Lani
05-30-2012, 03:13 AM
surgery. Retest at 6 months after surgery as well to see effect of systemic therapy.
Now is this really asking a lot to help decide what type of treatment best initially, whether the treatment given has worked (so another course of treatment can be given before bones break, liver and/or lungs involved, etc?
Unfortunately, this Norwegian study did not look at her2+ bc specifically, but other papers have shown her2+ bone marrow disseminated tumor cells are even more indicative of prognosis
Wouldn't knowing your breast cancer was more likely to recur in 75% of patients rather than 15% of patients, for example, influence your choice of treatment and wouldn't singling out those patients to have more specific studies looking for the driving signalling pathways, mutations, fusions etc to determine the best treatments for them be more cost effective than paying for oncodx or similar tests for everyone with breast cancer??? (not that they are doing that now, but only because of the costs involved--$3000 per test--- and the fact that similar answers can be obtained more cheaply with a few IHC tests)
Years ago, they used size, numbers of positive lymph nodes and grade to choose women after surgery without distant metastasis to classify them as at high likelihood of recurrence for bone marrow transplants-- very expensive and health-damaging and not very effective.
Patients with leukemia get bone marrow tests all the time and do not complain--it allows them to discover whether their treatment is working and change treatments if not.
Waiting to find out if CTCs can be as good as DTCs (bone marrow tumor cells) will probably take a long time. They can't decide on a technology and it may STILL turn out that they STILL are not as good as DTCs to determine whether a given breast cancer is likely to recur and if treatment eradicated it.
There are no guarantees that a clinical trial would show DTCs to always be able to predict prognosis or correctly steer therapy, but paper after paper shows them to be predictive and more accurate I would say than other tests.
Would you be willing to undergo such testing in a clinical trial to find out?
Usually these trials are done in Germany, where oncologists are trained to be hematologists as well and are comfortable doing the bone marrow sampling.
I suppose the same is true in Norway, where this study comes from. Why couldn't an oncologist cooperate with a hematologist or an orthopedic surgeon
in doing bone marrow testing if they are not comfortable with it/good at it.
A 85 year old neighbor of mine volunteered to have her bone marrow tested to earn a little money and advance medical science She said she was slightly sore for a day or so and said it was "nothing" She said it was done by a nurse practitioner in a minor surgery room.
Even Susan Love, when asked about bone marrow testing, didn't seem keen --but gave no answer as to why not. Blood samples are simpler and do not require equipment, special training, etc
I know I have asked this before, but doesn't it seem like this should be an area that should be pursued?
How many of you would agree to be tested to find out if, indeed, as in my previous post quoted Dr Bromberg saying Dr. Bromberg, "educated bone marrow is the key in disease recurrence and may even foster a future secondary cancer."
Now is this really asking a lot to help decide what type of treatment best initially, whether the treatment given has worked (so another course of treatment can be given before bones break, liver and/or lungs involved, etc?
Unfortunately, this Norwegian study did not look at her2+ bc specifically, but other papers have shown her2+ bone marrow disseminated tumor cells are even more indicative of prognosis
Wouldn't knowing your breast cancer was more likely to recur in 75% of patients rather than 15% of patients, for example, influence your choice of treatment and wouldn't singling out those patients to have more specific studies looking for the driving signalling pathways, mutations, fusions etc to determine the best treatments for them be more cost effective than paying for oncodx or similar tests for everyone with breast cancer??? (not that they are doing that now, but only because of the costs involved--$3000 per test--- and the fact that similar answers can be obtained more cheaply with a few IHC tests)
Years ago, they used size, numbers of positive lymph nodes and grade to choose women after surgery without distant metastasis to classify them as at high likelihood of recurrence for bone marrow transplants-- very expensive and health-damaging and not very effective.
Patients with leukemia get bone marrow tests all the time and do not complain--it allows them to discover whether their treatment is working and change treatments if not.
Waiting to find out if CTCs can be as good as DTCs (bone marrow tumor cells) will probably take a long time. They can't decide on a technology and it may STILL turn out that they STILL are not as good as DTCs to determine whether a given breast cancer is likely to recur and if treatment eradicated it.
There are no guarantees that a clinical trial would show DTCs to always be able to predict prognosis or correctly steer therapy, but paper after paper shows them to be predictive and more accurate I would say than other tests.
Would you be willing to undergo such testing in a clinical trial to find out?
Usually these trials are done in Germany, where oncologists are trained to be hematologists as well and are comfortable doing the bone marrow sampling.
I suppose the same is true in Norway, where this study comes from. Why couldn't an oncologist cooperate with a hematologist or an orthopedic surgeon
in doing bone marrow testing if they are not comfortable with it/good at it.
A 85 year old neighbor of mine volunteered to have her bone marrow tested to earn a little money and advance medical science She said she was slightly sore for a day or so and said it was "nothing" She said it was done by a nurse practitioner in a minor surgery room.
Even Susan Love, when asked about bone marrow testing, didn't seem keen --but gave no answer as to why not. Blood samples are simpler and do not require equipment, special training, etc
I know I have asked this before, but doesn't it seem like this should be an area that should be pursued?
How many of you would agree to be tested to find out if, indeed, as in my previous post quoted Dr Bromberg saying Dr. Bromberg, "educated bone marrow is the key in disease recurrence and may even foster a future secondary cancer."