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Author: Matthew Romeo

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Diagnosis FAQ

What is a CBC Test?

blood test vials for a CBC test.

CBC Tests and Cancer: What Doctors Look For in Your Results

Written By:

Matthew Romeo

A complete blood count test (CBC) is a blood test used to help monitor your overall health. In some instances, CBC tests are also used to help diagnose and track certain forms of cancer, like leukemia and Hodgkin’s or non-Hodgkin’s lymphoma.

blood test vials for a CBC test.

A complete blood count test measures:

  • Red blood cell count (RBC)
  • White blood cell count (WBC)
  • Platelet count
  • Hemoglobin (Hg or Hgb)
  • Hematocrit 
  • Mean corpuscular volume (MCV)

In this post, we look more into a CBC test, including how it is taken, what your results mean, and how it helps diagnose and monitor different forms of cancer and treatment.

Table Of Contents
  1. How Do I Understand My CBC Test Results?
  2. What are the Average CBC Test Results?
  3. Can Cancer be Detected from a Blood Test?
  4. Can Cancer Treatment Impact Blood Test Results?
  5. How is a CBC Test Taken?
  6. Learn More About CBC Tests

How Do I Understand My CBC Test Results?

When you receive your CBC test results, you often receive a report with a bunch of abbreviations and numbers that don’t make sense to the average person; however, once you understand what the abbreviations mean.

Dr. Kamran Mirza

In a complete blood count, you’re getting a bunch of information. There are three main types of blood cells that we’re looking for.

Dr. Kamran Mirza | Read More about what doctors look for in a CBC test.
White Blood Cell Test Results

White blood cells are your body’s primary defense mechanism. They help remove foreign materials and cellular debris, destroy infectious agents and cancer cells, and help produce antibodies. 

A CBC test typically provides the results of two white blood count measurements:

  • White blood cell count – the measurement of the total number of white blood cells in your blood count.
  • White blood cell differential – the number of each type of white blood cell in your blood sample. The five types of white blood cells are neutrophils, lymphocytes, monocytes, eosinophils, and basophils.
Red Blood Cell Test Results

Red blood cells perform the essential function of delivering oxygen from your lungs to other parts of your body, along with transporting waste like carbon dioxide out of the body. 

A typical CBC test provides results for 4 different types of red blood cell measurements:

  • Red blood cell count – the number of red blood cells in a blood sample.
  • Hematocrit – the percentage of your blood made up of red blood cells.
  • Hemoglobin – the amount of hemoglobin that is in your blood. Hemoglobin is the protein in your red blood cells that transports oxygen throughout the body.
  • Mean corpuscular volume (MCV) – measures the size of your red blood cells. Irregular red blood cell sizes may be a sign that something is wrong.
Platelet Test Results

Platelets play an important part in forming blood clots to stop you from bleeding. The only measurement a CBC test provides for platelets is the total number of platelets in your blood sample. 

What are the Average CBC Test Results?

Now that you know what each test measures, you may wonder, what are the average measurements for each test? When you receive your blood test results, the test usually provides the value you got, the reference range, and if your results fall within that range.

According to the National Cancer Institute, the normal CBC test results are:

TestUnit of MeasurementNormal Values
Erythrocytes (RBC)X 1,000,000/mm3Male: 4.5 – 6Female: 4.3 – 5.5
HematocritPercentageMale: 38 – 51%Female: 36 – 47% 
Hemoglobing/dL (grams per deciliter)Male: 14 – 17 
Female: 12 – 16 
PlateletsX 1,000/mm3200 – 500 
Leukocytes (WBC)X 1,000/mm35 – 10 

If your counts fall outside the normal range, it doesn’t necessarily mean that anything is wrong or you have cancer. However, your doctor will probably investigate further if you receive an abnormal result.

I get really cranky and crabby. Sometimes I’ll go to my primary care doctor to do a CBC just so I can see, “Okay, this is good. No surprises.” It makes me feel better, and he’s more than happy to do it.

Sheryl B | Read more about how CBC tests can help monitor cancer.

Can Cancer be Detected from a Blood Test?

Specific forms of cancers can be detected as part of a CBC result. However, it’s important to note that a CBC test is only one tool when diagnosing cancer. Just because you have abnormal CBC test results does not necessarily mean you have cancer. 

