BDI-International Magazine - Inaugural Issue

They analyzed a total of 3,583 blood
samples. More than 1,500 of these were
from cancer patients and the rest were
from people who did not have cancer.
Their test was able to correctly identify
which blood samples were from cancer
patients 99.4% of the time. This high rate
of accuracy is impressive.
Not only that but the test was able to
pinpoint the type of cancer the patient
had, that is, it could identify in what tissue
or organ the cancer began. Disease could
be detected at both early and late stages
across 20 different types of cancer,
including breast, colorectal, esophageal,
gall bladder, multiple myeloma, head and
neck, lung, lymphoid leukemia, ovarian,
and pancreatic cancers.
The test was also good at detecting cancers
that have a high mortality rate.
Of these, the accuracy rate was 32 percent
for patients with stage I cancer; 76 percent
for those with stage II; 85 percent for stage
III; and 93 percent for stage IV. Although
the results for stage I cancer are low, this
is still an important result as the patient
may not even realize at this early stage
that they had cancer, and would get an
earlier diagnosis than previously possible.
More research needs to be done before
this test can be rolled out to the general
public, but there’s much to be celebrated
in this work. The fact that they could
identify cancers with a low false positive
rate, and identify the tissue of origin so
accurately across a wide range of cancers,
gives us hope that this test will be available
to patients sooner rather than later.
In the UK, a group from Nottingham
University’s School of Medicine used
another type of blood test to detect breast
cancer and presented their results in
November this year. They examined the
presence of autoantibodies in the blood.
Autoantibodies are antibodies produced
in our own bodies in response to proteins
on the surface of cells called antigens. That
is, the body is trying to protect itself from
an internal threat. In this case, the
autoantibodies were produced in response
to tumor antigens on the surface of the
cancer cells that appear at the earliest stage
of cancer development. The researchers
wanted to see if autoantibodies specific
for breast cancer cells were produced in
the blood of breast cancer patients.They
found that 37 percent of samples from
breast cancer patients were positive for
these autoantibodies, and 79 percent of
the control group was correctly identified
as being cancer free.
This was a small initial study with just 90
cancer patients and 90 controls, but the
results are still very interesting. The
researchers have speculated that this
simple blood test could be used to detect
early stage breast cancer up to 5 years
before there are any clinical signs of
disease. The team is now testing 800
samples from patients and anticipates that
the accuracy of the test will improve with
larger numbers. They are also working on
a similar test for pancreatic, liver, and
colorectal cancer.
Results from another study in the UK were
revealed in September this year. The Early
Detection of Cancer of the Lung Scotland
trial is thought to be the world’s largest
clinical biomarker trial. Its aim is to detect
early stage lung cancer using a blood test.
This study involved over 12,000
participants at high risk for developing
lung cancer due to cigarette smoking. The
participants were split into two groups. A
control group was given X-rays and CT
scans if they developed any symptoms of
lung cancer, and the other group had a
simple blood test. Those in the blood test
group who tested positive were offered
further investigations such X-rays and CT
scans over a period of 24 months.
Similar to the Nottingham study, the
blood test screened for autoantibodies. Of
those who had a positive blood test, 41
percent were diagnosed with early stage
lung cancer, compared to only 27 percent
of the control group. Also, a late-stage
cancer diagnosis was less common in
those who took the test than in those who
received standard care. However, a
positive blood test did not always mean
that cancer was present, but rather was a
sign that the patient should be monitored
further. Interestingly, the study also
observed a behavior change among those
who had the blood test. They were twice
as likely as the control group to voluntarily
join a stop-smoking program. This happy
side effect would of course have a positive
effect on their overall health.So what do
these studies mean for us? Well, diseases
such as lung, pancreatic and ovarian
cancer are extremely hard to detect at an
early stage. Many patients do not have any
symptoms until the disease has progressed
to quite an advanced stage. When patients
are eventually diagnosed, often the disease
has progressed to a point where a cure is
unlikely and aggressive treatment is
needed. A simple blood test that could
diagnose cancer at an earlier stage could
have a huge impact on their long-term
survival.There is also a responsibility on
health professions to relay the results of
these blood tests sensitively.
They need to ensure that patients
understand the full implications of having
these tests and are not shocked by an
unexpected cancer diagnosis. Instead they
can reassure the patient that a cancer
caught in time is much more likely to have
a positive outcome.
These new blood tests for cancer could
save lives and reduce costs for healthcare
providers, insurers, and patients. Let’s
hope that they reach the clinic as soon
as possible.
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