re unsuitable, but because the system isn’t designed to surface them early. Clinical trials exist within the system, but not always within the patient’s line of sight. This gap reflects how healthcare systems prioritise time, information and pathways, often leaving clinical trials outside early decision-making conversations.
Who can take part and when it comes relevant
Clinical trials aren’t limited to severe or late-stage illness. Depending on the study, participants may include individuals with a diagnosed condition, those at higher risk of developing one and, in some cases, healthy volunteers. Each trial has defined eligibility criteria based on factors such as age, medical history, current treatment and disease stage. Eligibility is assessed by the study team based on specific criteria designed to ensure safety and produce reliable results.
Clinical trials become relevant at specific points in care. This may arise when treatment outcomes aren’t meeting expectations, when side effects affect long-term management, when a condition progresses despite care, or when reviewing options at the point of diagnosis. These are often the same moments when patients begin asking whether there are alternatives that haven’t yet been discussed.
Patients are guided through the decision-making process for joining a clinical trial with a strong emphasis on helping them make informed and comfortable choices. In Parkway Cancer Centre, when a patient is identified as potentially eligible, the clinical team explains the purpose of the study, the treatment involved, possible benefits, potential risks, and alternative treatment options in a clear and structured way.
Research coordinators and nurses play a key role in this process by offering additional explanations, educational materials, and practical support, helping patients understand what participation may involve on a day-to-day level.
Importantly, participation in a clinical trial is entirely voluntary. Patients are reassured that choosing not to participate will not affect the quality of care they receive, and that they can withdraw at any point if they decide it’s no longer right for them.
How to explore clinical trials
The process can feel complex, but it often starts with clear entry points. A primary care doctor or specialist can assess whether a clinical trial is relevant to your condition and stage of care, and in many cases, the first conversation begins in primary care where long-term decisions are first discussed. Verified registries provide searchable listings, including national health authority platforms, hospital systems and international databases.
In Singapore and across APAC, most clinical trials are conducted through public hospitals, specialist centres such as cancer or heart institutes, and university-affiliated research units. These centres have dedicated research teams who guide patients through eligibility and enrolment. Most clinical trials cover the cost of the study treatment and related assessments, although standard care costs or other expenses may still apply depending on the study. Understanding eligibility criteria early helps determine suitability, while asking practical questions ensures that participation aligns with personal and medical priorities.
Patients are typically introduced to a clinical trial through a structured process that begins when the treating oncologist identifies potential eligibility based on factors such as the type of cancer, stage of disease, prior treatments, and overall health.
If a suitable trial is available, the doctor will explain the study and why it may be relevant to the patient’s situation. The patient is then given a patient information sheet and consent form, outlining the study’s objectives, procedures, potential benefits, risks, and their rights.
A research nurse or clinical trial coordinator usually spends additional time reviewing these details, answering questions, and ensuring the patient understands what participation would involve in practice.
Patients are encouraged to take time to consider their options, discuss with family members, and return with any further questions. Only when they feel fully informed and comfortable are they asked to sign the consent form, if they decide to proceed.
A common perception is that clinical trials are a “last resort,” introduced only when no other options remain. In current oncology practice, however, they’re increasingly regarded as a high-quality care option that can be integrated at different points in the treatment journey, depending on the patient’s diagnosis and the scientific goals of the study.
Rather than being reserved for later stages, trials may be introduced at key transition points in care. This makes it important for clinicians to stay up to date with developments in the field and ongoing studies within their centre, so that appropriate trials can be offered at the right time for each patient.
How to start the conversation with your doctor
For many patients, the main barrier lies in not knowing how to ask. Clinical trials may not always be introduced proactively, as timing and clinical judgement influence when they’re discussed. Opening the conversation can be straightforward and helps clarify available options.
A discussion about clinical trials doesn’t need to be complicated. It’s part of understanding your overall care plan. In some cases, your doctor may explain that a trial isn’t suitable at this stage. In others, they may outline options you weren’t previously aware of, or refer you to a centre that is running relevant studies. These conversations can be brief, but they may shape what options are considered next.
“Are there any clinical trials relevant to my condition at this stage?”
“At what point would a trial become appropriate for me?”
“Would you recommend considering one now, or monitoring first?”
“Are there centres or specialists I should speak to about this?”
If a clinical trial is mentioned, it’s reasonable to ask how it compares with your current treatment, what the practical commitments are, and what the next steps would look like. This allows the discussion to remain grounded in your care priorities rather than feeling like a separate or unfamiliar pathway.
Building trust with patients who may feel unsure or hesitant about clinical trials begins with open and honest communication. As Dr Khoo explains, it’s important that patients understand their wellbeing is always the top priority, and that clinical trials are conducted under strict ethical guidelines designed to protect participants.
He emphasises that participation is entirely voluntary. Patients are encouraged to ask questions at any time and can withdraw from the trial without affecting their standard medical care.
The team also takes time to listen to patients’ concerns, explain the study in clear and transparent terms, and provide reassurance about safety monitoring, follow-up care, and ongoing support throughout the trial.
By creating an environment where patients feel informed, respected, and supported, they’re better able to make a decision that’s right for them.
Clinical trials shape the treatments in use today and remain one of the options within modern healthcare. What matters is whether they’re considered early enough, while options are still open and decisions aren’t yet constrained. For some, they may not be relevant. For others, they may offer options that aren’t routinely discussed. Rasing that question earlier can change what options remain.
Dr Khoo Kei Siong
Deputy Medical Director & Senior Consultant, Medical Oncology
Parkway Cancer Centre, Singapore
Instagram: @parkwaycancercentre_pcc
This article was produced by Healthful For You. The views and opinions expressed throughout are those of the authors and do not necessarily reflect those of the Expert Contributor. The Expert Contributor has provided input solely for the EXPERT INSIGHT and TIP segments, based on their professional expertise. These comments are intended to offer general guidance and may not apply to all individuals. Any interpretations or conclusions beyond that section are those of Healthful For You. This article is not a substitute for personalised medical advice, diagnosis, or treatment. Please consult your doctor or a healthcare professional regarding your specific health needs.
We hope you found this article informative. Healthful For You welcomes contributions from healthcare professionals, patients, and community members. If you have a story, research, or a perspective that can enrich our dialogue, please get in touch with us at [email protected].