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Medicine Science

A Cheap and Easy Blood Test Could Catch Cancer Early (technologyreview.com) 55

A simple-to-take test that tells if you have a tumor lurking, and even where it is in your body, is a lot closer to reality -- and may cost only $500. From a report: The new test, developed at Johns Hopkins University, looks for signs of eight common types of cancer. It requires only a blood sample and may prove inexpensive enough for doctors to give during a routine physical. "The idea is this test would make its way into the public and we could set up screening centers," says Nickolas Papadopoulos, one of the Johns Hopkins researchers behind the test. "That's why it has to be cheap and noninvasive." Although the test isn't commercially available yet, it will be used to screen 50,000 retirement-age women with no history of cancer as part of a $50 million, five-year study with the Geisinger Health System in Pennsylvania, a spokesperson with the insurer said. The test, detailed today in the journal Science, could be a major advance for "liquid biopsy" technology, which aims to detect cancer in the blood before a person feels sick or notices a lump. That's useful because early-stage cancer that hasn't spread can often be cured.
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A Cheap and Easy Blood Test Could Catch Cancer Early

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  • $500 a pop to be able to blacklist before the they any Cancer care is cheap to all health planes

    • by b0s0z0ku ( 752509 ) on Friday January 19, 2018 @02:08PM (#55962301)

      Currently insurance is guaranteed-issue in the US, and treating early-stage cancers is easier/cheaper than catching them late. So yeah, this will save money, and not by blacklisting.

      Also, $500 is cheaper than tests for cancer like scopes and CAT scans.

      • by Okian Warrior ( 537106 ) on Friday January 19, 2018 @02:55PM (#55962731) Homepage Journal

        Currently insurance is guaranteed-issue in the US, and treating early-stage cancers is easier/cheaper than catching them late. So yeah, this will save money, and not by blacklisting.

        Also, $500 is cheaper than tests for cancer like scopes and CAT scans.

        Talking to a researcher at Tufts, he pointed out that we have plenty of new diagnostics that can't be used because insurance won't cover them. The insurance companies are afraid that the diagnostic will uncover a condition that has to be treated, which would cost more than letting the condition go until it becomes untreatable and the patient dies quickly.

        So even though this test might suggest an earlier treatment that is cheaper, you still have to compare the actuarial value of not doing the test and letting the cancers go until they are discovered by some other method.

        We need some sort of game-theory change in how insurance companies operate, so that their goal is better health and not lower costs.

        Perhaps penalizing the company for deaths under a certain age (to encourage the company to value life over costs), or something similar.

        Simply mandating the test and other legislative directives won't work, because the companies still have the incentive to reduce costs - they will always be pulling in the opposite direction.

        We need a way to get the insurance companies to pull in the same direction as their customers, so that they both have the same goals.

        That being, better health.

        • Easy. Single payer. Problem solved.
        • by thomn8r ( 635504 ) on Friday January 19, 2018 @03:47PM (#55963195)

          The insurance companies are afraid that the diagnostic will uncover a condition that has to be treated, which would cost more than letting the condition go until it becomes untreatable and the patient dies quickly.

          I would seriously love to know if this is indeed true; I've always been cynical about insurance companies, but his is beyond even my worst opinions of them.

          • by sjames ( 1099 )

            Well, considerng their longstanding practice of cancelling policies AFTER a serious and expensive condition is discovered (stopped by ACA), which would pretty much leave the person to die, this would be in character.

      • by skids ( 119237 ) on Friday January 19, 2018 @02:59PM (#55962781) Homepage

        Whether it proves to be economical (or even ethical) depends greatly on the level of false positives, beyond the false positives, the number of results that show cancer but the particular cancer in question is something that would have no real health consequences, how harmful the treatments for the cancers are, and how expensive the treatments for the cancers are. Witness the evolution of thinking surrounding prostate cancer detection and treatment... a lot of lessons were learned there.

        That said, I think there are likely to be huge benefits from taking as many measurements as we can, starting as soon as we can, without acting on them and before in many cases we even know how to act on them. To me it's appalling that we aren't all wearing some bracelet that logs everything it can for future scientific study or potential diagnostic utility... both because part of the reason we don't is you can't trust anyone not to misuse or lose custody of data these days, and the other part of the reason is we'd rather spend our money on a few more pixels per inch or a screen that bends around the side of our cell phones.

        Both of those reasons disgust me.

        (BTW, for those who think as I do, I think this [phys.org] is a pretty friggin significant development. I can hear the rest of you yawning because it has nothing to do with emojis, bitcoin, or downloading copyrighted entertainment material without paying for it.)

      • "Also, $500 is cheaper than tests for cancer like scopes and CAT scans."

