[HN Gopher] Cancer DNA is detectable in blood years before diagn...
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Cancer DNA is detectable in blood years before diagnosis
Author : bookofjoe
Score : 132 points
Date : 2025-07-18 18:39 UTC (4 hours ago)
(HTM) web link (www.sciencenews.org)
(TXT) w3m dump (www.sciencenews.org)
| bookofjoe wrote:
| https://archive.ph/uE18w
| andrewstuart wrote:
| Blood testing sounds like a great opportunity for a
| startup.......
| adamors wrote:
| I wonder if they could work with very small amounts of blood
| ...?
| supportengineer wrote:
| What if they took a small amount, but ran many different
| tests with it?
| sylens wrote:
| What if the testing unit was so small it could sit on your
| kitchen counter and send the results digitally to your
| doctor?
| andrewstuart wrote:
| What if major venture capitalists rallied around a
| charismatic founder and gave the startup huge financial
| backing.
| cnst wrote:
| What if the founder had a really nice deep voice to
| convince everyone that they're legit?
| jjtheblunt wrote:
| that made me chuckle.
|
| then i remembered a month or so ago seeing this, and not
| knowing what to make of it.
|
| https://siphoxhealth.com/
| ada1981 wrote:
| Have you seen function health? It's now a unicorn.
|
| As far as I can tell, they did a wholesale deal with quest
| diagnostics, and run your results through ChatGPT and give you
| supplement / diet recs via a pretty web portal 2x a year for
| $499.
|
| Claim is it's 100 biomarkers and would cost avg person $15k
| retail.
|
| I'm a member and love it.
| andsoitis wrote:
| AgelessRx offers the Galleri Multi-Cancer Early Detection test:
| https://agelessrx.com/galleri-multi-cancer-early-detection-t...
|
| Ageless also provides many other longevity therapies.
| eej71 wrote:
| Some life insurance companies offered it for free as part of a
| service to existing clients. Mine claimed they would not know
| the results. I hope its true because I did take them up on the
| offer. Results were statistically favorable for me so I
| appreciate the test for what it is.
|
| Curious to see how these hold up over the long term.
| pnw wrote:
| That test is cheaper directly from https://www.galleri.com/
| ($799 vs $949).
|
| I get it every year. So far, so good!
| avgDev wrote:
| Quite interesting to me and first time I am hearing about
| this.
|
| Question for you, what do you do when it shows you may have
| cancer? Do you speak to your physician? Surely, this will
| change your life even if it doesn't need treatment for next 6
| years? Does the treatment change? Can the treatment be done
| based on those results?
|
| So many questions.
|
| I'm hoping we find more stuff for Alzheimer's. My aunt and
| now mother have it. I fear that I am next and I am too scared
| of doing the DNA test to check for genes.
| octaane wrote:
| You immediately bring the results to your doctor ASAP.
| They'll recommend follow-up testing since they want
| verification of third-party results and, well, are doctors
| and will know better about what to test for. If you do
| indeed have cancer, they will refer you to an oncologist
| who sub-specializes in that type of cancer.
| the_arun wrote:
| Isn't $799 expensive for average families?
| wiz21c wrote:
| what about Europe ?
| andsoitis wrote:
| > what about Europe ?
|
| what about Europe?
| ada1981 wrote:
| as far as tumors go, that one has become fairly benign in
| the last century.
| octaane wrote:
| I actually know a little about this through my work. Cell-free
| DNA (CfDNA) Has been known about for a few decades, but has
| become more of a focus in recent years because of the advent of
| immunotherapies, which are often highly targeted drugs. CfDNA has
| also been used in "liquid biopsies" i.e, a simple blood draw,
| because it can help you profile the tumor and location of the
| cancer.
|
| In my field, we all think that CfDNA testing will eventually
| become a standard thing that will go along with your annual
| physical's blood test, because it has predictive/preventative
| abilities.
| drdrey wrote:
| how actionable is the result? let's say you do detect trace
| amounts of tumoral DNA in your blood, what can you do? can you
| prevent it from developing into a full-on tumor if you don't
| even know where it is?
