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Circulating tumor cell test

missbutterfly
0 Recommendations

Hi everyone, I was just curious as to wether anyone else has had this "new" test done. My cancer center just started using this test in May and I just had it done for the first time. My result was a 1. From what I understand anything between 0-4 is within normal range. The PA acted like this was good news but at the same time my tumor markers went up again and she said we will have to keep an eye on this. So now Im confused, is my current hormonal treatment working, is there activity or not? Do any of you know more about this CTC test?

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15 replies

gasketman

The test has very strict requirements for it to work properly. It has to be shaken a min of seven times, keep at room temp and tested within 72 hours. The tubes do have an expiration date have them check it each time.
You need to have a baseline test first and then you measure against that beginning number each time.
It is suppost to be used to give interim results of cancer treatments between PET/CT's.
How it works - the iron solution inside the tube when shaken (not vigorously) coats the cancer cells. The blood is then spun at high speeds and finally the cancer cells are pulled aside using magnets so that they can be counted. (condensed version). Time limit 72 hours or test will not work.

This is what I learned by calling Johnson and Johnson.

Scott

gasketman

This might help http://www.veridex.com/pdf/7800047_04.pdf

http://www.veridex.com/Legacy_ProdInfo.aspx?grp=cifu&menu=cs

Hope that this helps. Biggest problem we have found is lack of experience on techs part. There are very few labs that do this test : 1. keep tube numbers and colors handy. 2. keep test number handy 3. draw blood early in day before 10:00am Mon -- Thur only (blood is only good for 72 hours on this test 4. have copy of test script to avoid delay.

If you need any thing else let me know.

Scott

gpawelski

Results of using the CellSearch System indicate that monitoring of circulating tumor cells (CTC's) can contribute to the understanding of tumor-blood interactions and may provide a valuable tool for therapy monitoring in solid tumors like breast, colorectal or prostate cancer. With cells being alive in circulation, it may mean that a patient would need additional treatment.

As for its accuracy, the cut off is 5 tumor cells. Less than 5 means that things are going well. More than 5 means that things are going poorly. But you can see that the difference between 4 and 6 is not all that great.

It is a monitoring system to determine if therapy is working. It's perhaps useful as an adjunct to and can be done earlier than other currently approved diagnostic modalities for following tumor response, such as x-rays, blood tests, CTs, MRIs, Pet imaging, history, physical exam, etc. However, you are measuring the drug effects on tumors "in" the patient, one treatment at a time.

It's not of value in "selecting" therapy. The patient may receive potentially toxic and ineffective drugs "before" circulating tumor cells are measured. The outcome for metabolic responders and non-responders with imaging and the CellSearch System is basically what is going on with cell-based functional profiling assays, showing what patients are benefiting from what drug agents "before" introducing them into the patient.

The CellSearch System could be utilized for confirmation after being administered the assay-directed most beneficial therapeutic agents. You still need to measure the net result of all cellular processes, including interactions, occurring in real time when cancer cells actually are exposed to specific cancer drugs.

nancyc

Scott! You are the go-to guy!

gasketman

Hope that I can help. Debi and I have been through alot of these tests and scans. If we do not know how it works or what it does. We will not do it until we do.
I do not know it all but am happy to help when I can.

Scott

w1pamela

Hi Miss Butterfly,
He just did the same one for me. It's a Circulating Tumor Test. It may have something to do with the new Triple Neg. treatment that includes HER2 neg, which I am. I brought it up to Mary when I was there, she talked to Dr. Lunin and he ordered it the CTC. Who knows the inner workings of the mind of an Onco. LOL Other then that I can probably tell you more on the 18th -- my next appointment with him. He will let me know then what my results are.
Are you HER2 Neg? That may be what is going on. Did you know I posted another note to you?
I was suppose to meet my friend at the new IHOP but ended up in Peace River with an anaphylactic reaction to --- we don't know what. I was worried it was the Zometa as I'd had my infusion that morning but Dr. Lubiner said he doubted it when he came to see me. I never did get to lunch with my friend. I still want to try the new IHOP.
Sounds like your CTC was good. Lets hope mine is also. I have been on such a sugar jag lately that I can only think I am just feeding the cancer. Sigh.
Oh well.
PamW

w1pamela

Hi Again,
Obviously Scott knows a lot more about this then what I read by googling it. So it's not to do with the new Triple Neg. therapy. But he( Dr.L.) is doing it so he must like the test for some reason. But --- am I reading this right, the test has to be taken 7 times to have value? Oh well, then I won't worry about the results at my next appointment. AND I don't have to worry about downing a whole box of Crunch 'n Munch last night. ;-O
I think I have to stop bringing him information about all the new testing I read about on here. LOL I am probably driving him and Mary nuts. Well as nuts as one appointment a month can make them.
TTYL
PamW

gasketman

Keep asking questions and stay interested in your care. The Doctors do not have all of the answers it is up to us to help them find the answers that we each need.

