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Dr. Andy

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CANCER

Background:
Where does Cancer come from?

  • Normal, Healthy Tissues Occasionally Produce Cancer Cells

    Every day your body naturally produces 3,000-4,000 cancer cells.

  • These are actually genetic mutations,flawed copies of DNA.
  • But this is not a problem, because your body is smart and quickly spots these mutant cells
  • Your immune system identifies and eliminates these mutated cells before they can replicate and begin to cause damage.

  • This model holds true for most of the population from birth through middle age. Assuming you are born with a healthy immune system and do not suffer from any condition that would impair it, your body will naturally deal with genetic mutations (the precursors of Cancer cells) on its own.

CTCs are Circulating Tumor Cells

  • CTCs are Circulating Tumor Cells — cells that are released from Cancer tissues, enter the blood stream, and flow (circulate) around the blood.
    CTCs are essentially bad guys who cause trouble in one town, then “hitch a ride” on the blood stream so they can go to other towns and cause trouble there. They become gangs of roving bio-terrorists, going from organ to organ (metastasis), causing damage to every place they infect.
    In this way, Cancer shifts from a single primary location, which might be easily treatable with surgery or radiation, to multiple locations that deteriorate rapidly. The end result is Stage 4 — advanced, normally untreatable Cancer.

So, if we already know that CTCs are the culprit,
and we know they get around by traveling in the bloodstream,
why can’t we track these bad guys down
and eliminate them?

  • Good question!
    The simple answer is: we can spot them, we can track them, and we do try to eliminate them, but once Cancer reaches an advanced stage, our treatments usually do not work very well.
    Well, then, you should find these CTC “bad guys” sooner and deal with them while they’re still small… Exactly! And that is a problem that medical science has been wrestling with for years: our testing methods have been pretty crude, so we don’t normally “see” Cancerous cells until it’s already late.
  • CT scan, one of the standard diagnostic
    instruments in any major hospital

  • Consider this: It takes 3 years or more for a Cancer cell to grow to 1 mm in size. At that size, our most commonly used non-invasive diagnostic instruments (CT scans and MRI scans) cannot see those cells. They are already at least 3 years old or more, but CT and MRI scans cannot see them.
  • PET scan, one of the key tools now being used to detect Cancer in its early stages.

  • A few years later, when Cancer cells have grown to 5 mm, our more advanced PET scans can see them. This is encouraging, but it means that these cells have been growing and circulating in your body for years!

Liquid Biopsy

In this Clinic, we use a remarkable new technique called Liquid Biopsy. You’ve probably heard the term “biopsy” on TV: it involves inserting a needle or an endoscope into a patient’s body so that doctors can snip off a little piece of what they think might be diseased tissue, then examine it to determine the progress of the Cancer. This kind of biopsy is invasive (not fun for the patient) and usually happens late — it means that doctors are taking tissue samples based on information from scans such as CTs or MRIs, which cannot see early-stage Cancer. We do something completely different.

  • We use a special kind of highly sophisticated blood test to measure the presence of CTCs (Cancer cells) in the blood. It is called a 3D Microfluidic Device or microfluidic chip, but its key role is in liquid biopsy.
    Liquid biopsy involves no surgery, no invasive instruments, just a simple blood test. From that sample, we can test for the presence of CTCs. And more importantly, we can detect them at much smaller scale than either PET scans or CT scans.
    That means we can spot Cancer earlier!
    • You can think of the liquid biopsy chip like a very fine filter. Imagine a fine sieve, such as a metal coffee filter.
    • In terms of this analogy, we “pour” the blood sample through the filter to see what happens.

      Normal blood cells are small, as well as soft and pliable — so they pass right through the filter.

    • But CTCs are larger and less flexible, so they get “caught” by the filter. In this way, our liquid biopsy can detect CTCs at a very early stage, much sooner than external scanning equipment.

This microfluidic technology has three big advantages

  • 1. It’s minimally invasive, involving just a simple blood sample. That means it can be done repeatedly with minimal discomfort to the patient.
  • 2. It’s much, much more accurate than the external scanning methods, even PET scans. We are aiming to be able to positively identify and measure CTC Cancer is cells in the bloodstream at a size of 1 mm or less.
  • 3. Because it is a simple, easy test, we can repeat it frequently at any intervals we choose. That means we can constantly study Cancer cells over time. We can see how they are changing, we can determine the degree of malignancy, and we can monitor the blood to see how well our anti-Cancer treatments are working.
    • This is the “liquid biopsy” revolution — not waiting until the CTCs in your blood become 5 mm or even 10 mm before we can see them but being able to see them and measure them much sooner. If we can identify and measure CTCs sooner, we can begin treatments sooner, which means we have a much better chance of defeating Cancer.
      This technology is nothing short of revolutionary.

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