| mikert89 wrote:
| The big secret is that they could detect cancer very early in
| most people, but the health care companies don't want to pay for
| the screening. You can pay out of pocket for these procedures. I
| was told this by a cancer researcher
|
| EDIT:
|
| Adding these caveats:
|
| 1. There is a ton of nuance in the diagnosis, since most people
| have a small amount of cancer in their blood at all times
|
| 2. The screenings are 5-10k + follow up appointments to actually
| see if its real cancer
|
| 3. All in cost then could be much higher per person
|
| 4. These tests arent something that are currently produced to be
| used at mass scale
| melling wrote:
| Probably not true. It's much cheaper to catch cancer early than
| to treat advanced cancer later
| mikert89 wrote:
| Nope, the cost is 5-10k maybe more, and there is alot of
| nuance and follow ups to those detections
| HPsquared wrote:
| That's true in the case someone actually does have cancer,
| but what about paying for all the negative tests?
| vasco wrote:
| Yeah but then you'd go through life having biopsies all the
| time. If all people did a full body MRI almost everyone would
| have weird lumps that doctors would have to biopsy to be
| really sure, and then what do you do? Do you biopsy yourself
| every time some weird tissue appears? Most of those will be
| nothing and you'll be going through the complications of
| surgeries and anesthesia all the time just to always make
| sure.
| rwmj wrote:
| Assuming some future MRI technology which was very cheap,
| wouldn't you have MRIs at fairly regular intervals, to
| first see if the lump was growing or changing shape? And if
| this was being done at population scale, you'd train up an
| AI on the known outcomes, to have it flag up problems for a
| human to review.
| cogman10 wrote:
| Assuming MRIs weren't exorbitantly expensive, then the
| answer would probably be to simply rescan a month or 2
| later and biopsy the lumps that don't go away.
| deadbabe wrote:
| Wrong.
|
| The usual story is that you're just better off not knowing
| because you'll end up doing more harm than good chasing every
| little suspicious diagnosis. Cancer happens all the time, but
| many times doesn't lead to anything.
| delfinom wrote:
| Health insurers would absolutely pay for the screennig if the
| sum spent on screening everyone was cheaper than long term
| cancer care.
|
| It's the same reason they pay for annual physicals in the first
| place.
| mikert89 wrote:
| Nah the tests can go up to 10k per person
| graeme wrote:
| >if the sum spent on screening everyone was cheaper than
| long term cancer care
| doctoring wrote:
| The not so big secret is that we can detect cancer early in a
| lot of people, but we also would detect a lot of not-cancer. We
| don't currently know the cost/benefit of that tradeoff for all
| these new types of screening, and therefore insurers and health
| systems are reluctant to pay the cost of the both screening and
| the subsequent workup. This is not just a financial
| consideration, though the financial part is a big part -- the
| workup for those that end up as not-cancer has non-negligible
| risks for the patients as well (I have had patients of mine
| suffer severe injury and even die from otherwise routine
| biopsies), and on top of that, some actual cancers may not
| really benefit from early discovery in the first place.
|
| This is not to downplay the potential benefit of early cancer
| detection... which is huge. And in the US/UK anyway, there are
| ongoing large trials to try to figure some of this stuff out in
| the space of blood-based cancer screening, as part of the path
| to convincing regulatory bodies and eventual reimbursement for
| certain tests. As mentioned, you can currently at least get the
| Galleri test out of pocket (<$1k, not cheap, but not exorbitant
| either), as well as whole body MRIs (a bit more expensive,
| ~$2-5k).
| mikert89 wrote:
| Yeah, after a detection there is alot of work to determine if
| what they detected should be worried about. But this doesnt
| take away from the fact that cancer can be detected very
| early, and these screenings could easily save your life
| rscho wrote:
| ... or could do you harm, which is an important point.
| ospray wrote:
| To clarify is the harm that many healthy people would
| stress while it was confirmed the detection was not
| cancer?
| rscho wrote:
| No, the potential harm comes from follow-up tests. That's
| why screening strategies are designed by professionals.