The different types of cancers that a CBC test can detect include:

It’s important to remember that a CBC test is not the only diagnostic tool or blood test used to diagnose cancer. Therefore, a diagnosis cannot be made solely based on the results of a CBC test.

One of the things I didn’t know until I spoke to my doctor is that he asked me to always let him know when we did CBCs if I had exercised before or a day before. In many cases, exercise increases your white cell counts. 

Jeremy S | Learn more about how CBC tests might be impacted.

Can Cancer Treatment Impact Blood Test Results?

Cancer treatment can impact your CBC test results. Some care teams may use a CBC test to track how treatment may affect you. The forms of treatment that can impact your CBC test results include:

  • Chemotherapy – May lower your white blood cell, red blood cell, and platelet counts.
  • Surgery – Your red blood cell count may be low following surgery.
  • Radiation therapy – May lower your red blood cell and platelet counts.

While these are just the general forms of treatment that may impact your CBC test results, cancer-specific treatments and drugs may also affect your results.

How is a CBC Test Taken?

You may not even notice, but a CBC test is typically part of the routine blood work you get for your annual physical. The test is taken by simply withdrawing a small vial of blood to be tested in a lab. 

Due to its ease and accessibility, the CBC test is a great way to continuously screen for cancer.

Learn More About CBC Tests

Visit our navigating cancer page if you want to learn more about CBC tests or cancer in general. There you will find resources from dealing with a cancer diagnosis to information about the latest treatments.

Categories
Clinical Trials FAQ

The Belmont Report: Protecting People in Clinical Trials

Doctor smiling while holding a stethoscope

The Belmont Report: Protecting People in Clinical Trials

Written By:

Matthew Romeo

Clinical trials advance cancer research and help current and future generations find new treatments for disease. However, when patients enroll in a clinical research trial, they want to know that they are safe and that the trial won’t do more harm than good. 

Doctor smiling while holding a stethoscope

Enter the Belmont Report, a set of fundamental ethical principles and guidelines that assist researchers in resolving ethical principles when conducting research involving human subjects. In this article, we look at the history and content of the Belmont Report and its implication on cancer research.

Table Of Contents
  1. History of the Belmont Report
  2. The 3 Basic Ethical Principles
  3. Applications of the Belmont Report
  4. Institutional Safeguards
  5. Are Clinical Trials Safe?
  6. Learn More About Clinical Trials

History of the Belmont Report

The Belmont Report was created due to several contributing factors that made the need for a code of ethics in medical research using human subjects essential. 

The extreme human rights violations during World War II, followed by the events of the Tuskegee study, prompted Richard Nixon to create the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. This commission ultimately produced the Belmont Report.

The Nuremberg Code

Following the horrors of World War II and the information unraveled in the Nuremberg Trials, the international scientific community discovered a need for a code of ethics when conducting research on human subjects.

The Nuremberg Code, published in 1947, was created as a guide to satisfy moral, ethical, and legal concepts surrounding human experimentation. The document laid out 10 essential points for conducting ethical research. Amongst other things, the points included the following:

  • Requirement for voluntary consent
  • Qualifications for researchers conducting experiments
  • The importance of ensuring the benefits of an experiment outweigh the risks
  • Participants’ right to terminate the experiment
  • Investigators duty to terminate an experiment if they believe it will result in harm to the subjects

While the Nuremberg Code was a good start for providing ethical guidance in conducting human research, it soon became apparent that further action was needed.

Colorectal Cancer Clinical Trials

“Trials happen in early-stage disease. They can be as a first-line treatment, when someone is first diagnosed, and also with advanced disease, where the goal of the trial is how to improve the standard treatment either by adding new medication or changing medications completely based on data from studies in advanced disease.”

Dr. Cercek | The Latest in Colorectal Clinical Trials
Public Health Services (PHS) Tuskegee Study

From 1932 to 1972, the United States Public Health Service (PHS) conducted a study to observe the effects of syphilis if it remained untreated. During this period, the PHS observed the impacts of syphilis on nearly 400 black men. 

The main problem of the study was that the patients were not informed of the true intent. In fact, they were blatantly lied to as they were told that they would be treated for the disease in return for meals, medical exams, and burial insurance. However, throughout the study, patients were denied access to penicillin, the treatment for syphilis. 