You do not need seven tests to find out information from the CTC test. The CTC test is very new and has not been used very long. The test is very touchy and if your tech drawing the blood does not know what to do the test is no good. There are only afew labs that run this test right now. Most will draw the blood but then need to send it out to have it tested for you. (the blood and iron will only work for 72 hours) If you need more information about it I would be glad to post it.

The seven or eight times actually is how many times the tube has to be inverted back and forth to cover the cancer cells with the iron compound inorder for the test to work. Sorry for the confusion --- my kids say I do that to them too! Lol

w1pamela

Thanks Scott,
I wanted to post because Miss Butterfly and I go to the same doc at Florida Cancer Specialists and I would bet he knows what he is doing, young and very smart. It will be interesting to hear my results as I am a sugar junky, so I am probably just feeding the cancer. ;-O I will have to tell him, if the results are bad, that I want another test done "after" I stop the sugar ingestion for a bit, lol .

I just had him do the test for ONJ as I am on Zometa and what I found out (and may end up paying full price for it as the insurance co. doesn't have it on their list of tests) is that it hasn't been worked up for women 64. I will say that Dr. L's PA could figure out about where I would fall (it has only been tested on women up to 49) in the next order and I am in a safe range, which relieved my mind a bit, so if I have to pay for it, so be it. It is on appeal right now so if I win it may help others with their insurance. I made a VERY good case for myself. I have bad teeth anyway, so "I" think they should pay for the test. Sigh, we will see what they say. (Insurance Companies, sigh)
Thanks for the infor.
Pam Weiner

EyesOTex

Pam, what treatment are you on? I am on Xeloda and Zometa, but from the way things feel I'm not too sure they're working. I'm triple negative, too. I wish I had qualified for a CTC trial that was going on when I first found mets, but I didn't. Anyway, I have to wait 4 more weeks to get another PET scan, which as everyone knows is agonizing when you don't think you're treatment is working. *sigh*

EyesOTex

Dang, I hate the way my brain is now. I don't see any way to edit and I am extremely hacked off that I wrote "you're" instead of "your"............................ that's what I get for not previewing.

w1pamela

Hi Eyes o Tex,
I am Progesterone + and Estrogen + HER2 - So I am on Arimidex and it seems to be working quite well, it's the Zometa that gives me problems, he just lowered my dose. But I had an anaphylactic reaction to something, we aren't sure what yet, that day, so I don't know if the lowered dose worked, between the Prednisone and the Benadryl, my brain stopped working for two weeks. LOL

Yes, my thinking is say off, and it's difficult because I am in college online, but I keep plugging away at it. I just have to let them know when I am worse and when I am better. Two weeks after the Zometa I start to feel better. I have some problems with the Arimidex but much more when I get the Zometa.
Chemo brain, when they use chemicals to alter your body it's still referred to as Chemo brain. I haven't lost my hair but I seem to have a lot of the other problems, I mean they all have side effects, but I try to think about them as medicines that are keeping me alive, so I WILL put up with the SE.
Hope that helps. Chemo brain is real and is a real problem.
Pam

beachgirl6

I've had this test too. First time was Nov 08 through Qwest lab and it was 0. Then Jan 08 also Qwest and 0. Then again March 09 BioReference and 0. Then again in June 09 BioReference and 0.

Problem is May 5 09 PET showed hotspot confirmed by biopsy to be cancer. So doc says the test is no good for me. Now that I see all the directions outlined above I wonder if they ever did it right. I don't remember watching them shaking it and I usually had it in the afternoon on a Wed.

Any idea on which labs are the good ones to use? Anyone else find they had 0's but also confirmed cancer cells?

thanks for the info

gasketman

Beachgirl,
Do you know if they do the actual test at your lab??

If not let me know your lab and i will find out who actually does it in your area.

The CTC test was design to help track patients progress without exposing them to radiation and is very accrate for most people.

Let me know and I will do my best to find your answer.

GOD BLESS

Scott

beachgirl6

Scott

I'll find out from the lab tech. She's good at giving info out. The doc and the nurser practioner were pretty matter of fact that since it didn't show anything in June 09 when we had a confirmed biopsy then it wasn't a good test for me. I contacted the Dr. Susan Love foundation and they have an ask the doctor email option. Doc from there said that perhaps since my cancer is inflammatory and it usually travels in the lymph system then perhaps the test didn't show it because it wasn't in my blood yet.

My point is maybe its accurate to a degree for me. If the CTC are not in my blood then we know its not traveling that way and we can concentrate of other means. Still think it should be one of many tools in the process.

Might not see the "good lab tech" this week so if not, next week when I do I will post back with her answer. My understanding is the blood was drawn in the doc office and sent to LabCorp. I'll also try to find out from LabCorp if they do the test or send it out. My curiosity is sparked.

Thanks for the info
Beachgirl

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