Diagnosing cancer early. Cancer or no cancer? screening test. 1

Best cancer screening method answers first a simple question. Is there a cancer in the body? Or not? If answer is ‘yes’, then more targeted cancer diagnostic tests can be employed. If ‘No’, a patient is saved from potential risks of radiation exposure and invasive cancer testing.

Cancer rates increase due to worsening environment. Cancer risks increases due to sedentary lifestyle of people. There is more cancer because people are living longer. But a lot of cancer screening and prevention methods are very old. What is new in cancer prevention? Dr. Anton Titov, MD. What is new in cancer screening? Dr. Anton Titov, MD. It’s true that the incidence of cancer is increasing worldwide. Cancer rate comes to alarming levels of 14 million new cancer cases every year. About two-thirds of cancer patients are going to die every year. But at the same time there is some improvement in cancer screening. Dr. Nadir Arber, MD. We do see some declining in the mortality from a few cancers. There is less mortality from lung cancer and colon cancer. Dr. Anton Titov, MD. It’s true. Usually early cancer detection is lagging behind the novel cancer therapies. Cancer screening lags behind rise in cancer incidence. But still we have new cancer detection methods on the horizon. There were two articles just this year. One cancer screening article is from Johns Hopkins. It is from the Dr. Burt Vogelstein group. Another cancer prevention article is from Australia. There are blood tests that can detect cancers. Diagnostic tests can find several cancers. In my eyes this is a real breakthrough. If you can find a blood test that can tell us if there is cancer there or not. This could be a breakthrough! Dr. Nadir Arber, MD. We are also developing the similar cancer detection tests in our lab. Dr. Nadir Arber, MD. We  are using the simple blood tests. You can identify about 6-7-8 cancers. It depends on the difference between people with cancer and healthy people. In particular, we are happy that we are able to detect some pre-cancers. Dr. Nadir Arber, MD. We can detect colon polyps. If you are able to detect polyps, then we know who needs a colonoscopy. Because these people are prone to develop colorectal cancer. You are correct. Dr. Nadir Arber, MD. We are lagging behind in early cancer detection. But at the same time there is promising new cancer diagnostic tests. The ultimate cancer detection test is a blood test. If it can be a general preclinical cancer stage blood test. It can tell you, “yes or no for any cancer”. This is the best early cancer detection test. General early cancer detection test is better than a separate diagnostic test for breast or colon cancer tests. Because it is complicated. You’re looking for something that is similar to CRP, C-reactive protein. CRP tells us if there is inflammation in patient or not. Sometimes we can have the similar things for early cancer presence overall. Early cancer detection is going to be a breakthrough. Eventually we are going to achieve it. Is any cancer present? Dr. Anton Titov, MD. The preclinical cancer detection test is going to be found sooner than we think. This is very interesting. Dr. Nadir Arber, MD. We are talking about something similar to a “liquid biopsy” for people who might already have cancer. But liquid biopsy is looking for circulating tumor cells in patient’s blood. Perhaps there will be blood tests that are similar to liquid biopsy. These will be diagnostic tests for screening a general population for certain cancer markers. These cancer markers are present on circulating normal cells. Maybe early cancer screening tests can do tumor cells detection? Dr. Anton Titov, MD. Yes, in liquid biopsy it’s true. Dr. Nadir Arber, MD. We are looking for CTC, circulating tumor cells. There are also some other molecular cancer markers. Dr. Nadir Arber, MD. We are working on CD24. Dr. Nadir Arber, MD. We think CD24 is very promising early cancer detection marker. There is some other early cancer markers. Most probably there will have to be combinations of a several early cancer detection tests. But the wisdom is to have one cancer detection test in one test tube. Obtain medical second opinion on cancer. Then it’s going to achieve the real impact. Dr. Anton Titov, MD. You think universal cancer detection test will come to the market in the next 5 to 10 years? Dr. Anton Titov, MD. It must be in the next five years! Next 5 years for a universal cancer detection test? Dr. Anton Titov, MD.