We are heading more towards using circulating tumor DNA as a biomarker (for example: http://www.nature.com/nm/journal/vaop/ncurrent/abs/nm.3519.html). However, how 'early detection' relates to 'targeted therapy' is a whole other ball game. Your broad statement that "cancer is curable when detected early" is unfortunately incorrect - it is different on a cancer-by-cancer basis.

In my opinion, the only way to get at your question is to define the hierarchy of genetic events that contribute to tumor evolution, and to target the early events. This is what I'm working on. We have a reasonably compelling manuscript coming out in Nature Communications in about 2 weeks, and another one under review elsewhere. I also have a review in press at Current Opinion in Hematology that discusses this subject.

Thank you for your ref., it is great to know and will follow the later ones too. Thank you also for correcting my over-statement, I meant atleast if detected early, it may be possible to surgically excise them, and followed up with detection methods. And that's what I wanted to know about the newer diagnostic approaches as you have mentioned. I am aware different cancers behave differently, but I thought the topic would be too vast, so I just set some examples of epithelial cancers where targetted therapies were used.

I think its more of a socio-economiic question. Unfortunately supply and demand for what is invariably reagent based diagnostics has been the main market model for some time

The implementation of soft ionization mass spec techniques, be it slow, will give a great paradigm shift away from looking for specific biomarkers.to shotgun proteomics and metabolomics and follow up sequencing.

We should all buy time of flight machines and pool the data. But then we have the problem of unscrambling all the data in the same way whole genome screening falls short

It a great view, thank you for the comment. Yes, I truly believe the challenge lies in understanding, analyzing and the mass data generated by hi-througput studies of specific cancers both at the genomic and expression levels. As of now we have to depend a lot on the specific scanning data using PET or CT scans to identify tumour masses or metasatsis at the clinics. While there are few new specific diagnostic biomarkers to follow up the specific lesions for diagnostic or prognostic views, well that's how it appears..

I think that your question es perfectly valid and relevant, although the research efforts should be make in bought fields -diagnostic and therapeutic-, in Mexico, there are research groups (i.e. the one where I make my MSc) that are searching for immune markers, such as antibodies against E4, E5, E6 and E7 of HPV and Ras for the early detection of precancerous lesions in the cervix.

In my opinion this is the most important approach to the prevention and resolution of cancer, nevertheless, the therapeutic targets are almost equally important in view of the ageing populations and changes in the distribution of the population pyramid in the developing nations. This will require the attention and treatment of more and more cancer cases that doesn't have the opportunity of early detection because of their poverty condition.

Thank you for your valuable comments on both aspects, and I would love to get the refs when you complete the project and to be able to add other antibodies for early detection in the clinics at a later point will be very helpful.

Diagnosis of cancer is the main concern and once diagnosed, maximum of cancers have better efficacy towards therapeutic drugs. "Biomarkers" that are well defined, specific and sensitive to diagnosis serves gold standard in early detection followed by effective therapy. 

Thank you , Santosh, I believe too biomarker research is vital, as it paves the way for both diagnostic and therapeutic outcome, although early detection atleast saves a lot of ordeal for the cancer patient. Than kyou for your ref.  

We fully support the position of Dr. M. Green. He very aptly put it :"The only way to get answer at your question is to define the hierarchy of genetic events that contribute to tumor evolution, and to target the early events".

I would add the following: Without a stable theoretical framework and summarizing the conceptual foundation for the problem of cancer is not possible to effectively conduct its diagnosis and treatment. Unfortunately, even the growth of research activity will not be able to resolve this issue without creating a systemic understanding of the mechanism of formation of cancerous mutations and the development of this process.

We sure, that the solution to the problem of diagnostic must lie in the plane of a clear idea of why the body does not "see" the new tissue, cells, which begin to grow out of control, and we call it - CANCER?

It really questions of the hierarchy evolution and development of cells and tissue, and we would have to add that these are issues of aging and (or) damage inside the cell, which leads to their mutation and rebirth.

Tissue cells of the body have a certain life cycle. This cycle is shorter and it does not coincide with the cycle of life of the body and the entire organism of the owner. In each organ and tissue of the individual during of the all life constantly going processes of cell regeneration and death (the phenomenon of cell regeneration and apoptosis). At any given time in the internal environment of the body some of the cells must be born again, and some part must be torn away. Bodies grow and change shape, structure and grow old together with the host. The life cycle of cells in each tissue are different in length. For example, the normal life cycle of the erythrocyte 100-120 days, and hepatocyte can live from 54 to 400 days.

After the end of the life cycle of the cell must be destroyed by the immune system of the body. So it becomes the cell will be a "stranger" to the body and destroyed them (utilized within the body). The organism thus supports persistence of organ and tissue structures to ensure its vital functions.

Therefore we can say that the internal "stranger" is "his owns". But in time the cell became "strangers" and the antigenic structure of this cells will be "stranger" in the body's own tissues, because ceased its life cycle and their intended function. They will be destroyed - "recycled" within the body .

The process of regeneration and cell death in the body began with the birth of the body does not stop during the life. That part of the immune system that is responsible for this makes a great job, it is quite comparable to that part of the immune system, which is responsible for the fight against external "strangers", and maybe even exceed it in importance and intensity.

The process of destroying internal "stranger" is likely "disposal-utilization" of their own cells and tissues, which occurs within the body and the organism's reaction to the process is other than the reaction of the organism's systems to an external "invasion".

At physiological condition with constant level of metabolic processes, not exceeding the physiological fluctuations, the reaction of the organism are not aggressive, not accompanied by disorders of life support systems, no requiring additional intervention of adaptive-compensatory mechanisms.

Certainly, the reaction of the body depends on the amount of internal antigenic material, which is designed to "destruction" - utilization. Because this is directly related to the level of regeneration processes and update the cell, the tissue or organ. In severe external conditions of life, injuries, traumas and wounds of systemic disorders in the inner antigenic level of the organism can lead to serious consequences and the death of the organism. The organism itself is capable of destroying the inside.

Therefore, we conduct diagnostics of tissue structure, the level of its regenerative processes and physiological cell death as a result of apoptosis.

Our group has established biomarkers based on a new class of substances called us PSY substances. These are substances with partially syngeneic properties. They are suitable for detecting the level of regeneration and apoptosis of cells in the examined tissue. We can develope, produce and test such biomarkers kits for rapid diagnostic of tissue's structure in humans and animals. Details can view article in my profile.

Thank you for the detailed description of the renewal of tissue structures and sharing your promising new class of biomarkers, very impressive, I will check out your article.