No stone left unturned: Challenges encountered during recruitment of women with advanced ovarian cancer for a phase I study

The recruitment and accrual of participants for cancer clinical trial research is often challenging. Chronic low accrual rates negatively influence the findings and generalizability that can be drawn from the available pool of research. There is a need for further evidence regarding both unsuccessful and successful approaches and useful strategies that investigators have used to counter common recruitment challenges. During recruitment for an intervention study examining the safety, efficacy, and feasibility of a potentially novel supportive therapy, a variety of steps were taken to avoid and subsequently overcome potential and real recruitment challenges the investigators faced. In this article the authors provide an overview of common recruitment challenges as well as the actual challenges encountered, procedures and strategies implemented to counter these challenges, while investigating the combined intervention of flaxseed oil, fasting, caffeine, and exercise in women with recurrent or multi-drug resistant stage III or IV ovarian cancer.