Overturning barriers will take heavy lifting

The great bulk of our knowledge relating to the appropriate therapy for cancer has come from well-conducted clinical trials. However, participants in clinical trials represent a relatively small proportion of the overall patient population with cancer, and this proportion is even smaller for elderly patients. In recent years there have been calls to attempt to increase the enrollment of elderly patients onto clinical trials. Reasons for failure to enroll such patients might include factors relating to the cancer treatment protocols themselves, such as eligibility requirements; excluding patients with comorbid conditions; patient-related issues, which might include logistic issues, as well as attitudinal issues; and physician-related issues, which may also include logistical and attitudinal components. The article by Dr Steiner and colleagues1 in this issue of th