Many patients want to find out if they really are 'all clear' with 'No Evidence of Disease' or they want an early warning system to tell them if their cancer is starting to come back. Early detection protocols have included the RGCC Circulating Cancer Cell test and Liquid Biopsy, but AI is changing all that!
Do I still have cancer or has it gone for good?
“Well done. You are all clear”
How many times have patients heard this from a surgeon who has just removed a lump in a breast or a section of cancerous colon? What would make him even say it? How could he possibly know if cells had already been fired off from the tumour before the surgery, or even released by his surgery into the blood or lymph? Yet at CANCERactive, we have patients who now don’t want to take the drugs because their surgeon has said they are all clear! It’s modern medicine at its worst.
Others ask about the opposite event, where they are told the cancer was caught early and there are no cancer cells on the loose in the body, but the team want to give you chemotherapy with all its damaging side-effects, just in case? Oncologists might even talk about micrometastases, where cancer cells are present but can't be detrected by scans or even during lymph node removal.
Tests do exist to see if you have cancer cells circulating in your body, some have been around for about 20 years! It’s just that few people in the UK know about it because doctors don’t use them. They prefer to work by guesswork; (they call it experience). Now, as AI sapproaches, big changes are coming, not just to your Hospital, but to blood analysis for cancer cells.
At CANCERactive, we have thought Circulating Cancer Cell Tests tests have been an important development for years! Let's start simple and move on to the newer clever AI tests!
The RGCC test for circulating cancer cells
The Research Genetic Cancer Center (RGCC) in Greece, run by Dr. Ioannis Papsotiriou, uses their own RGCC test. Although this has had much inaccurate skeptic criticism in the past, this is now being used by a number of top hospitals including MD Anderson, Sloan Kettering and Dana-Faber, who say it works across all cancers.
RGCC laboratories claim to be able to pick up the existence of cancer cells at minute, molecular levels way before standard hospital tests show anything. And they claim their tests can show static cells, circulating tumour cells and even cancer stem cells.
AND, RGCC tests show what might work (or not) against your cancer
But there is another reason for using an RGCC test. After searching and measuring for cancer cells, a second test cam analyses which drugs, and supplements might best deliver against your specific cancer. You might test in advance to understanding which drugs would work best. You might test when you find your current drugs are not working -you can switch quickly to an alternative, rather than wait for a scan to tell you after 3 months..
Rather than locking the stable door after the horse has escaped many women with breast cancer would like to know if their cocktail of 4 breast cancer drugs was going to work BEFORE one even entered their body. And given the notoriety of side-effects, the majority don’t want to be used as human guinea pigs.
Chemosensitivity testing
RGCC can sort this out in part 2 of their programme. RGCC claim that once they have circulating cancer cells isolated, they can then do sophisticated ‘chemosensitivity testing’, checking what compounds work, and importantly what do not, with your particular cancer cells in a test tube.. This is not just limited to drugs; they can test supplements and natural compounds too. Chemosensitivity testing measures the sensitivity of the cancer cells to the drug or natural compound BEFORE you are treated with it.
GO TO: CANCERactive article on Chemosensitivity testing
You might think this is a good idea - especially when FEC-T breast cancer treatment has now been shown to be completely unnecessary in 15 per cent of cases by a Belgian test called the ‘Mamaprint’ (see below).
Doctors don’t like chemosensitivity testing. "Just because it works in the test tube doesn’t mean it will work in real life," is the mantra. Yes the tests could rubbish their expert decision. And if it DOESN’T work in the test tube it almost certainly won’t work in real life either!
In Europe, RGCC blood tests are sent to their centre in Greece, as they are from Melbourne, Australia. Skeptics disparagingly call this ’the Greek Test’ as if that disparages the science. They apparently don’t know the nationality of Hippocrates.
There is another view. Dr Thomas Lodi and Chris Woollams on the latter's Sunday Show discussed whether the circulating cells were actually typical of the original primary. And secondaries can sometimes be quite different from the primary.
Next Generation testing?
This observation by Lodi and Woollams is important - using blood tests for circulating cancer cell numbers is valid and should not be expensive, but what you do with those cells in terms of analysis may not be fully reflective of the primary tumour. NextGen Oncology (6), led by Dr. Martin Luzbetak, M.Sc., is in Düsseldorf, Germany - they too operate using blood samples for analysis of circulating tumour cells and chemo/biologic sensitivity, but they prefer tissue samples of the primary tumour for genetic analyses. And accuracy can lead to Dendritic Cell Therapies or Peptide vaccines through a collaborating genetics company CeGaT (7), (a genetic and diagnostic company also in Germany and the USA). So it's one thing seeing if you have high numbers of Circulating Cancer Cells, but it's a completely different ball game if you want to use the genetic information accurately to move forward.
Precision Medicine - Liquid biopsy testing for circulating cancer cells and tumour DNA
Clearly, genetic testing is moving rapidly. First, we had the advent of ’Precision Medicine’. The Liquid Biopsy arrived. Previously used to measure the risk for Down’s Syndrome in the foetus, Liquid Biopsy can also measure whether you have any remaining cancer by looking for higher levels of Circulating Cancer Cells in the blood. Go To: Liquid Biopsy Testing with lung cancer patients
The really clever part - liquid biopsy can measure circulating tumour DNA, ctDNA, - pieces of DNA thrown off by the current tumours, and so show in the very early moments of treatment, a real time picture of whether the drugs are working or not, and whether the tumour is fading or becoming more aggressive.
