The ideal cancer treatment is to create a plan that stays one step ahead of the tumor. However, every patient’s cancer changes over time and often changes more quickly in response to treatment. Physicians work to hit this moving target with the best therapies available but there are often several therapies to choose from. That’s why it’s important for your doctor to determine as quickly as possible when it’s time to change therapies from one that either never worked or stopped working to one that will better control your cancer.
However, using standard diagnostics, it can take as long as 3 months to find out whether the treatment is working or has failed – a time span that cancers can exploit, growing and becoming more difficult to treat.
Researchers at Jefferson’s Medical Oncology Associates at the Sidney Kimmel Cancer Center have pioneered and implemented new tools to monitor a patient’s cancer in real time through a simple blood test. Starting September 2014, Jefferson will offer patients this new diagnostic blood test, often called a “liquid biopsy” or circulating-tumor-cell (CTC) count, to detect cancer cells that have been shed or are actively moving from one site to another into the bloodstream. The test lets doctors check for changes in the tumor quickly and easily, without repeating additional painful surgical biopsy that aren’t a good option for some patients, or scans, which can’t detect small increases in growth.
Is the test useful for any cancer?
Today, the test is FDA-approved for breast, colon, and prostate cancers that have metastasized, or begun to spread. But our researchers are working on expanding this to other cancers and have a number of clinical trials open (ask your doctor if you are interested in participating).
Can my doctor use CTCs only to track my cancer?
Whole body scans, and in some cases tissue biopsies may remain important in tracking the spread and growth of your cancer, but the CTC test provides your oncologist with more information more frequently than is possible with other tests and it is particularly important to predict the spreading as a consequence of treatment failure. It is the only test recognized that can inform your doctor about the risk of cancer spreading to other organs.
All your doctors need is a small vial of your blood. Solid tumors (in other words, cancers that don’t originate in blood cells) will often release individual cancer cells into the bloodstream when the cancer is metastatic, in order to seed the cancer to new locations in the body. Researchers have discovered that when a blood sample contains a small number of these cells, the tumor is more likely to be stable, with its growth under control – the sign of a successful medication. When the number of circulating tumor cells, or CTCs, as they are called is high, the cancer is probably growing and may suggest that it’s time for a new course of action.
Today, the CTC test is available in only a handful of academic medical centers on the East Coast, and Jefferson is the only institution in Philadelphia that has it. In addition, Jefferson is home to one of the researchers who developed the technology, Dr. Massimo Cristofanilli, MD, providing our patients with the benefit of his expertise.