SIDEBAR: Expect Questions from Your Patients


Get Permission

“We have already received several calls and requests from patients who desire to participate in our research or get the test done,” Anthony Lucci, MD, said about the response to a study published in The Lancet Oncology and media coverage of the findings. Dr. Lucci is lead author of the study, which found that a blood test for circulating tumor cells predicted early recurrence and decreased overall survival in chemonaive patients with nonmetastatic breast cancer. He is also Professor of Surgery, Department of Surgical Oncology, at The University of Texas MD Anderson Cancer Center in Houston, where the study continues.

Most of the callers are patients who have recently been diagnosed with breast cancer. “What we tell them,” Dr. Lucci said, “is that we are continuing to accrue patients under a clinical study here. So if the patients are eligible for the protocol, we tell them we welcome their participation, but we are still not offering it as a routine test.” Those interested in participating can learn more about the trial at www.mdanderson.org/patient-and-cancer-information/cancer-information/clinical-trials/index.html. 

Uncertain Impact on Management

He also tells patients that many insurance companies don’t yet cover the blood test for nonmetastatic patients, and “even if we were to receive the information from the test, it wouldn’t necessarily change their treatment, because this study wasn’t designed to see which treatments work best to get rid of those cells. We don’t really know exactly what to do with the information. That is the next step,” Dr. Lucci said.

“Not every patient with these cells is going to get a recurrence,” he continued. “It is another prognostic indicator, like lymph nodes. The higher the number of cells—just like the higher the number of affected lymph nodes—the greater the chance that the disease could try to emerge somewhere else. But nothing is absolute. So just having a circulating tumor cell or cells doesn’t always mean that the patient is going to have a recurrence.” 

He counsels those with a breast cancer diagnosis to “be patient and participate in clinical studies, because I think in the very near future we will know how to use this information to better treat patients.” ■


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