More than 2 years ago, Tomasetti and Vogelstein brought that question to prominence when they tried to sort out environmental versus inherited causes of cancer. They examined the extent to which stem cell divisions in healthy cells—and the random mutations, or “bad luck” that accumulate—drive cancer in different tissues.
Vogelstein and Tomasetti developed new test that successfully detected cancers 70 per cent of the time in trials. and they stated that ".. Our study lays the conceptual and practical foundation for a single, multi-analyte blood test for cancers of many types. We estimate the cost of the test to be less than $500, which is comparable or lower than other screening tests for single cancers, such as colonoscopy. The eight cancer types studied here account for 360,000 (60%) of the estimated cancer deaths in the U.S. in 2017 and their earlier detection could conceivably reduce deaths from these diseases. To actually establish the clinical utility of CancerSEEK and to demonstrate that it can save lives, prospective studies of all incident cancer types in a large population will be required. ..." now
It is not easy to understand how cancer became an easily detectable disease from bad luck?
I am still suspicious about cancerSEEK test (already existed cancer- why it is called cancerSEEK?). Our aim is to develop a test to catch tumor volume and site even in the thousands of cells already existed at its primary site. Concerning the breast cancer, I donot know that this test is homogenously active in all molecular subtypes
CancerSEEK is actively promoted today, so, probably there's not enough experience with it, if it passed the FDA approval process, it must have an acceptable sensitivity and specificity according to ROC Study.
The text next comes from a page called: 'Healthcare packaging':
'The experimental test they developed, called CancerSEEK, focuses on eight prominent cancers including lung, breast, colon, pancreas, liver, stomach, ovary and esophagus. These types of cancer were chosen due to frequency and current lack of screening modality.'
There are scientifically supported screening procedures for *Lung cancer, in high risk population, low dose CAT,..;for *Breast cancer, breast imaging,... implemented in women over 40, in some, earlier, having shown a Survival benefit, although discussed today; Colonoscopy is a top evidence grade Screening way for *CRC, for everyone above 50, for high risk groups, earlier; *Pancreas is a 'hard to photograph' organ, even if the test results is positive, I wonder how would the surgeon locate where in the pancreas lump is; *Liver cancer has a well defined population at risk, and an standard screening by ultrasound imaging and alpha-fetoprotein assessment, always under review; *Stomach cancer screening was considered futile out of high risk populations, as some Asian places, where screening is already implemented; several attempts were made for screening *Ovarian cancer, a gene-mediated malignancy, the 'interval cancers', these appearing between an screening and the next one, negated the Survival benefits, but recent publications exist about OvCa screening worth doing in selected high risk populations, for the high risk group best known, carriers of BRCA mutations, preventive surgery is standard care; *Esophageal cancer is somehow connected to Barrett's esophagus and some environmental and lifestyle carcinogens, besides that dosing some Iron, some low dose Aspirin, as in many other tumors, reduces risk, the subject is under study by Gastroenterologists.
Once upon a time, a Zyon based group offered a machine that, with a Nuclear Magnetic Resonance on a Blood sample, was able to detect if a malignancy was present in the patient; when approached by an investor about purchasing the machine, my conclusion was in the negative, as the test indicating: you have a cancer, but not telling where, will induce nothing but anxiety.
This CancerSeek test seems focusing on different markers to previous screening procedures for these tumors, if it is reasonable adding this test to people having had a negative result in tests about which more experience exists, may require an observational study.
'Ca, a cancer journal for clinicians', includes periodically recommendations for cancer screening, it's of open and free access.
You know, there are people who have enough money to pay for luxuries, such as gold, fancy clothes, art, Ferraris,... some will buy this test, and provide the rest with valuable, 'in field' information about its results; when a new medical procedure or therapy appears, you can't wait until there is enough resources as to offer it to everybody, you can't, let us say, block the installation or operation of NMR units until there's one in every village, in the name of 'equity', that most times is against justice.
For an screening test to be standard, it must offer a survival benefit, either in terms of Overall Survival, or the very hard to standardize QALY.
Incorporating this type of tests to standard practice requires more evidence than it may exist today, situation differs in places of private health care, and of public health care services, who must look at budgets, however, if they were fair enough, the first element they'll consider in reducing expenses is the number of people having revenues from the 'planning' job, and how much each one receives from this.
Control Clin Trials. 2000 Dec;21(6 Suppl):251S-272S.
PMID: 11189683
The time will tell us; as of today, it's an interesting offer, that may deserve some attention, but many of this appear each year.
Thanks, regards, Salut +
I am afraid that by the time blood test is positive - that is cancer cells are in the circulation - it may be too late. Nevertheless, it seems to be a step in the right direction
To Ariadni: your concept of presence of circulating tumor cells being marker of advanced disease may be under partial experimental research challenge today, it seems, same as fetal cells circulate in woman's blood, and the possibility of cells from woman, or from another fetus in the same womb entering the fetal vessels, that presence of tumor cells in blood (epithelial-mesenchimal transition) can be common from the very beginning of malignancy, same as quite a few people having a right to left heart shunt develop small septic micro-embolisms (Osler whitlow), few of them are hit by a Brain abscess.
Salut +
There is a lot of literatue about circulating tumor cells (CTC) and even about circulating tumor DNA (ctDNA). Breast cancer studies about detection of CTC (even in very early stages of the disease such as pT1N0M0) and its relation to high risk of relapse or worse survival. Lung cancer studies with ctDNA also ....
I dont know if this test CancerSEEK can detect CTC or ctDNA, and i wonder if it can distinguish between different cancer types or just says ther is cancer anywhere. Because it will be very interesting for example if the test says there is lung cancer cells, then we will proceed to more invasive procedures and imaging techniques like bronchoscopy, CT, PET, etc. The same for endoscopy for gastrintestinal tumors, IMR for breast and so... Iam not only thinking in people with money...but in people at high risk like Lynch, BRCA carriers or even heavy smokers....
... N.P., S. Z., K.W.K., L.D., and B.V. are founders of Personal Genome Diagnostics, Inc. and PapGene, Inc. B.V. and K.W.K are on the Scientific Advisory Board of Sysmex-Inostics. B.V. is also on the Scientific Advisory Boards of Exelixis GP. R.H.H. is on the Board of Directors of MiDiagnostics. ...
Interestıng
It may be better to use it in routine practice after validation is established related to hard outcomes. That will be achieved with highstandard science. Also, its value and cost-benefit analyses must be favorable.
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