| It's a pretty complex field, and all the people here
| fielding their opinions on how we should proceed about
| tests don't have a single idea about the implications of
| their theories.
| mikert89 wrote:
| this is medical gate keeping ("only the holy priests can
| practice medicine"), please take this attitude elsewhere
| rscho wrote:
| Honestly, you don't have access to the necessary data to
| make rational decisions. That's not gatekeeping, it's
| logic. I don't have access to it either, although I'm
| indeed a healthcare pro. Screening strategies are a
| hyperspecialized domain and only experts somewhat
| understand what they're doing. It's just like making
| theories about what the CERN guys should be doing while
| not having passed physics 101 with no access to
| experimental data. That's why I'm just saying: you're
| certainly allowed to question, but you certainly can't
| make up assertions either.
| _coveredInBees wrote:
| What a ridiculous statement to make. No wonder the US is
| in the state it is in. Lets let the ignorant and
| uninformed decide on policy rather than the scientific
| community and experts. What could possibly go wrong?
| terminalshort wrote:
| How could the screening do you harm? (other than
| financial)
| rscho wrote:
| What are you gonna do if the screening test comes back
| positive?
| jmcgough wrote:
| There's not a lot of evidence that full body MRIs are
| beneficial. A lot of people have pre-cancerous growths that
| may or may not become cancer in the future, so you may just
| be giving them unnecessary surgery, and surgeries are not
| risk-free. If you don't operate, they might develop an
| anxiety disorder.
|
| We do a lot of CT imaging in the emergency department and
| it sucks if we incidentally find an abnormal growth in a
| young patient's CT head. These are usually benign and often
| not worth performing brain surgery to get a biopsy.
| ospray wrote:
| I had one at detected at 5mm close to the amigdala and
| they just scanned again in 3-6 months on MRI to prove it
| wasn't growing. That was a decade ago.
| DiscourseFan wrote:
| Most healthy, active people who eat decently, get enough
| rest, and avoid drinking and smoking, will be able to
| eliminate cancer as it comes up. The only people who would
| benefit from these screenings are already unhealthy and
| cancer might be just one of many potential conditions they
| could experience--the goal of healthcare is not to dedicate
| an inordinate amount of resources for procedures that may
| amount to not much of any long term benefit.
|
| People talk about the "immune system" but they are really
| referring to a number of systems the body uses to regulate
| itself, more or less successfully, around environmental
| pressures. The body is a system under tension, sometimes
| extreme tension leads to extreme success (success here being
| growth of power), sometimes it breaks the body, and sometimes
| the systems have been slowly failing for a while, and most
| treatments will not help. Medicine is only useful in the
| specific case where the power of the body would be promoted
| if not for one thing, that the body would be healthy, at
| least manageably so, without that issue.
| cogman10 wrote:
| > Most healthy, active people who eat decently, get enough
| rest, and avoid drinking and smoking, will be able to
| eliminate cancer as it comes up
|
| Incorrect.
|
| There are tons of cancers that hide and mask with symptoms
| common to other symptoms. Kidney cancer, for example,
| presents pretty similarly to both kidney stones and UTIs.
| Even blood in the urine isn't proof positive that anything
| is wrong beyond either of those conditions. And, by the
| time blood is in the urine, it's often too late.
|
| Liver cancer is even worse. The first symptoms you get can
| be thought of as a simple pulled muscle, just a little ache
| in the back. By the time you have appreciable problems,
| like turning yellow, it's quite advanced and too late to
| really do much.
|
| There are common cancers like colon, skin, breast, and
| prostate that more fit your description of being mostly
| harmless so long as you get regular screenings and eat
| healthy. But, for every part of the body, a cancer can form
| and the symptoms are very often invisible.
|
| I'm unfortunately all too familiar with how cancer looks.
| My wife currently has stage 4 cancer that started as kidney
| cancer. She does not drink or smoke, gets enough rest, and
| is very active.
| unsupp0rted wrote:
| What's a good way for an otherwise healthy person to
| screen for kidney cancer, in terms of trade-offs?
|
| Annual MRI?
