Cancer Free? Check Your Circulating Tumor Cells

December 10, 2018

Cancer Free? Check Your Circulating Tumor Cells


 ReferencesJenny Hrbacek Cancer FreeWikipediaTherapeutic Adv Med Onco

  Circulating tumor cells are not rare. Hang on. You may have them. Right now. Yup, everyone one of us may have circulating tumor cells that are being shed off a cancer. Your immune system may handle them and you may never get disease. Or, they may represent hidden disease that is still years away from presentation. What they represent is that shedding and spreading of an original clone of cancer cells to distant places. The thought is that metasteses are what kill the majority of people with cancer by causing the disease to spread to so many sites that surgical control, or radiation therapy, can no longer keep up. 

When you hit about 1 kg of cancer total, your burden is so great your body cannot maintain itself and you succumb to the illness. From our prior week's newsletters, you should now understand that a visible 1 cm cancer lesion has a billion cells in it, which represent about 7-10 years worth of growth, or 30 generations of doubling. As the cancer grows, it sheds cells into the lymph system, or into the blood system and those cells float away. Generally, they don't stick and survive. Most are filtered out and are gobbled up by your immune system. We think that the majority of them are able to successfully spread only when they travel in bunches or groups. But there they are, and that's what will do you in. Your lung, your liver, your bones and occasionally your brain tend to be where the cells are captured and then establish a new colony. 

Cancers in the bowel tend to then spread to the liver, as that is the next upstream filter. Breast can go almost anywhere. Prostate is commonly in bone. On and on. Hmmm. So, you may have circulating cancer cells floating around from a cancer that is only 13 generations into its growth, so is so tiny you can't see it. You can't feel it. You can't find it to biopsy it. But with antibody technology, you can find it, bind it, measure it and know it is there. Just not exactly where. We can even find fragments of circulating DNA (ctDNA) from destroyed cancer cells that indicate something amiss; either the cancer cells dying and disintegrating from your immune attack. And all 5-7 years before it shows up clinically. 

At that stage, the cancer is likely to be more mature than a cancer at the 23 generation stage. Or more mature than the 27th generation stage, when it is still too small to be seen but is now even less mature and more aggressive and out of control. Earlier generations are more prone to be vulnerable to lifestyle changes: diet, supplements like curcumin, mushrooms, alkalinity, polyphenols. And here is the kicker. What happens if you change your diet and exercise and after three months, your CTCs go down? Would you continue to eat the way you are eating with lots of vegetables and no animal protein? Would your fast mimicking diet not seem so onerous? You betcha. The test is from Biocept in San Diego. They can also test for some specific markers of specific cancers like HER2, ER, EGFR, BRAF, ALK, PD-L1, KRAS, NRAS, PR, AR, ROS1, RET, MET, and FGFR1. And if you understood one word of that sentence, you are way ahead of the fame. The test needs to be done at least two weeks away from any prior treatment and requires a courier service to ship it. The company claims their validated biomarkers are 83-90 percent sensitive and 92-99 percent specific. Some insurance companies pay for it, and Biocept is willing to give it a try. But you can get it for around $ 700. 

 WWW: What will work for me. Goodness. This is a roadmap to allow folks with disease the opportunity to monitor how they are doing. It's a bit pricey, but the data is pretty powerful. Knowing that you may be getting a 7-10 year jumpstart is pretty cool if you want to know. Would you get chemotherapy for a specific cancer before you could even see the cancer? It raises many issues, to be discussed by you and your oncologist/doctor. I'm doing it. 

 Pop Quiz

  1. Most people with cancer die from the size of their primary cancer? T or F         Answer: False. Most people die from the accumulated mass and disruption caused by the original cancer spreading to distant sites by cancer cells floating around and taking root in distant places. It's still breast cancer if it started in your breast and is now mostly in bones. And it will very likely have protein markers you can measure on it.
  2. How big does a cancer have to be to show up on a physical exam?                   Answer: Usually in the range of 1 cm, which is a billion cells, which is 30 generations.
  3. What happens to circulating cancer cells when you start a lifestyle strategy change that is successful?                                                                                                                    Answer: The CTCs (circulating cancer cells) go down. Success!
  4. Which would you rather have, surgery on your lung to biopsy a cancer ($ 25,000 and 3 days in the hospital) or a blood test ($ 700 in 5 a minute blood draw)?                    Answer: Your choice
  5. The blood test for circulating cancer cells becomes? What?                               Answer: A liquid, affordable biopsy.