        Not to mention that it will be 50$ in Canada, 5$ in Europe and 0.5$ in India.

    • Bill for my wife's recent MRI (2 lumpectomies + radiation in 2015)

      MRI General .......... $4804
      Drug Spec (sedation) .. $256
      Adj (ins) ........... -$3645
      Pmt AET RCP .......... -$216
      ... other adjustments
      Total due ............ $1198

      We'll do this every year for a couple more years, plus mammograms twice a year.
    • $500 a pop to be able to blacklist before the they any Cancer care is cheap to all health planes

      "Nothing is so good in this world that the people won't tell you exactly what's wrong with it." - Mark Twain

  • by Baron_Yam ( 643147 ) on Friday January 19, 2018 @01:43PM (#55962103)

    That's pretty high for a test with a less-than-stellar detection rate (roughly 2/3 false negative for breast cancer and 1/3 false negative for pancreatic cancer).

    My (statistically uninformed) gut says you're going to get a lot more extremely anxious people worse off from false positives than you're going to save with early diagnosis.

    Hopefully it can be improved - both in accuracy and cost - because I'd gladly give a vial of blood to a lab every year for an 'all-clear'. I just don't see this as being a good option yet.

    • by RhettLivingston ( 544140 ) on Friday January 19, 2018 @02:06PM (#55962285) Journal

      In addition, they say nothing about benign positives. That is worrisome.

      Cancer is described by many as a failure of the immune system. They say that we develop cancerous cells constantly that the body detects and eliminates. We only get problematic cancer when the immune system fails to detect and eliminate these cells.

      An early detection test with very high sensitivity may start to detect this daily battle. These positives would not be "false" but neither would they necessarily indicate that the body is losing the battle. We do not have good data at this time on how many small cancers the body successfully eliminates before they become a problem that we can detect with traditional methods.

      The real danger here is that there is no economic incentive for those in the cancer industry to do anything other than diagnose and treat it, ironically, with treatments that often cause further cancers. They are unlikely to do the research to tease out whether a positive indicates out-of-control cancer.

      • by Anonymous Coward

        Somebody might decide to kill themself if they think that they have a terminal cancer. They do that just over a wrong medical diagnosis. This might help to reduce the probability though.

    • Shouldn't be a problem as long as doctors present the results properly. They should report that the test indicates a possibility of cancer, and that the next steps are to do more testing, not make out your will. I don't know what the incidence of cancer is in the general population, but if it's significantly lower than 1% and the false positive probability is uncorrelated with other risk factors, then it's most likely that the test is wrong... but the probability that it's correct is high enough to warrant

      • And although it would turn up a lot of false positives, it would also catch a lot of cancers very, very early, making survival rates higher and costs lower.

        It's not something people like to talk about, but early detection doesn't correspond to improved survival (see, for example, Screening for prostate cancer: systematic review and meta-analysis of randomised controlled trials [nih.gov]).

        Forty years ago, prostate cancer was considered a fast-moving, highly lethal cancer. PSA screening was introduced, with a heavy

        • by sjames ( 1099 )

          Let's not forget that those unnecessary treatments were expensive and far from benign. A lot of pain, disfigurement, incontinence, impotence, and likely a few deaths.

  • by geekmux ( 1040042 ) on Friday January 19, 2018 @01:49PM (#55962141)

    With the amount of profit surrounding cancer treatments, this tends to be a perfect weapon for corrupt business practices. I wouldn't be surprised if we magically start detecting cancer far more than the average after this test becomes part of a routine annual physical.

    Take a good hard look at cancer drug revenue patterns over the last five years. Take a look at the mark-ups, and the out-of-pocket costs. It's fucking obscene.

    You want to detect and cure the real disease? Cure the strains of greed that bring forth corruption.

    • Greed can not be cured.
      It can be controlled however, but for that you'd need a functioning democracy.
      Democracy isn't functioning...
      • by Kjella ( 173770 )

        Greed can not be cured. It can be controlled however, but for that you'd need a functioning democracy. Democracy isn't functioning...

        Well it's a little bit more complicated than that. Universal single player systems work well for conditions that have an easy diagnosis and a known treatment. For things that are experimental and where there's no guarantee of result the public system has a real problem differentiating between those who really give it an effort and those who just slack.

        We have one of these guys at work, IMHO he's a notorious work dodger. He's the kind of guy who at the slightest road bump says "I don't know how do that", "Wh

    • With the amount of profit surrounding cancer treatments

      So, how much profit is there in cancer treatments? Articles I found trying to google the subject spent a lot of time conflating "cost to patient (or insurance company)" with "profits" (no, income is not the same as profit, even if you don't like the people you're giving money to), without bothering to provide any numbers for actual, you know, profits....