| cogman10 wrote:
| IDK TBH. My wife had all the general recommended
| screenings. The only thing that showed potential problems
| was slightly elevated WBC. It was ultimately what they
| thought was a UTI that stayed a little too long that got
| us to get a CT and ultimately the diagnosis.
|
| I do wonder if a 5 year whole body MRI or CT would be
| generally beneficial for the population. I don't think it
| needs to be Annual to have benefits.
|
| The problem is it really isn't uncommon for your body to
| create random puss fill sacks all over the place. It's
| one thing our cancer doctor warned us about. My wife is
| now on a 6 month CT regimen and ultimately, they'll just
| ignore new lumps.
| PaulHoule wrote:
| Or cancers that aren't clinically relevant.
|
| Many prostate cancers, for instance, are slow growing and
| won't kill you before something else does. If you try to take
| that kind of cancer out surgically or zap it with radiation
| or chemo the side effects could be severe.
| agumonkey wrote:
| But what could we expect as fair price if mass scale production
| happens ?
| daedrdev wrote:
| Doing this could be actively worse for you and society based on
| the false positive rate. Testing and accidental unneeded
| treatment carry very real risks that could lead to net
| suffering and more death or damage if enough people are tested.
| mikert89 wrote:
| This is a collectivist opinion on something which is very
| personal
| rscho wrote:
| It's not personal, it's perfectly rational statistics,
| _i.e._ epidemiology. Designing screening strategies is not
| an amateur 's game.
| daedrdev wrote:
| Would you take a test if doing so statistically increases
| your probability of death?
|
| Is it moral for a doctor to give a test they think is going
| to increase someone's chance of death.
| twothreeone wrote:
| That's just wrong. Taking a test doesn't do anything to
| the data-generating process, your chance of death is
| 100%. The test merely informs your posterior about the
| timing of the event.
| andsoitis wrote:
| > The big secret is that they could detect cancer very early in
| most people, but the health care companies don't want to pay
| for the screening.
|
| thanks for adding the caveats; they suggest that there are good
| reasons why it isn't clear cut that health care companies
| should pay.
| biotechbio wrote:
| Some thoughts on this as someone working on circulating-tumor DNA
| for the last decade or so:
|
| - Sure, cancer can develop years before diagnosis. Pre-cancerous
| clones harboring somatic mutations can exist for decades before
| transformation into malignant disease.
|
| - The eternal challenge in ctDNA is achieving a "useful"
| sensitivity and specificity. For example, imagine you take some
| of your blood, extract the DNA floating in the plasma, hybrid-
| capture enrich for DNA in cancer driver genes, sequence super
| deep, call variants, do some filtering to remove noise and
| whatnot, and then you find some low allelic fraction mutations in
| TP53. What can you do about this? I don't know. Many of us have
| background somatic mutations speckled throughout our body as we
| age. Over age ~50, most of us are liable to have some kind of
| pre-cancerous clones in the esophagus, prostate, or blood (due to
| CHIP). Many of the popular MCED tests (e.g. Grail's Galleri) use
| signals other than mutations (e.g. methylation status) to improve
| this sensitivity / specificity profile, but I'm not convinced its
| actually good enough to be _useful_ at the population level.
|
| - The cost-effectiveness of most follow on screening is not
| viable for the given sensitivity-specificity profile of MCED
| assays (Grail would disagree). To achieve this, we would need
| things like downstream screening to be drastically cheaper, or
| possibly a tiered non-invasive screening strategy with increasing
| specificity to be viable (e.g. Harbinger Health).
| tptacek wrote:
| This seems like yet another place where the base rate is going
| to fuck us: intuitively (and you've actually thought about this
| problem and I haven't) I'd expect that even with remarkably
| good tests, most people who come up positive will not go on to
| develop related disease.
| rscho wrote:
| Ideally, you'd want a test (or two sequential ones) that are
| both very sensitive (rule candidates in) and specific (rule
| healthy peeps out). But that's only the first step, because
| there's no point knowing you're sick (from the populational
| and economic pov) if you can't do something useful about it.
