With cancer, early detection equals a greater likelihood that treatment will have a positive outcome.
Physicians have known this for a long time, and the statistics back them up. Survival rates for those afflicted with many types of cancer have risen dramatically in the past few decades. And one of the primary reasons is that we are diagnosing cancer earlier and with much greater accuracy.
Not only are people more mindful about getting regular checkups, but diagnostic techniques have improved by leaps and bounds, as well.
In the not-too-distant past, the only way to get a close-up look at what was going on inside a patient's body was via exploratory surgery, which is not unlike using a sledgehammer to drive a threepenny nail. There's considerable collateral damage.
X-rays, which were discovered at the turn of the last century, added an important new tool to the diagnostic arsenal, and they remain the most common first option today. And there things stood until the 1970s, when the whole field suddenly exploded.
Ultrasound machines use sound waves to map internal body structures. They're simple and cheap, provide immediate results, and don't involve radiation. Though they've been around since 1950, they weren't perfected until 1979, when they added computing technology for image enhancement.
Computed tomography (CAT) and positive emission tomography (PET) scans were also introduced in the '70s. Both provide detailed maps of internal body structures, with CAT scans employing X-rays and PET scans gamma rays. Nowadays, CAT and PET scans are often performed in immediate sequence in the same session, and the results can be quickly correlated to provide very detailed views of moving organs, in three dimensions and real time.
The magnetic resonance imaging (MRI) machine was first studied on humans in 1977. An MRI scanner generates a powerful magnetic field that agitates atomic nuclei into giving off photons, which have frequencies that can be translated into an image.
Finally, needle aspiration biopsies -- which came to market in 1981 -- involve the removal of a small number of cells from a suspected problem area. They are minimally invasive, generally safe, and often the procedure of choice for examining potential tumors that lie just under the skin.
All of these tools are an improvement on cutting each patient open. Although each has its drawbacks as well as its benefits, they have comprised the physician's options for the past thirty years. What has been missing is a diagnostic that reveals the presence of cancer, no matter where it is or what stage it's at. Something, in other words, that will provide the earliest of early detections. And, oh yes, it should also be non-invasive and risk-free.
That's the golden key, and though it may seem like asking for too much, doctors are close to having it in their hands.
Last December, in a paper published in Nature, researchers at the Massachusetts General Hospital Cancer Center revealed the results of tests with a new cancer blood test. The test uses microchip technology to sift blood to search for circulating tumor cells (CTCs), which come from solid tumors and roam through the blood.
CTCs are hard to find because they're rare, accounting for just one in a billion among cancer patients' blood cells. Yet the test homes in on them with great accuracy. Used on 116 cancer patients, including people with lung, breast, prostate, pancreatic, and colon cancers, the test spotted CTCs in the blood samples from 99% of them. It detected CTCs even when there were only 5 CTCs in a milliliter of blood. At the same time, the test returned no false positives in blood samples from 20 healthy people.
The test requires only a couple of teaspoons of blood, and doctors initially want to put it to work providing instant feedback on whether a particular therapy is or is not working. Most exciting, though, is its potential for early diagnosis. Although researchers stress that a great deal of work remains to be done, providing cancer screenings as a routine part of one's conventional blood workup seems like an attainable goal.
This is such a breakthrough that Johnson & Johnson immediately announced it was throwing its considerable resources behind the effort to bring the test to market. And four major cancer research centers in the U.S. have signed on to do follow-up research this year.
A home cancer test kit? No, that's not even on the horizon as yet. But the possibility can now be imagined. And technology has repeatedly demonstrated that what can be imagined can eventually be created.
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