On 10/13/22, the website Cancer.net posted the following.
Oncology Vol 36 p 600-603: "Circulating Tumor DNA as a marker for minimal Residual Disease", Ben Fangman, MD, et al
It is interesting reading. I have been asking for this test, for a few years, now. I have brought the subject up to each and every doctor whose paths I cross in the Memorial Sloan Kettering complexes. I am like a fly on the ass of an elephant but I pursue it. I am hopeful that I have relatively few rather than many circulating cancer cells in my body. There are reasons for my optimism. The sooner I/they find the answer, the sooner my treatment can be tailored to me. That goes for all of us.
To repeat the theme for today, "Knowledge is Power.".
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jersey-jazz
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It is specifically about colo-rectal cancer, and about detecting microscopic levels of disease that does not show up in scans. -- That is what I got from a glance at the very short article.
I learned that cell-free circulating tumor DNA (ctDNA) is shed from either a primary tumor or metastatic site via secretion, apoptosis, or necrosis into the bloodstream, where it can subsequently be collected by venous sampling. From this, I assumed that that our cancer markers are an example of ctDNA occuring when our tumours are obvious. It seems that, in other cases, the concern is to detect "molecular residual disease (MRD)—sometimes also referred to as “minimal residual disease “in solid tumors". "In patients without radiographic evidence of disease, MRD detection allows for earlier intervention, potentially when minimal disease, without a substantial tumor protective microenvironment, may still be curable."
The article primarily seems to be focused on the many, varied assays that may be done to detect MRD in colo-rectal cancer. I have no clue whether these assays might be equally relevant to other forms of cancer. In any case, their primary use seems to be in non-metastasized cases.
Dear C. This article focuses on cancers unlike our MBC but, in my mind, can be adopted to suit us is such useful ways.. I have explored this subject and and two years a go, I contacted a manufacturer. They told me that the are doing trials at Memorial SLoan Kettering. My oncologist didn't tell me that! I am pretty determined to find out if this can be applied to us. I want to know just how much cancer is in my body so it can be treated accordingly, not indicriminately.
I see in my Foundation One report, ctDNA was measured. Mine was 1. This report says it does not indicate treatment or OS unless more than 1.25. Another article I saved said that 1 was related to OS, and looked at positive/negative at baseline and positive/negative at followup, with each combo associated with different length of OS. From what I can tell from those, higher ctDNA might indicate different Rx. Is that what you are thinking?
Dear Tammy - I see the reply that I wrote to you has not come up in answer to your question. Please, then, read the reply I gave to Aprilfoolz1. It is all so exciting for me. I know little about the trial that I will be involved with but I know that it has to do with the circulating tumor cells. I will learn more on Dec 8. I think that the flies on the ass of the elephant may have multiplied over the years and have become a force, meaning, that I think that me questioning and bringing up this subject often and regularly may have given me a pass into the circulating tumor cell world.
Dear April -Wow!!! It's all happening. That study that you are enrolled in is so to the point. I believe in my heart of hearts that it is the kind of studies that will give the key. Thank you so much for this.
My news is that I have been received into a trial at Memorial Sloan Kettering about my year's long favorite hobby horse. It concerns the circulating tumor cell tests. I really don't know much, yet. On December8, I will have a televisit with a member of the team and will have my questions ready. I sincerely hope that she will be able to answer the questions to my satisfaction.
I've just spent some time learning more about the Fred Hutchinson Cancer centers, all in the state of Washington. You are a lucky person to be near them. I too am lucky to be near MSK. I so wish that the methods used to locate criminals across state lines would be used by hospitals, specifically, cancer centers. Can you imagine the metastasis of information about MBC?
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Good news on tumor markers
Liver tumors progressed 
Tumors shrinking on ibrance and letrozole 
Xeloda and tumor markers
