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  1. A system to detect circulating tumor cells in the bloodstream earlier and less invasively was recently granted FDA approval, with Wilmot Cancer Institute researchers and Wilmot patients playing a major role in the groundbreaking studies. The new technology is for “liquid biopsies” to track metastatic breast cancer but could be applied in the future to other cancers. Additional research led by a radiologist at the University of Rochester Medical Center confirms that ultrasounds are an effective predictor of ovarian cancer in women of average risk who develop a mass in the pelvic region. The Radiology journal study generated buzz recently because sorting out which women may need surgery or further follow-up care is full of nuances and challenges in the real world of busy medical clinics. “As part of a leading translational research team, it is gratifying and exciting to see the movement of science toward innovations with actionable information that can guide treatment decisions,” said Richard Moore, M.D., chief of the division of Gynecological Oncology and director of the Targeted Therapeutics Laboratory at Wilmot. Richard Moore, MD Liquid Biopsies Could Simplify Metastatic Breast Cancer Detection Last month, the U.S. Food and Drug Administration granted a United Kingdom-based company, ANGLE, the first-ever product clearance for technology called the Parsortix PC1 Clinical System. It harvests cancer cells from a patient’s blood sample, isolating tumor cells based on size and deformity, for analysis. It takes about two hours for results. Moore’s laboratory at Wilmot was the sole location nationally to test whether the technology produces the same results each time, a research concept known as reproducibility. He also was an investigator on several clinical trials sponsored by ANGLE, enrolling more than 500 local women during the past few years in breast and ovarian cancer trials. “Technology like this is a big deal because it’s designed to capture living cancer cells early on, before a tumor is found by conventional means such as a CT scan or a surgical biopsy,” Moore said. “And if tumor cells are detected,” Moore said, “the technology also allows us to test for gene expression to discover if a patient could benefit from a treatment that would target those genes — all from a simple blood draw." Kyu Kwang Kim, Ph.D., research assistant professor of Obstetrics and Gynecology at URMC, and Negar Khazan, Ph.D., performed the work in the Moore lab. All of the data generated at Wilmot was part of the company’s FDA submission, ANGLE said. Moore is continuing to work with teams at ANGLE, which is also funding studies using the Parsotix system to detect ovarian and endometrial cancer. Investigation of liquid biopsies is exploding; in fact, another Wilmot team led by James McGrath, Ph.D., and Jonathan Flax, M.D., is developing a liquid biopsy test to detect cancer-specific cells for colorectal cancer, which disproportionately impacts Black individuals in the 27-county region from which Wilmot draws patients. What Does Cancer Look Like? For some types of cancer, such as ovarian, routine screening and early detection is not always possible. Akshya Gupta, MD This is why research led by Akshya Gupta, M.D., assistant professor of Imaging Sciences at URMC is important: He validated an accurate way to classify pelvic lesions that show up periodically in women who do not have a high risk of ovarian cancer. The study showed that based on ultrasound appearance, pelvic lesions can be effectively placed into two categories — classic and non-classic — with 93 percent sensitivity. “Classic” is for fluid- or fat-filled cysts that carry a very low risk of being cancerous. “The incidence of ovarian cancer in the general population is very low and the vast majority of lesions that we see as radiologists have classic, benign features where the risk of cancer is exceptionally low, below 1%,” Gupta said. “That’s reassuring.” But what separates the classic lesions from the ones that need immediate attention? “Non-classic” masses usually have a solid component or blood flow within the lesion that can be seen on Doppler ultrasound. Of the 970 lesions analyzed in Gupta’s study, the non-classic ones had a 32 percent frequency of malignancy in younger women and a 50 percent chance of being cancer in older women. Gupta explained that algorithms have existed for years to assess pelvic lesions but they are often based on patients who have already been referred for surgery or to a gynecological oncologist. These women have a higher incidence of cancer compared to the general population. Therefore, he said, the classic versus non-classic approach can help to stratify lesions when radiologists are called upon to triage women of average risk for ovarian cancer. Many of these cases come about when women go to their doctors with concerns about an ovarian cyst, minor abnormal bleeding, or if a small pelvic mass is discovered incidentally during an evaluation for a different health issue.
  2. [Note: this was a discussion that Rodney started in response to a post on another thread. After talking about it with Rodney, we thought it worthwhile on this new "General Health and Longevity" forum to start a new thread on colon cancer screening. So I've moved the discussion to its own thread here. While our good diets make colon cancer less of an issue for CR practitioners than the general population, it is a serious enough health risk (3rd leading cause of cancer deaths) that it is worth serious consideration, and screening for. -Dean] Despite having no known family history of colon problems of any kind in previous generations, my brother and I both seem to acquire a new polyp about every two years. So, of course, we need to have occasional colonoscopies. My last colonoscopy was two weeks ago, and prior to that the previous one had been in 2009. You can guess how many new polyps they found this time: three of course: One of moderate size, one smaller, and one tiny one ...... likely to have appeared, respectively, in 2010, 2012 and 2014. All of them were quickly and painlessly removed and sent to pathology. Polyps of course, start off benign, but if left long enough, are likely to turn into cancer. Now the relevence of this to Dean's post is that none of the nine polyps I have had removed over the years have shown even the very earliest suggestions of turning cancerous - even the one just removed, for example, that probably had been sitting there for five years since 2010. (But what would the current status of the one found in 1998 be, had it not been found and removed?) It seems likely the explanation of the benign nature of my polyps might be that I have gone a long way out of my way to avoid eating stuff that, while no doubt devastatingly tasty, might also be devastatingly carcinogenic (incinerated fat, for example, in particular). Anyway, SFSG. I have noted to have another colonoscopy in 2019 and expect them to find another two then. Six years is a bit too long to go between checks for someone who regularly seems to sprout new ones. Anyone approaching the age of 60, who is aiming to live to be 100, and has never had one, probably ought to get a baseline colonoscopy and then follow the gastroenterologist's advice. Having them reduces the chance of getting colon cancer - a rather common form of the disease - by not far short of 100%. Not only that, the health systems have finally figured out that doing colonoscopies at appropriate intervals - which will vary from patient to patient - is less expensive than the cost of treating the cancer when it appears if colonoscopies are not done. Incidentally, all my polyps have been found in the ASCENDING colon or at the very start of the transverse colon. They would never have been found by any other investigative technique until far too late. It may also be worth mentioning that it is surprising to me how often, even when cancer is found in a polyp, if it is found early, the cancer can be surgically cured. And I do mean *genuinely* cured - not the five-year supposed cure so often talked about in cancer treatments. But changes in diet are of course necessary if cancerous polyps are not to recur. Rodney. "The unverified conventional wisdom is almost invariably mistaken."
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