“Two new studies published on Wednesday of patients with breast and prostate cancers add to growing evidence that detecting bits of cancer DNA circulating in the blood can guide patient treatment.
“Enthusiasm is building for ‘liquid biopsies,’ which offer a non-invasive alternative to standard tissue biopsies and are expected to be a multibillion-dollar market.
“But a key question remains: Do they really work?
“The stakes are high. At least 38 companies are working on liquid biopsies for cancer, according to analysts at investment bank PiperJaffray, who think the U.S. market alone could eventually reach $29 billion a year.”
In 1998, Dave Bjork went to the doctor for a high fever accompanied by chills so intense that he shivered even though he wore three jackets. A chest X-ray revealed pneumonia and Dave went back to his life. “I didn’t think anything of it,” he says.
But then Dave had another bout of pneumonia only a few months later, and his new X-ray and his old one had a terrible similarity. “My radiologist held up the two X-rays and showed me that the infection was in the same spot,” he says. Next came a CAT scan and a call from his doctor saying they’d found a tumor in his lung. Continue reading…
“The way we find cancer in our bodies today is often messy, imprecise and even potentially dangerous. It often involves taking sometimes fuzzy, unreadable images with CTs, MRIs and X-ray machines and cutting open our bodies to harvest bits of tissue for further analysis.
“Most of us never think to undergo such testing until it’s too late, and the cancer has already well on its way to killing us.
“A California-based company called Pathway Genomics is aiming to shake up this way of thinking about cancer detection. In September, Pathway announced that it would be offering an ‘early warning’ test that it says can detect snippets of abnormal DNA — for a whole group of major cancers, including breast, ovarian, lung, thyroid and prostate — in otherwise healthy people from a single vial of blood.”
“A molecular imaging biomarker is able to detect fast-growing primary prostate cancer and distinguish it from benign prostate lesions, addressing an unmet clinical need. The new research, published in the July 2015 issue of The Journal of Nuclear Medicine, is significant for patients with suspected prostate cancer that has not been confirmed by standard biopsy.
” ‘We were able to demonstrate in our research that PSMA PET imaging was more specific than MR imaging for detection of clinically significant high-grade prostate cancer lesions, and importantly was able to distinguish benign prostate lesions from primary prostate cancer, currently a difficult diagnostic imaging task,’ stated Steven P. Rowe, MD, PhD, resident at Johns Hopkins Medical Institutions in Baltimore, Md. ‘Additionally, this work demonstrated a direct correlation between PSMA PET radiotracer activity in prostate cancer and prostate adenocarcinoma aggressiveness (Gleason score).’ “
“Men with an elevated, genetically inherited risk for prostate cancer could be routinely identified with a simple blood or urine test, scientists at UC San Francisco and Kaiser Permanente Northern California have concluded, potentially paving the way to better or earlier diagnosis.
“The study, which compared 7,783 men with prostate cancer to 38,595 men without the disease, is available online and will be published in an upcoming issue of the journal Cancer Discovery.
“The new study is one of the first to come out of the collaboration between UCSF and Kaiser Permanente Research Program on Genes, Environment, and Health (RPGEH), which analyzed genetic samples and health records from more than 100,000 volunteers, making it one of the largest research projects in the United States to examine the genetic, health and environmental factors that influence common diseases such as prostate cancer.
“The researchers modeled prostate cancer risk using 105 specific bits of DNA that commonly vary among individuals and that they confirmed are associated with prostate cancer risk. While they estimated that each of these genetic variants only modestly alters risk, they determined that men with combinations of these DNA variants that placed them among the highest 10 percent for risk were more than six times as likely to be diagnosed with prostate cancer compared to the men who ranked among the lowest 10 percent for prostate cancer risk.”
“It’s a good idea to keep an eye on your moles, to see if any of them are changing, which can be a sign of skin cancer, experts agree. But a new study finds that the sometimes-deadly skin cancer melanoma usually arises in normal skin, where there is no dark spot or sign of cancer until the melanoma suddenly shows up.
“Moreover, melanomas that arise in non-mole areas of the skin tend to be more aggressive and deadly than those that do arise from moles, the study found.
” ‘We find that the ones without a [mole] appear to be more aggressive,’ said Dr. David Polsky, the study’s lead researcher and a professor of dermatology, pathology and dermatologic oncology at New York University School of Medicine. ‘We think that there are biological differences’ between melanomas that develop within moles and those that develop elsewhere on the skin, and it’s possible that these differences underlie the difference in aggressiveness, he said.”
“Mammograms at 40 or 50? Every year or every other year? What’s the best colon check?
“Screening for cancer has gotten more complicated in recent years with evolving guidelines that sometimes conflict. Now a doctors’ group aims to ease some confusion — and encourage more discussion of testing’s pros and cons — with what it calls advice on ‘high-value screening’ for five types of tumors.
“Too often, even the doctors who order those tests aren’t sure of the latest recommendations, said Dr. Wayne J. Riley, president of the American College of Physicians, which published the advice Monday in the journal Annals of Internal Medicine.
” ‘We want to make sure that folks get the right test at the right time for the right conditions,’ Riley said. ‘We also want our physician colleagues to try to avoid the customary, knee-jerk reaction to just test without having some sort of dialogue’ about the right choice for each patient.”
“A new study offers help to patients and doctors who are trying to deal with mammogram results that many women consider troubling and confusing: the finding of ‘dense’ breast tissue.
“Not only is breast density linked to an increased risk of cancer, it also makes cancer harder to detect because dense tissue can hide tumors from X-rays. But the new research indicates that not all women with dense breasts are at very high risk.
“Patient advocates urge women with dense breasts to ask doctors about extra tests like ultrasound or an M.R.I. to check for tumors that mammography might have missed. Studies have found that those exams can improve detection of tumors over mammography alone in dense breasts.
“Pressed by advocacy groups, 22 states have passed laws requiring that breast density be reported to mammography patients, and similar federal legislation has been introduced in the House and the Senate.”
“A statistical model using kallikrein markers better predicted high-grade prostate cancer in men with elevated PSA levels and reduced unnecessary biopsies compared with PSA level and age alone, according to the results of a prospective analysis.
“ ‘Risk of death from prostate cancer is strongly associated with levels of PSA in blood measured in middle-aged men,’ Hans Lilja, MD, PhD, of Memorial Sloan Kettering Cancer Center, and colleagues wrote. ‘Evidence from randomized screening trials in Europe shows that PSA-based screening can reduce deaths from prostate cancer, but also leads to overdiagnosis and the risk of overtreatment among elderly men with a limited life expectancy.’
“Previous retrospective studies identified four kallikrein markers — free PSA, intact PSA, total PSA and human kallikrein-related peptidase 2 (hK2) — that can predict biopsy outcomes, according to study background.”