![]() ![]() |
Audio Asylum Thread Printer Get a view of an entire thread on one page |
For Sale Ads |
67.246.17.21
Circulating tumor DNA (ctDNA) is found in the bloodstream and refers to DNA that comes from cancerous cells and tumors. As a cancer grows, cells die and their contents, including DNA, are released into the bloodstream.
ctDNA will frequently reveal a tumor before it is radiologically or subjectively apparent. it is called a 'liquid biopsy'. It is no longer experimental.
These tests are available commercially. They are about $1K each at present, although costs will come down with volume.
No insurer will pay for them.
Their argument against this early detection?
'Early detection of a cancer has not been shown to alter patient survival'
Huh?
Follow Ups:
There has been an incredible amount of money spent in this space to 'find' the fingerprint of early cancer-
There have been a couple of companies that have launched a product (Guardant and Foundation Medicine, now part of Roche) but none of the companies have developed a test for multiple cancers, and the AOC - Area Under the Curve - read as percent of accurate tests of the population tested - has not reach into the 90s yet.
in theory this should be an excellent solution,
however in practice, there are many steps along the way where the sample can be compromised, and there is no reference or gold standard yet.
It may, perhaps will, happen - but it is not a slam-dunk yet.
Happy Listening
I am currently part of a large (4500 patients) clinical study of ctDNA screening versus conventional (but intensive) surveillance in the diagnosis of bowel cancer reoccurence. A previous small study in Australia showed a positive impact on survival by alerting early chemotherapy. This is being conducted at the expense of the pharma company (2250 patients with ctDNA tests quarterly for 5 years)...at least $50 million for the ctDNA tests plus the conventional testing and quarterly CT scans for 4500 patients, plus storage of 8 blood samples per year for all patients, so that long term post cancer tracing can be done. Knowing that there is a 20% chance of reoccurrence and death within a 5 year period is sobering, and anything we learn here could be of great benefit to the 4.3% of the population that will develop bowel cancer in their lifetime.
If one does a PUBMED search for colon cancer recurrence one will get 12,321 hits. If one does a PUBMED search for Colon cancer recurrence calcium one gets 114 hits. Below is one of the 114. If one does a PUBMED search for colon cancer recurrence and filters for randomized controlled trials, RCTs one comes up with 458 hits. If you scroll down and look at the titles one can come up with easy things to read about like increased aerobic exercise,coffee and likely more as I just looked for a short time. So far the low hanging fruit looks like Vitamin D status, magnesium, coffee, aerobic exercise calcium and dairy products.
Embrace the Mundane-Alfred E. Neuman
Observational Study J Clin Oncol
. 2018 Apr 10;36(11):1112-1120. doi: 10.1200/JCO.2017.75.5413. Epub 2018 Feb 28.
Nut Consumption and Survival in Patients With Stage III Colon Cancer: Results From CALGB 89803 (Alliance)
Maybe ask your MD if it is OK to eat a couple of ozs of tree nuts a week. Best of luck.
Embrace the Mundane-Alfred E. Neuman
"Can Circulating Tumor DNA Support a Successful Screening Test for Early Cancer Detection? The Grail Paradigm"
Embrace the Mundane-Alfred E. Neuman
All that shows is that 10 ml is too small a blood sample. That's 3 oz.
when some insurance executive point out that the test might work very well to determine who they might, or might NOT wish to insure.
A positive test might be the ultimate in preexisting conditions.
![]()
"Reality cannot exist because it cannot keep up with the lies on the Internet."
Until there's evidence linking early diagnosis with statistically better outcomes (and/or less overall expense to insurers/payors), the benefit ain't worth the cost.
all the best,
mrh
Early detection reduces mortality in many cancers. How many will die while waiting for the evidence?
eg:
Reduced lung-cancer mortality with low-dose computed tomographic screening
a simple google will reveal many more
Incidentally the commonest Ca found this way is lymphoma.
Are you planning to wait for lumps?
I guess we should stop doing pap smears and mammograms too?
FAQ |
Post a Message! |
Forgot Password? |
|
||||||||||||||
|
This post is made possible by the generous support of people like you and our sponsors: