Blood Test Spots Multiple Cancers Without Clear Symptoms, Study Finds (theguardian.com) 53
Doctors have told health services to prepare for a new era of cancer screening after a study found a simple blood test could spot multiple cancer types in patients before they develop clear symptoms. From a report: The Pathfinder study offered the blood test to more than 6,600 adults aged 50 and over, and detected dozens of new cases of disease. Many cancers were at an early stage and nearly three-quarters were forms not routinely screened for. It is the first time results from the Galleri test, which looks for cancer DNA in the blood, have been returned to patients and their doctors, to guide cancer investigations and any necessary treatment.
The Galleri test has been described as a potential "gamechanger" by NHS England, which is due to report results from a major trial involving 165,000 people next year. Doctors hope the test will save lives by detecting cancer early enough for surgery and treatment to be more effective, but the technology is still in development. "I think what's exciting about this new paradigm and concept is that many of these were cancers for which we do not have any standard screening," Dr Deb Schrag, a senior researcher on the study at the Memorial Sloan Kettering Cancer Center in New York, told the European Society for Medical Oncology meeting in Paris on Sunday.
The Galleri test has been described as a potential "gamechanger" by NHS England, which is due to report results from a major trial involving 165,000 people next year. Doctors hope the test will save lives by detecting cancer early enough for surgery and treatment to be more effective, but the technology is still in development. "I think what's exciting about this new paradigm and concept is that many of these were cancers for which we do not have any standard screening," Dr Deb Schrag, a senior researcher on the study at the Memorial Sloan Kettering Cancer Center in New York, told the European Society for Medical Oncology meeting in Paris on Sunday.
And Elizabeth Holmes is fuming (Score:2)
A "simple blood test" to spot cancers (and other diseases) was the central idea of Theranos. And now others have actually made it a reality. Lizzie's probably pulling her hair out right now.
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20mL of blood is a little more than a single drop of blood (which is still a ludicrous claim at any point in the near future).
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20mL of blood is a little more than a single drop of blood (which is still a ludicrous claim at any point in the near future).
No, I think your claim that 20mL is more than one drop is, and will be, pretty valid. :-)
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I wouldn't go that far. There have been lots of advances in microfluidics recently. But it's probably over 10 years away.
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"is a little more than a single drop of blood" is NOT the way I'd describe 20mL. Think 2cm x 2cm x 5cm. Or a sphere 3.3cm in diameter (1.25 inches).
The ability to detect around 50 types of cancer is a major improvement over taking 50 bloodtests, I admit.
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"is a little more than a single drop of blood" is NOT the way I'd describe 20mL
Even if you were being sarcastic?
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"20mL of blood is a little more than a single drop of blood "
In Germany that's a shot.
Or a half one in other countries.
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I don't think other countries are doing shots of blood. Maybe that's just a Germany thing. Like the raw ground beef.
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"I don't think other countries are doing shots of blood."
Speak for yourself.
"Maybe that's just a Germany thing. Like the raw ground beef."
Hardly. raw ground beef is called 'filet américain' the name a dead giveaway, more ungerman isn't possible.
Germans eat raw ground PORK, with a Brötchen and lots of onions, it's a delicacy.
I'm not even German and I eat it every Wednesday morning, when my butcher makes it fresh for every bun.
Just like medium rare horse-steak, also, lots of onions.
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20ml. The Galleri test uses two 10ml vials. It was a bit of an exaggeration of scale difference to prove a point, of course.
Re:And Elizabeth Holmes is fuming (Score:4, Informative)
And it's not correctly positioned to say "many of these tests are not routinely screened for", which implies these are mystery cancers anyone can get. Around 40 of those cancers are so rare that the reason they're not routinely screened for is simply because there isn't a clinical need.
It's still remarkable what they've done. But they need to make it appear amazing to justify the $B of investment and further $6B acquisition by Illumina, and it's not quite as game changing for cancer as they're making it out to be.
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Well, if a cancer is sufficiently rare, the reason for not testing for it is that more false positives will be detected than the accurate detections. This can seriously annoy people.
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I'm sure they are a LOT more than annoying to you. But false positives are a real problem. and by "seriously annoying" I was thinking about requiring exploratory surgery and (for some dangerous) biopsies. Doing that to 1000 people for each you treat is not a good choice.
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They're just sequencing the DNA floating around in the blood sample. Twenty years ago it was science fiction, but it's pretty simple today. The actual cost of the next gen sequencing is probably more like a couple hundred dollars than the couple thousand they're charging, and next next gen sequencing is likely to bring it down to a couple bucks. The dedicated hypochondriac could test themselves every morning.
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I kind of doubt you're "in this space," or maybe you're just trying to sell something. Your numbers seem to be from 2015 or so. Illumina themselves put sequencing a genome, which means assembling the thing not just looking for suspicious SNPs, at about $600. You can buy an Oxford Nanpore machine for $1000: https://www.nature.com/article... [nature.com]
Anyway, as I said, the process is absolutely bog standard. Every reasonably equipped university bio lab sequences DNA routinely and every grad student can build a library
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Theranos was trying to do multiple tests with a single drop of blood from a pinprick.
Multiple tests from a 20 ml draw from a vein is much easier.
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A "simple blood test" to spot cancers (and other diseases) was the central idea of Theranos. And now others have actually made it a reality. Lizzie's probably pulling her hair out right now.
All it is doing is showing that the grift worked once, so it has to come back.
Version 2 is more clever - as asymptomatic diseases are a lot easier to disprove or prove. A bold move - let's see how it works out.
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The Theranos concept wasn't the problem, it was the execution. When your company's leadership is willing to cut corners and blatantly lie about what the company's product can do, reality will eventually show up. Just because Theranos failed, doesn't mean that the concept is doomed to fail.
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This is going to be _expensive_. (Score:4, Insightful)
And I don't mean the price of testing. I mean if we now have a test that shows early stage cancers (many of which will probably just go away before becoming dangerous) that means they'll now be doing a lot more follow up testing and potentially treatments for cancers that otherwise would not have been noticed and indeed wouldn't have become dangerous.
Don't get me wrong, still a good thing for sure and they'll no doubt improve it, find better cheaper forms of after-screening, treatment, etc.. but it could be a huge cost sink for a national health care system.
Re:This is going to be _expensive_. (Score:4, Interesting)
I don't think the current state of science suggests that any cancer can spontaneously resolve. All cancers currently found at an early stage are known to continue developing.
There is some possibility that occasional pre-cancerous cell mutations get destroyed by the immune system. However, those do not rise to the level of what "cancer" is, nor are they what tests find. By the time any, even extremely sensitive, test finds one - it is an established cancer that is not going away.
That said, some cancers develop slowly, so the person could live out their normal life expectancy and/or die from something else. That's def. a possibility, and one medical professionals will have to handle. In countries where medicine is not "pay for service" they will probably find some balance between immediate treatment and watchful waiting. In US - patients will have to make that decision.
Re:This is going to be _expensive_. (Score:4, Informative)
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That is what I said too. Cells - yes. Cancer (medically defined) is more than a few atypical cells.
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As one researcher put it, we all have cancer all the time (at the level of individual cells gone wrong), but what we call clinical cancer happens when we stop fighting it off, or it beats us.
I can see this tool being valuable as an early diagnostic for relatively silent cancers. I expect the quantity of DNA in the blood correlates fairly well with how advanced it is, so maybe it won't see the one-cell-here-and-there cancers at all.
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And they're be on your medical records and insurance companies may count them as pre-existing conditions. Not a big deal now under ACA rules, but if (certain) politicians are ever successful in their perpetual attempts to overturn/abolish the ACA, then that could be an issue.
Re:This is going to be _expensive_. (Score:4, Insightful)
With a large enough study size, they can estimate the number of cancer deaths that would have happened, along with the expenses involved, and compare them with the deaths and expenses involved with the test. My guess is that the test will result in increased life expectancy and lower costs (early cancer is likely cheaper than later cancer), but I'm just speculating. But before making this a routine test (which is what the creators of the test almost certainly are hoping for), they should provide real data to that effect.
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The expenses of treating more advanced cancer cases would probably be considerably higher. If it's something that should be watched rather than treated, that's what the doctors should recommend. As the already do in things like many prostate cancers.
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Yup. National heath care systems are going to be screwed with this, all based on the "potential" of cancer occurring.
But that certainly won't stop Greed N. Corruption in every medical system from fearmongering the living shit out of you, for profit.
While you might view this as "still a good thing", Common F. Sense and the history of Greed, holds me in reserve.
I got it last month (Score:3)
Insurance isn't paying for the Galleri test in the US yet, so it was out of my pocket.
The results were negative. That means I'll still be here to provoke the trolls for a while.
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Oh there will always be threats and risks not covered by the test. One can never be too sure how much time is left.
False positives and false negatives (Score:4, Insightful)
From the article: Further analyses found the blood test was negative for 99.1% of those who were cancer-free, meaning only a small proportion of healthy people wrongly received a positive result. About 38% of those who had a positive test turned out to have cancer.
This means that if you test 100 cancer-free people, 9 will receive a positive result. And also it means that if you receive a positive result, it is more likely (62%) that you are cancer-free than you have a real cancer (32%).
False negative rate is not reported in the article.
Don't get me wrong, this is a HUGE advancement. However, we have to be VERY careful with the result and we always need to have an expert interpreting the outcome. A cancer diagnosis is a life-changing event, and there is always some residual false-positive rate. Besides the cost, this is one of the reasons to not have population-wide constant screening, but only when early synthoms appear. Let's hope that this tool accelerates detection.
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You dropped an order of magnitude.
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99% of 100 is 99.
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As other people comment, there is an obvious mistake and it's 9 false positives per 1000 tests. But the idea is the same, for those 9 people the concern is huge.
Good point (Score:2)
Although your figures are off, it's still a good point, and people who read only the synopsis might miss it. Here are the numbers from the article:
6621 people were tested.
92 people were found positive by the test.
35 people were found to have cancer.
So 57 people were found positive but had no cancer.
The article implies that there are no cancers in the rest of the group, but it's not 100% clear if that's the case.
So basically 57 out of 6586 people with no cancer were found positive.
By the way, there's a bad f
A miracle! (Score:2, Interesting)
Then you take the new miracle drug that cures all these forms of cancer, and are cured immediately. No symptoms before, none afterwards.
100 thousand a dose? 2 million? Of course today, it has to be lifetime maintenance - that's where the real bucks are.
I know we live in an age of grifters and fools, but this seems like higher level grifting than mere mortals could imagine.
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This exact issue came up in my discussion with my doctor about whether to spend the money on the test. He has been recommending it for his patients but he hasn't had anyone return positive results. He acknowledged the risk of false positives, but the screening does not typically bring treatment without further investigative measures. If you return a positive result on this test without other evidence of disease, it doesn't currently indicate anything beyond surveillance.
Ugh - Imagine waiting around for maybe 20 years after getting a positive hit. I know that some people really want to know what is going to kill them, but the idea that say "I have (insert) cancer, but it won't even show up for 20 years, or maybe never if a false positive."
That would be a great hit at parties. Not to mention it would now be a pre-existing condition if you changed jobs and healthcare providers (assuming the idiotic US healthcare non-system.)
No shit sherlock! (Score:2)
Why didn't anyone before come up with this multi-billion dollar idea?
Rediscovery (Score:2)
from amazon
Microcompetition with foreign DNA and the Origin of Chronic Disease. Paperback – August 1, 2003
The cause of many of the chronic diseases such as cancer, atherosclerosis, obesity, diabetes, osteoarthritis, multiple sclerosis, is unknown. Therefore, current medications, if available, treat symptoms rather than cause. Under such conditions, recovery and prevention are unattainable. Recently, Dr. Hanan Polansky discovered that the cause of these diseases is an infection with a latent, or "dorma
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I just received the book and have only read the first chapter. It discusses some virus cells lines were infected with various viruses and at a certain point its reproduction of new viruses was limited by the host DNA transcription machinery. Thus there is competition for various resources within the cell and this can lead to problems. One major item binded by viruses is p300/cbp. This signaling protein is according to literature the most connected via pathways of any protein. It keeps androgen receptors in
The next question should be: which need treatment? (Score:2)
I've heard it said that any adult has, at any given point, six cancers that are being perfectly well managed by their immune system and that these six will either be extinguished, or never amount to much, clinically.
So, of these detected cancers, which actually need treatment? Or is this the wrong test and, in fact, will produce a huge false positive rate for clinically relevant cancers?
Was in it (Score:2)
I was in this trial. The sensitivity is quite poor for many cancers, and the specificity ain't all that great, either. Whether it's worth using for screening is a tossup, because a lot of patients would put too much stock in it, one way or the other. For me, more data is better, but not for everyone, since most people don't understand that data is not binary.
That's great (Score:1)