Clinical trials are critical to informing the care of patients with cancer. However, only
3-5% of patients with cancer enroll in clinical trials. Poor accrual to trials has major
implications with regards to the pace of progress, the cost of clinical cancer research, and
the generalizability of results. The investigators have recently shown in an analysis of
7,776 cancer clinical trials registered on clinicaltrials.gov that approximately 20% of
cancer clinical trials fail to complete enrollment at all; the most often cited reason was
poor accrual.
Prior research has identified barriers to cancer clinical trial accrual that can be generally
categorized in the domains of availability, awareness, and acceptance. Much attention has
been paid to the barriers involvement awareness and acceptance - however, trial availability
is likely a "rate limiting step". This pilot study is the first in a series of planned steps
to attempt to shift the current paradigm of "bringing patients to trials" to "bringing trials
to patients." With the integration of telemedicine visits, the investigators aim to decrease
the burden of participation for patients, begin to address geographic barriers, and
ultimately improve trial accrual. In this study, men with biochemically recurrent prostate
cancer (a rising PSA after definitive local therapy) will receive the antidiabetic drug,
metformin. Patients will require a single on-site visit for study enrollment. The remainder
of the 6 month study will be conducted via a HIPPA secure telemonitoring system (monthly
visits conducted via telemedicine with tablet computers provided to each patients).