      • With the amount of profit surrounding cancer treatments

        So, how much profit is there in cancer treatments? Articles I found trying to google the subject spent a lot of time conflating "cost to patient (or insurance company)" with "profits" (no, income is not the same as profit, even if you don't like the people you're giving money to), without bothering to provide any numbers for actual, you know, profits....

        The numbers are a bit dated (2014), but greed has been brought into question for years when it comes to the Cancer Industrial Complex. Here's an interesting read on it:

        http://healthimpactnews.com/20... [healthimpactnews.com]

        We've poured billions into cancer research, and what do we have to show for it? 1 in 20 people got cancer a century ago. Now it's 1 in 3, and Greed will never allow a cure.

  • While I'll agree that it's not very invasive, I can't see how anyone can actually claim it is non-invasive unless they have a way of getting your blood without actually having to penetrate your skin.
    • by Baron_Yam ( 643147 ) on Friday January 19, 2018 @01:53PM (#55962181)

      > I can't see how anyone can actually claim it is non-invasive unless they have a way of getting your blood without actually having to penetrate your skin.

      They infect you with a hemorrhagic fever first, then simply wait for the blood to come out on its own.

      Do I have to think of everything?

    • by Anonymous Coward

      Really depends how much blood you need.

      A tiny prick of the finger is all it takes. My type 1 diabetic son checks his blood glucose on his own upwards of 7 times a day.

      He was diagnosed when he was 5, and able to do it himself within a month.

      • by mark-t ( 151149 )

        I agree, as I said, that it's not terribly invasive, and certainly not inconveniently so, but by definition, poking a hole in the skin to get blood is an invasive procedure.

        Invasive means that some foreign thing has to enter, ie "invade", the body. In the case of a blood sample, this thing is the needle.

        An example of wholly non-invasive procedure is something like a urine sample.

    • How about a punch to the nose?
    • by Anonymous Coward

      The more accurate term would probably be that this is minimally-invasive outpatient procedure.

  • subject says it all.

    that's the problem with healthcare in general---people don't care (since they get it either via insurance or medicaid), providers don't care (they get paid either way), the insurers don't care (they just raise the premiums, or "uh, oh, medicaid cannot run out of money")... it's a win-win for drug companies. They might as well sell it for $5000, and say "oh, this is dirt cheap... it could save YOUR LIFE! Isn't YOUR LIFE worth someone else paying $5k?"
     

    • by sjames ( 1099 )

      So much for the claims that HMOs would push back on outrageous costs and bring them back to reasonable levels.

      • I tried out the usual kind of insurance in 2017. My wife and I are over the moon about changing back to an HMO for 2018 -- it is both cheaper and better.
  • ... now is a method to cure cancer early.
    • Most cancers are already far easier to treat if they're caught early.

      I bet that comment sounded a lot more clever before you typed it.

  • There's a hypothesis being developed that states that actually cancer is a lot more common than people might think, it's just that the immune system detects it and rejects most (maybe the vast majority?) of cancers before they become a clinically noticeable issue.

    If suddenly we start catching cancers so early and start treatment, we might end up treating a lot of cancers that would have got destroyed by the immune system, thus possibly damaging folks far more with exposure to chemotherapy and unnecessary surgery.

    I do think this theory has some basis in fact: once I had a growth on my face that I became certain was a basal cell carcinoma, the least dangerous form of skin cancer. However, before I managed to get medical attention on it, this growth got irritated, bled a little bit, and completely disappeared without even a scar. Standard treatment would have left a scar, so seemingly I was better off without any treatment.

  • by Anonymous Coward

    A robot processes patient blood samples for evaluation with the CancerSEEK test.
    Fred Dubs, Johns Hopkins Medical Pathology Photograph
    Rewriting Life
    A Cheap and Easy Blood Test Could Catch Cancer Early
    50,000 healthy people will be screened in an effort to detect hidden tumors.

    by Emily Mullin January 18, 2018

    A simple-to-take test that tells if you have a tumor lurking, and even where it is in your body, is a lot closer to reality—and may cost only $500.

    The new test, developed

  • I thought it had been determined that routine physicals cause more harm than good by essentially picking up more false positives causing unnecessary surgery and anxiety.

  • Just saying that there is a lot missing before we can call this 'a good thing'.

    Some cancer treatments are only 'safe' if you've got nothing left to lose. What do you do if your doctor says, "The tests show that you have very early onset ___ cancer"?

    And how certain is the doctor? FTFA: "The algorithm guessed right 83 percent of the time."

    Question: Has the health system has developed protocols to address very advanced warning of cancer?
    Answer: No.

    Yay! Now you can start worrying sooner about that cancer y

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