An Oncology Nurse Who Learns From Patients in Clinical Trials

When Margaret Campbell, B.S.N., RN, first came to Dana-Farber Cancer Institute in Boston in 2003, she’d never heard the term “research nurse.” But after working in the inpatient sphere, including surgery, the emergency department and the intensive-care unit, and as a visiting nurse for years, she began searching for something different.

“I still loved patient contact and wanted to stay in the health care field,” she says. “I didn’t want to go into management or anything that would take me out of a clinical setting.”

Read more: Margaret Campbell, B.S.N, RN, Wins CURE®’s 2022 Extraordinary Healer® Award

As it happened, a colleague at Dana-Farber explained what a research nurse was and what the job entailed. Campbell was intrigued. The position would allow her to remain in the clinical setting while continuing to work with patients, even as she learned something completely new to her.

At the time, Boston College was offering a program to earn a certificate as a clinical research associate, so she enrolled and started down the path she’s followed ever since.

“Nothing prepared me for what the job was until I got here,” Campbell says. “My position is working with the breast oncology disease group. We see patients who are interested in participating in clinical trials. The job requires symptom management of side effects and overseeing patients while they’re in the trials. When we first meet a patient, we explain the trial to them: what’s involved, what they need to do with the screening part in order to get into the trial, investigational drugs involved in the trial and how it may or may not benefit them.”

Campbell sometimes has to deal with misconceptions when she suggests a patient consider entering a trial.

“Some patients say they don’t want to be guinea pigs,” Campbell says, “so I explain to them that it’s actually an opportunity to explore a drug they wouldn’t otherwise be able to get.”

Being deeply involved in every stage of a clinical trial allows Campbell to communicate to her patients exactly what the trial will entail, what the side effects will be, how long the trial will last and other information that can help make a decision.

“We sit in during on-site initiations when a trial is being activated and learn all about it,” Campbell says. “We’re actually the gatekeepers of the trial.”

In that role, she and other research nurses work closely with the trial’s sponsors — usually pharmaceutical companies, academic groups or single-physician principal researchers — and provide input into the study, along with the clinical research coordinators and the trial’s monitors.

Selection criteria differs with each trial, and part of Campbell’s job is to research all the eligibility requirements to determine if a patient is a good match. Many patients learn about currently available clinical trials from the website clinicaltrials.gov. Candidates arrive from all over the country, in all stages of progression.

“You’ll typically see patients with more aggressive cancers, but also those in earlier stages who want to try a new drug,” Campbell says. “They’re very smart and savvy and have done extensive research on the new treatments available, so they have lots of questions when they come in.”

Patients with breast cancer have access to a large array of new types of treatment.

“Traditionally, all we had was chemotherapy,” Campbell says, “which just kills fast-dividing cells, so it’s not as selective as newer therapies. Now we can identify different mutations and track them, which we couldn’t do back 10, 15 years ago. There’s a lot going on with targeted therapy, immunotherapy and conjugated therapy, where a vehicle actually brings a drug directly to its target. We’re able to fine-tune therapy to attack a particular cancer’s characteristics.”

Of course, there are still side effects with the newer therapies, and they can be unpredict- able. Often a drug that has worked for a long time for a patient will suddenly stop working, and a new one must be tried. And as with most of us, COVID-19 has had a negative impact on Campbell’s job. But through it all, her patients continue to inspire her.

“It’s affected everyone,” says Campbell. “It’s hard because patients’ treatments are keeping them alive, so you have to find a way to continue to treat. It has really elevated their anxiety, and we certainly don’t want their treatment to be interrupted, especially for those with metastatic cancer. Even missing a couple weeks could be very detrimental to the patient. Depending on their type of cancer, it could start growing again. So it’s been difficult, just the extra steps of masking, going through screening and so on.”

But through it all, says Campbell, her patients continue to inspire her.

“Some of my patients have children, families and careers and should be enjoying their lives doing things that young people do. Instead, they’re faced with this horrific disease. Yet they’re still taking care of their children and doing what they need to do in their lives, not without overcoming many difficult challenges,” Campbell says. “I learn from many of my patients, and their journeys remind and inspire me to recognize what is truly important in life.’”

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