Jeff Vance, 40, thinks he's probably still considered terminally ill. Colorectal cancer had spread by the time he discovered he had it. But no one's marking his time in months now. And he's feeling "really good."

Miles and a different diagnosis away, Judy Grant feels like she's in the happy part of the movie "Awakenings." She was, she said, "experiencing the world in a very ghostly way" because of chronic fatigue, an illness that left her so drained she had to force herself to get up and shower a couple of times a week, resting her head against the shower wall two or three times "just to get through it." Now the colors, the vibrancy, the zest have returned.

The difference, both say, was strict adherence to their treatment plan and participation in a clinical study — just one of the steps an experimental drug must make on its way from being a notion that something might help to becoming a treatment you buy at the pharmacy or a better medical device or new surgical technique.

A surgeon may implant one patient with a new style of artificial hip and implant another with the standard hip to compare results. An oncologist may add a medication to chemotherapy for colon cancer, like the clinical study Vance participates in, or a hospital may give antibiotics to some patients and not others before certain surgeries. It's all done to learn what works, to improve treatment, to reduce suffering.

On any given day in the United States, experts estimate there are nearly 50,000 ongoing clinical studies. At Huntsman Cancer Institute alone, 86 different treatment variations are being examined. Type any medical condition into the search engine at www.clinicaltrials.gov, the National Institute of Health's database, and you're apt to find something hopeful that's being studied.

Patients can access many of those studies without leaving Utah, through hospitals, private physicians, research companies.

The trials may be sponsored by organizations or individuals such as physicians, medical institutes, foundations, pharmaceutical companies, federal health agencies and others. Increasingly, large national groups dedicated to promoting research of a specific illness are helping fund studies of potential treatments.

Should I?

"Clinical trials are the way we determine what works in treating patients," said Dr. Stephen Prescott, executive director of the Huntsman Cancer Institute. "The medications we have to treat diseases of all types all come from applying a scientific method of asking 'Does this treatment work?' "

www.clinicaltrials.gov summarizes why someone might want to be in a clinical trial and covers the risks.