The lack of information provided and disregard for the patients’ well-being led to a class action lawsuit and increased scrutiny of human subject protection policies. 

National Research Act (1974)

The National Research Act of 1974 was passed due to the public attention surrounding the PHS Tuskegee Study. The Act created the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, which was charged with developing a code of ethics and conduct for research involving human subjects.

While the Nuremberg Code provided the guidelines for ethical human subject research, the National Research Act codified those requirements into US law. The National Commission produced the Belmont Report in 1979, which remains one of the most important reports in protecting the safety of human subjects in medical research. 

The 3 Basic Ethical Principles

The main product of the Belmont Report was the publication of three basic ethical principles to help guide and resolve ethical problems surrounding research with human participants. The three principles are:

  • Respect for Persons: All people should be respected. This includes children and individuals who may not be capable of making informed decisions due to mental or physical disabilities.
  • Beneficence: Research should not intentionally harm humans. In addition, researchers should look to maximize the potential benefits of a study and minimize the potential risks.
  • Justice: The benefits and burdens of research should be distributed fairly.

Although the Belmont Report was published almost half a decade ago, its guiding ethical principles still remain relevant today. In the next couple of sections, we will look at how these guiding principles have been applied to the way clinical trials are managed.

“A big part of what we do is help to educate and really clarify what clinical trials are.”

Leah Szumita, Clincal Trial Support Director at The LLS| Watch “What is a Clinical Trial Really?“

Applications of the Belmont Report

The three ethical principles are phenomenal foundational ideas; however, they are just that: ideas. Understanding how the idea translates to actual clinical trials is essential for research participants to feel safe agreeing to participate in trials.

Here are a few of the ways that the three principles have been applied to research:

  • Respect for Persons -> Informed Consent: Patients have the right to make the decision to participate or not to participate in a trial. To consent to participate in a trial, potential participants must receive information about the trial, be able to comprehend the impacts of a trial, and voluntarily agree to the trial. All three factors must be present to provide informed consent.
  • Beneficence -> Assessment of Risks and Benefits: Researchers need to thoroughly examine the benefits and potential risks of a study. Without clear supporting evidence that a trial will do more good than harm, the study can’t move forward. 
  • Justice -> Selection of Participants: Researchers are required to implement a fair and equitable method for selecting study participants. When possible, participants should be from a diverse set of backgrounds.

These three applications have become standard practice in conducting research. All three applications should be clearly evident in all trials.

Institutional Safeguards

Researchers can generally be trusted to have the safety and well-being of their patients in mind. However, research and academic institutions have created several fail safes to ensure that patients are well protected. 

Institutional Review Boards

The Institutional Review Board (IRB) is a group specifically formed for the purpose of ensuring that people participating in clinical trials are protected and that all federal laws are followed. Before they are formed, IRBs are approved and overseen by the Office of Human Research Protections. 

Before a clinical trial can start recruiting patients, they must receive approval from an IRB. The trial is then continuously overseen by the IRB to ensure compliance.

Data Safety Monitoring Boards

A Data Safety Monitoring Board (DSMB) is a panel of experts that are typically brought on during a phase III clinical trial. The DSMB observes the progress of a clinical trial and stops it if:

  • It becomes clear the treatment is much better or much worse than the current standard of treatment.
  • There are extreme safety concerns that make it obvious that the risks of the trial outweigh the benefits of the trial.
Clinical Investigators

While both the DSMB and IRB are not directly involved with the study, the clinical investigator, sometimes referred to as the principal investigator, is directly overseeing all aspects of a clinical trial. 

The clinical investigator is responsible for ensuring that all trial participants understand any risks involved with participating in a study and for ensuring their safety throughout the trial. 

“Never think of trials as being exposed to random things. They’re very well thought out. More often than not, you have a high level of reassurance.”

Dr. Rafael Fonseca | The Latest on Multiple Myeloma

Are Clinical Trials Safe?

As a result of the Belmont Report and the resulting events that followed, clinical trials have become much safer for participants. Doctors are required to inform patients of all the potential risks of enrolling in a clinical trial and ensure that the potential benefit of the trial outweighs the risks. 

