Background
Migration of Circulating Tumour Cells (CTC) into the bloodstream may be associated with early carcinogenesis, and can provide a biomarker for cancer progression and treatment effectiveness.1,2 An increase in CTCs in a patient’s bloodstream is associated with cancer progression, while a decrease in CTCs is associated with cancer containment or remission. Several technologies have been developed to identify CTC, including the Isolation-by-Size-of-Epithelial-Tumour (ISET) technology (Rarecells, France), combining blood filtration and analysis by microscopy using standard histo-pathological criteria.3 The ISET-CTC method has been validated in several studies and provides very high specificity and sensitivity.4
Aims and methods
Using the ISET-CTC method the study aimed to compare CTC count to cancer status and cancer risk, by monitoring treatment effectiveness in cancer patients and by screening for CTC in patients with a family history of cancer or clinical indication but no tumour mass.
Results
Between Sep-2014 and Apr-2016 we undertook >360 CTC tests, 180 (50%) were screening requests. CTC were detected in 90 (50%) of those patients screened and follow-up tests including scans were scheduled within 1-6 months of CTC results. In up to 50% of male patients with normal PSA (prostate specific antigen) levels but with CTC, PET scans using PSMA (Ga-68 prostate-specific membrane antigens) revealed increased uptake in the prostate, which is indicative of early prostate cancer. Early breast cancer was detected in a small number of asymptomatic women with positive CTC tests. All patients with detected CTC received advice on adjuvant immune-stimulating nutritional therapy. Repeat CTC testing at 3-6 months available for 18 patients after adjuvant nutritional therapy revealed reduced CTC count.
Conclusions
CTC screening provides a highly sensitive tool for the early detection of patients at risk of developing cancer. Evidence-based adjuvant nutritional therapy can reduce CTC count and cancer risk.