Many patients assume that if a clinical trial is a good option, their doctor will automatically mention it. In reality, the process of how doctors decide whether to recommend a clinical trial is far more complex and in many cases, trials are never discussed at all.
This gap leaves thousands of eligible patients in Canada unaware of potential treatment options that could be relevant to their condition. Understanding why this happens can help patients, caregivers, and families make more informed decisions and take a more active role in their care.
This guide explains:
- How physicians evaluate clinical trials
- Why trials are often not recommended
- What patients can do when clinical trials are never mentioned
How Doctors Evaluate Clinical Trials
When deciding whether to recommend a clinical trial, doctors must balance medical evidence, patient safety, logistics, and ethical responsibility. The decision is rarely simple.
1. Standard of Care Comes First
Physicians are trained to follow established clinical guidelines. If an approved treatment with proven outcomes exists, it will almost always be recommended before a trial. Clinical trials are typically considered when:
- Standard treatments have failed
- No approved therapy exists
- The trial offers a meaningful scientific rationale
This explains why early-stage patients may never hear about trials even when trials are actively recruiting.
2. Eligibility Is Often Unclear
Clinical trials have strict inclusion and exclusion criteria, including:
- Cancer subtype or disease stage
- Prior treatments
- Age limits
- Organ function and lab values
Doctors may avoid discussing trials unless they are confident a patient qualifies. Reviewing eligibility takes time, and many physicians simply don’t have access to up-to-date trial matching tools.
You can learn more about eligibility requirements in this guide:
👉 https://horizonnt.ca/articles/are-clinical-trials-right-for-you-separating-fact-from-fiction/
3. Limited Awareness of Available Trials
Most doctors are not aware of every trial recruiting in Canada, especially outside major academic hospitals. Trials change frequently, open and close quickly, and vary by location.
Unless a doctor is directly involved in research, they may only know about:
- Trials at their own institution
- Trials sponsored by partners they already work with
This is a major reason eligible patients are missed.
Why Doctors Often Don’t Recommend Clinical Trials
Even when a trial could be appropriate, it may never be mentioned. Here’s why.
4. Time Constraints in Clinical Practice
Clinical appointments are short. Discussing a trial requires:
- Explaining risks and benefits
- Addressing patient fears
- Reviewing consent and logistics
Many doctors prioritize immediate treatment decisions over longer trial discussions especially when the patient is newly diagnosed or emotionally overwhelmed.
5. Concern About Patient Anxiety
Doctors often worry that introducing clinical trials may:
- Increase fear or confusion
- Be interpreted as “no other options left”
- Overwhelm patients already processing complex information
This protective instinct can unintentionally limit patient awareness.
6. Misconceptions Still Exist, Even Among Professionals
Despite advances in research ethics, some clinicians still associate trials with:
- Higher risk
- Experimental uncertainty
- Burdensome follow-up
In reality, Canadian clinical trials are tightly regulated by Health Canada and ethics boards, with strong patient protections in place.
For a deeper look at common myths, see:
👉 https://horizonnt.ca/articles/top-myths-about-clinical-trials-in-canada-debunked/
7. Lack of Direct Referral Pathways
Even if a doctor believes a trial could help, they may not know:
- Who to contact
- How to refer a patient
- Whether the trial is still recruiting
Without a clear pathway, the conversation often stops before it starts.
When a Doctor Is More Likely to Suggest a Trial
Doctors are more likely to recommend a clinical trial when:
- Standard treatments have been exhausted
- The patient asks directly about trials
- The doctor is part of a research institution
- The trial aligns closely with the patient’s condition
- Recruitment support is available
This highlights the importance of patient advocacy and external trial discovery tools.
What Patients Can Do If Trials Aren’t Mentioned
If your doctor hasn’t discussed clinical trials, it doesn’t mean you’re not eligible or that trials aren’t appropriate.
Ask Direct, Informed Questions
Consider asking:
- “Are there any clinical trials relevant to my condition?”
- “Would I qualify for any trials right now or later?”
- “If not here, where else could I look?”
These questions signal engagement without challenging medical authority.
Seek Independent Trial Matching Support
Platforms like Horizon Trials help patients:
- Discover relevant clinical trials in Canada
- Understand eligibility in plain language
- Navigate next steps without pressure
This complements not replaces your doctor’s care.
You may also find this helpful:
👉 https://horizonnt.ca/articles/how-to-find-the-right-clinical-trials-for-you/
How Horizon Trials Helps Bridge the Gap
Horizon Trials was built to address the exact gap between patients and clinical research.
What Horizon Trials Does Differently
- Focuses on patient-first education, not just listings
- Helps patients understand why a trial may or may not fit
- Supports informed conversations between patients and doctors
- Improves trial awareness beyond hospital networks
By empowering patients with knowledge, Horizon Trials makes clinical trial discussions more productive and less intimidating for everyone involved.
You can learn how patient recruitment is evolving here:
External Authoritative Resources
- Health Canada – Clinical Trials Overview https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/applications-submissions/clinical-trials.html
- Canadian Institutes of Health Research (CIHR) – Clinical Research Ethics https://cihr-irsc.gc.ca/e/193.html
- ClinicalTrials.gov – Understanding Clinical Trials https://clinicaltrials.gov/ct2/about-studies
Key Takeaway
- Doctors follow guidelines and prioritize standard treatments
- Time, awareness, and logistics often limit trial discussions
- Not hearing about trials does not mean they aren’t an option
- Patients who ask questions are more likely to receive trial information
- Horizon Trials helps patients discover and understand trials independently
Not sure if a clinical trial is right for you?
Horizon Trials helps patients across Canada explore clinical trials with clarity and confidence.
👉 Explore available clinical trials or learn more at https://horizonnt.ca/