While it’s impossible to guarantee that a trial will be completely safe, patients can be assured that they’ll have all the information they’ll need to make the decision that is right for them. 

Learn More About Clinical Trials

Dr Gasparetto

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Saad Z. Usmani, MD



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Latest Data on Newly Approved CLL Drug Pirtobrutinib Presented at ASH 2023 Top CLL doctors share their thoughts on pirtobrutinib Accelerated approval was granted to pirtobrutinib (JAYPIRCA, Eli Lilly and Company) by the U.S. Food and Drug Administration (FDA) for the treatment of adult patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (CLL/SLL)

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Role:Hematologist-oncologist, associate professor
Focus:Leukemias, Lymphomas, BMT
Institution:UT Southwestern
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Role: Hematologist-oncologist, researcher
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Role: Hematologist, researcher
Focus: Chronic lymphocytic leukemia (CLL), Hairy Cell Leukemia (HCL)
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Focus: Multiple myeloma, Waldenström’s Macroglobulinemia, early screening, clinical trials
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Kris C. J.

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Sources:

American Cancer Society. Protecting People in Clinical Trials. Accessed at https://www.cancer.org/cancer/managing-cancer/making-treatment-decisions/clinical-trials/what-you-need-to-know/protection-for-study-participants.html on October 15, 2023

Columbia University. Ethics and the IRB. Accessed at https://www.tc.columbia.edu/institutional-review-board/irb-blog/2020/the-history-of-the-belmont-report/#:~:text=The%20Belmont%20Report%2C%20a%20founding,a%20rich%20history%20of%20development.&text=“Good%20judgment%20comes%20from%20experience,experience%20comes%20from%20poor%20judgment.”&text=The%20Institutional%20Review%20Board%20(IRB,for%20research%20with%20human%20subjects on October 15, 2023.

HHS. The Belmont Report. Accessed at https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/index.html on October 15, 2023

University of North Carolina. Nuremberg Code. Accessed at https://research.unc.edu/human-research-ethics/resources/ccm3_019064/ on October 15, 2023

ERAU. History of Ethics. Accessed at https://erau.edu/-/media/files/university/research/irb-history-of-ethics.pdf on October 15, 2023

FDA. Institutional Review Board Frequently Asked Questions. Accessed on https://www.fda.gov/regulatory-information/search-fda-guidance-documents/institutional-review-boards-frequently-asked-questions October 15, 2023.

Categories
FAQ

Diagnosing Chronic Lymphocytic Leukemia (CLL) Stages

Diagnosing Chronic Lymphocytic Leukemia (CLL) Stages

When diagnosed with Chronic Lymphocytic Leukemia (CLL), the doctor will also assess how far the disease has progressed. Determining the progression of CLL is called staging.

CLL has two commonly used staging systems: the Binet staging system and the Rai staging system. Keep reading to learn more about these two systems and what they mean for CLL treatment. 

Table Of Contents
  1. What is CLL?
  2. What are Cancer Stages?
  3. Staging Systems for CLL
  4. CLL International Prognostic Index (CLL-IPI)

What is CLL?

Chronic Lymphocytic Leukemia is a form of blood cancer that starts in lymphoid cells, which are inside the bone marrow, and eventually spreads into the blood. Although CLL is one of the most common forms of Leukemia, it is slow-growing and typically not diagnosed until later in life.

Read CLL 101 to learn more about the basics of CLL and how to identify its symptoms.

What are Cancer Stages?

Part of a cancer diagnosis typically involves staging the cancer through a series of examinations and diagnostic tests. Cancer stages are a way to describe the state of cancer. It examines how far cancer has progressed by assessing:

  • Your cancer’s location and size

  • How far the cancer may have spread into nearby tissues

  • If the cancer has spread to lymph nodes or distant parts of the body

Cancer stages are important because they allow your care team to compare your cancer to others who have been in similar situations. Staging can help formulate the treatment options and assist in giving a prognosis.

Staging Systems for CLL

Most forms of cancer are staged based on the tumor size and how far the cancer has spread. However, CLL does not typically form tumors and has usually spread via the blood by the time it gets diagnosed. Therefore, a different type of staging system is required for CLL.

