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Over 8.2 million people die of cancer each year due to the bad accessibility to detection methods and treatment. The problem is that people are finding out they have cancer too late which makes it harder to treat. Cancer is the 4th most leading cause of death between adults 20-39 years old in the United States. Nearly half of people who have cancer arent diagnosed early enough. This makes it harder for the treatment to succeed, making it more likely for the patient to die. Circulating tumor DNA can help detect cancer cells quite early on. Once a cancer has spread it makes it a lot harder to treat and get rid of. Circulating tumor DNA cancer detection method can help doctors identify if a patient has the cells for cancer. The most important part about this technology is that it can identify cancer cells before theres a tumor. This technology can help doctors start treating the patient quickly which will increase their risk of survival and increase the chance of the treatment being successful.
Cancer cells break down during their life allowing ctDNA to be released into someone’s bloodstream. A liquid biopsy is also called ctDNA examination of a blood sample. It can notice and spot cancer-related to mutations. Solid biopsies cannot show tumor dynamics or sensitivity to the treatment because they are invasive and cannot always be done effectively. It’s better to develop a less invasive detection method. Circulating tumor DNA cancer detection method can be a good alternative. Circulating tumor DNA comes from cancerous tumors and cells. Cells die as the tumor grows and cells are restored by new ones. The dead cells break down and the DNA is released in the bloodstream. Circulating tumor DNA very small pieces of DNA. A biopsy sample of tissue is often tested for specific genetic variation (also called mutations).
Circulating tumor DNA is extracted in a non-invasive way using a blood sample. Doctors are required to have approximately 3ml of blood in EDTA coated tubes. EDTA tubes are important to lower coagulation of blood. The serum and plasma factors of blood can be split up using a centrifugation step. Circulating tumor DNA can then be extracted from these fractions. Most studies use plasma for ctDNA. To remove residual intact blood cells, plasma is prepared again by centrifugation. The supernatant is used to get the DNA, which can be done using special kits. Many different amplification and sequencing methods are needed for the examination of ctDNA after removal. These methods then can be divided into two different groups depending on if the goal is to interrogate all genes in a non-targeting manner, or if the goal is to monitor and observe certain mutations and genes.
Advantages
- Circulating tumor DNA cancer detection method can be very advantageous because it’s detected in the blood and it’s less invasive and risky for multiple tumor biopsies, and to monitor and track the tumor.
- Evidence shows that there is a big chance that ctDNA cancer detection method can benefit and improve the early detection of a tumor and the treatment.
- By searching for ctDNA in the blood can point out key molecular markers which can be missed out if another tissue biopsy is hard to follow.
- Test results are generally available earlier than tissue biopsy. Doing a liquid biopsy makes it possible for doctors to make an early diagnosis.
- To approximate the risk for metastatic progression or metastatic relapse liquid biopsies can be done.
- Circulating tumor DNA can often be repeated and can be done as often as necessary if the patient’s tumor progresses or if doctors want to monitor the cancer.
- Liquid biopsy costs less than tissue biopsies.
Disadvantages
- Some cancer patients have little tissue left after a liquid biopsy, which might not be enough for the genetic testing that could form the cancer treatment later.
- Tumors can be dangerous and difficult to reach after more than one biopsy.
- In the blood it’s hard to detect small quantities of DNA variation, mainly when the patient has a small volume of the cancer.
- Tests can come out negative if the patient’s cancer volume is too small.
- Circulating tumor DNA tests can cost thousands of dollars. Insurance coverage is variable. This can be hard for people who cannot afford the expensive test, but would like to get tested.
- Liquid biopsy procedures arent as well known and done as tissue biopsy. More verification is necessary to find the real value of liquid biopsies in the medical world to support the clinical benefit of the test.
- More studies are needed to identify whether the test is accurate enough and its ability to identify certain tumors.
- Test sensitivity challenges also exist. Circulating tumor cells are quite rare compared to the hematological molecules found in someone’s blood sample, there are challenges to the tests accurate enough detection ability.
Personal Opinion
I think ctDNA cancer detection method is a better alternative from tissue biopsy because its less invasive but it can still detect ctDNA just as well. However, the test might come back negative if the patient’s cancer volume is too small, which is a disadvantage for the patient because the test is expensive and they might want to do it again. Nevertheless, the technology has lots of advantages which make it beneficial.
Liquid biopsy is offered and developed in a number of small laboratories in the UK. In 2018 there were a total of 316,680 cancer diagnoses in the UK. Because the tests aren’t very well known and developed yet so many people dont do them. Cancer is a genetically inherited disease and if a patient’s test comes back negative but someone in their family has had cancer before they might want to do the test again. The test costs 1,200$ which is very expensive for some people especially if they have to do it more than once. The poverty rate in the year 2018 was 11.8% in the USA. Meaning almost 12% of the US population likely couldnt afford to do the test again or to even do the test the first time. This connects to the economic factor because the test is expensive and not everyone can afford it. Moreover, ctDNA testing is still being developed which makes it inaccessible for many people.
Summarizing, I believe that ctDNA testing is very beneficial for the world and cancer patients. It has a big potential for helping detect cancer and help cancer patients survive in the future.
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