| So you also have to include downstream tests and treatments
| in your assessment and all this suddenly becomes a very
| intricate probability network needing lots of data and
| thinking before decisions are made. And then, there's
| politics...
| Spooky23 wrote:
| You might be able to target and preemptively treat some
| aggressive cancers!
|
| I lost my wife to melanoma that metastasized to her brain
| after cancerous mole and margin was removed 4 years earlier.
| They did due diligence and by all signs there was no evidence
| of recurrence, until there was. They think that the tumor
| appeared 2-3 months before symptoms (headaches) appeared, so
| it was unlikely that you'd discover it otherwise.
|
| With something like this, maybe you could get lower dose
| immunotherapy that would help your body eradicate the cancer?
| ada1981 wrote:
| It could motivate to shift to plant based diet; start
| meditating; stop drinking; begin regular 5-7 day fasts; etc.
| zaptheimpaler wrote:
| I guess the problem is a mismatch between detection capability
| and treatment capability? We seem to be getting increasingly
| good at detecting precancerous states but we don't have
| corresponding precancer treatments, just the regular cancer
| treatments like chemo or surgery which are a big hit to quality
| of life, expensive, harmful etc.
|
| Like if we had some kind of prophylactic cancer treatment that
| was easy/cheap/safe enough to recommend to people even on mild
| suspicion of cancer with false positives, we could offer it to
| positive tests. Maybe even just lifestyle interventions if
| those are proven to work. That's probably very difficult
| though, just dreaming out loud.
| eps wrote:
| > due to CHIP
|
| What is CHIP?
| biotechbio wrote:
| https://en.wikipedia.org/wiki/Clonal_hematopoiesis
| bglazer wrote:
| Clonal hematopoiesis of indeterminate potential.
|
| It's when bone marrow cells acquire mutations and expand to
| take up a noticeable proportion of all your bone marrow
| cells, but they're not fully malignant, expanding out of
| control.
| siliconc0w wrote:
| Sadly health insurance in the US is unlikely to pay for most
| preventative care because the followup costs of false-positives
| and that they are betting that down the line someone else will
| pick up the tab when you get sick decades later (like the
| government).
|
| It's kind of why I'm favor of universal option to align financial
| incentives. Like given how sick the US population is, it probably
| makes sense to put a lot more people of GPL-1s and invest in
| improving their efficacy and permanence. Like nationalize-the-
| patent COVID-operational-warp-speed level urgency. There are over
| 100M Americans that are pre-diabetic, the cost of treating a
| diabetic is about 20k/yr. So $4 trillion in new costs, on top of
| the misery and human suffering.
| johnisgood wrote:
| It is sad that prevention is not something the US considers
| very important.
| ziml77 wrote:
| They care about prevention but only if it's very cheap. I get
| emails all the time from my insurance company about joining
| their program that is supposed to help you live a healthier
| lifestyle.
| johnisgood wrote:
| Any details on this program?
| riscy wrote:
| How do you convince those pre-diabetic people to use a GLP-1?
| There was quite a bit of backlash about the one-time injection
| COVID vaccine when it was mandated.
| lispisok wrote:
| Are you expecting the government to mandate GLP-1 agonists
| the same way they tried to mandate the covid shot?
| ada1981 wrote:
| I wonder how much of that is directly tied to corn subsidies.
| ruralfam wrote:
| I have a friend nearing mid-60s. Retired military so now
| covered by Medicare, then Tri-Care. Having prostate issues. PSA
| went from 12 to 19. Desperate to get a PET scan to determine
| his is benign BPH, or cancer. Cannot get his scan approved
| since both insurances will not approve a PET as an early
| diagnostic tool (scan is about $7500). Cannot imagine what will
| happen if everyone getting a cancer DNA signal of this type
| tries to get clarification via additional tests. USA health
| care really does not work that way. HTH, RF
| cpncrunch wrote:
| Seems like it might be overhyped. Here is the study
|
| https://aacrjournals.org/cancerdiscovery/article-abstract/do...
|
| Full text is paywalled, and no mention in abstract of false
| positive rate in control group. Has this test actually been
| independently verified? No mention of that important fact in the
| press release.
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