In the UK, Professor Charlie Swanton of the Francis Crick Institute has completed a Liquid Biopsy test on Lung Cancer patients and found it 92 per cent accurate.
An American Government paper on real time Liquid Biopsies becoming a mass market reality, states:
"Certain fragments of DNA shed by tumours into the bloodstream can potentially be used to non-invasively screen for early-stage cancers, monitor responses to treatment and help explain why some cancers are resistant to therapies. For most tumours, a tissue biopsy is quite challenging in that it is costly, painful, or potentially risky for the patient. All these are good reasons to learn about cancer through blood and to get excited about the possibility of carrying out liquid biopsies".
Also in America, The Mayo Clinic originally launched CellSearch (1); more correctly The CellSearch Circulating Tumour Cell (CTC) test. This test is FDA approved and each result at the Mayo Clinic is confirmed by a Cyto-technologist and a pathologist. It is used across a number of cancers and measurements are predictive of potential survival.
But a quick Google Search finds various tests and training - the Parsotix test, OncoDNA, Qiagen, even an advertisement from the UK NHS to go a ’Precision Medicine Course’.
In fact, ordinary CTC tests are getting a bit old fashioned now that ctDNA has come along. But CTC tests can detect the presence of metastatic cancer long before standard imaging can show up any problems. Having a blood test could predict you have cancer long before a scan would show anything.
CellSearch has now expanded beyond the Mayo Clinic in the USA, and advertises itself as "The first and only clinically validated, FDA-cleared blood test, for enumerating circulating tumour cells".
The NHS is trying out a National predictive test - The NHS Galleri test. This is a trial in the UK by the NHS to see if they really can bring Early detection to the world of cancer. To date the test seems successful and the Roll Out has started. You can read more here.
Precision Medicine using AI
What comes next? The most recent advancements in artificial intelligence (AI) are revolutionizing blood analysis for medical diagnostics, particularly in cancer monitoring and aging research.
A new AI method (5) called Fragle, developed by scientists at A*STAR Genome Institute of Singapore, uses machine learning to analyze the size of DNA fragments in blood samples to track cancer treatment response and detect early relapse, offering a faster, cheaper, and more versatile alternative to traditional methods.
The Fragle method analyzes circulating tumor DNA (ctDNA) by detecting distinct size patterns in DNA fragments, enabling accurate and frequent monitoring of cancer treatment response across various cancer types. It is designed to be compatible with standard hospital DNA profiling techniques, potentially reducing costs from over SGD $1,000 to less than SGD $50 per test.
The method has shown high reliability in hundreds of patient samples and is being tested in a clinical trial involving over 100 lung cancer patients to detect relapse earlier than routine scans.
Simultaneously, researchers at the University of Vienna and Nankai University have used AI and metabolomics to identify aspartate as a key biomarker of physical fitness and healthy aging, linking blood chemistry to metabolic health and potentially brain resilience.
Other cancer tests
In the USA, America Metabolic Laboratories offers sophisticated cancer profiling using a range of blood and urine markers including the PHI test and sensitive HGC test. American Metabolic Laboratories, located in Hollywood, Florida, specialises in advanced metabolic testing, including the Cancer Profile© and Longevity Profile©, which are designed for the early detection of cancer and other metabolic disorders. The Cancer Profile©, originally developed in 1980 by Dr. E. K. Schandl and brought to the laboratory in 1995, has evolved with new technology and scientific findings to analyze blood samples for cancer-related biomarkers. The laboratory also offers testing for cancer tumor markers, cardiac risk markers, and sex hormones, along with interpretation of lab results (4).
Then there’s a test launched as long ago as January 2016 called the Oncoblot – being used by Dr. Garry Gordon, co-founder of the American College for Advancement in Medicine (ACAM). The ONCOblot® Test is a blood-based diagnostic tool that detects the presence of cancer by identifying the ENOX2 protein, which is produced by cancer cells and shed into the bloodstream. This test can tell if someone has cancer cells in their body years before CAT scans or PET scans show anything (2).
In Belgium there's MammaPrint (3) - it is not a blood test; it is a genomic test that analyzes the activity of 70 specific genes in a tumor sample obtained from a biopsy or surgical removal, not from blood. This test is used to assess the risk of early-stage breast cancer recurrence and helps determine whether a patient might benefit from chemotherapy. https://www.canceractive.com/cancer-active-page-link.aspx?n=3805&Title=Mamaprint%20test%20saves%20unnecessary%20chemo%20use
References
1. Cellsearch - https://www.cellsearchctc.com/
2. Oncoblot - www.oncoblotlabs.com
3. Mamaprint for breast cancer - https://agendia.com/mammaprint/
4. America Metabolic Laboratories - www.Americanmetaboliclaboratories.net.
5. Fragle test in Singapore - https://www.a-star.edu.sg/gis/home/press-releases/press-releases-2025/new-ai-method-makes-cancer-tracking-faster-and-easier-using-blood-tests
6. Next Gen Oncology - Contact
7. CeGaT - Whole Genetic Testing