The three commonly accepted staging systems for CLL include:

  • Rai system – widely used in the United States

  • Binet system – commonly used in Europe

“[My doctor said] If your white count is elevated and you have no reason like an infection, it could be leukemia.”

Andrew S | Read More

Rai Staging System for CLL

The Rai staging system requires a patient to have lymphocytosis to be diagnosed with CLL. Lymphocytosis is a symptom in which a person has a high number of lymphocytes (a form of white blood cells) in their blood and bone marrow that is not linked with another cause. 

A patient must have at least 5,000/mm3 monoclonal lymphocytes to be diagnosed with CLL under the Rai staging system. A monoclonal lymphocyte means that all the lymphocytes can be traced back to one original cell due to their chemical pattern.

In all stages of the Rai Staging System, a patient has lymphocytosis. In addition, the stages differ by the following symptoms:

  • Stage 0 – No additional symptoms other than lymphocytosis

  • Stage I – Enlarged lymph nodes and lymphocytosis, but no other symptoms.

  • Stage II – Enlarged spleen, potentially an enlarged liver and lymph nodes, and lymphocytosis.

  • Stage III – Red blood cell counts are low (anemia). In addition, the spleen, liver, and liver may be enlarged, and lymphocytosis.

  • Stage IV – Platelet counts are low (thrombocytopenia), and you may have the symptoms from the other stages.

When determining treatment options for CLL, a doctor will use your stage to determine the risk that CLL poses to your health. The stages are broken into three risk levels:

  • Low risk – Stage 0

  • Intermediate risk – Stages I & II

  • High risk – Stages III & IV

The higher the risk, the more intensive the treatment plan will be. However, all stages of CLL should be monitored closely and treated when appropriate.

woman hiking with scraped leg and arm

Because CLL is usually slow-growing, it was a watch and wait situation. I had labs and saw my oncologist every 3 months to see if any lymph nodes were enlarging, talk about any symptoms and look at my lab work. 

Lacey B | Read More

Binet Staging System for CLL

The Binet Staging System is more commonly used to assess the progress of CLL in Europe. The system looks at how many different tissues containing lymph nodes have been impacted and if a patient has a low red blood cell or platelet count. 

The Binet Staging System is broken into three stages:

  • Stage A – Less than three areas with lymphoid tissue are enlarged, and red blood cell and platelet count are normal.

  • Stage B – Three or more areas with lymphoid tissues are enlarged, and red blood cell count and platelet count are average.

  • Stage C – red blood cell or platelet count is low, and one or more areas of lymphoid tissue are enlarged.

As you may have noticed, the main difference between the two staging systems is that the Binet System evaluates progression by the number of areas with lymphoid tissues that are enlarged. At the same time, the Rai System focuses on which of the tissues have been impacted. Both view low platelet and red blood count as the furthest progression of CLL.

“Everybody’s a little bit different. You’ll see some people diagnosed with CLL, and they’ve had it longer than I’ve been a doctor, and they’re doing fine with it. Their white count is the same as it has been for the last couple of decades.”

Dr. Kerry Rogers | Read More

CLL International Prognostic Index (CLL-IPI)

The CLL International Prognostic Index was released by a large working group in 2016. While the index isn’t a staging system, it is a prognostic tool that helps guide doctors on how to proceed with treatment. 

The index uses genetic, biochemical, and clinical parameters to form a scoring system that breaks patients into four prognostic categories. The prognostic factors include:

  • TP53 deleted or mutated =4 points

  • Unmutated IGHV = 2 points

  • Serum beta-2 microglobulin concentration > 3.5 mg/L = 2 points

  • Rai Stage I – V or Binet Stage B – C = 1 point

  • Patient age > 65 years = 1 point

A patient receives the corresponding points for each prognostic factor they have, and they are then totaled up to fall into one of the four risk categories. The risk categories and their associated treatment recommendations include:

  • Low Risk (0-1) – do not treat

  • Intermediate Risk (2-3) – only treat if the patient is highly symptomatic

  • High Risk (4-6) – treat unless the patient is asymptomatic

  • Very High Risk (7-10) – use novel agents or treatment in a clinical trial rather than chemotherapy

Categories
Diagnosis FAQ

BRAF Mutations and Cancer

BRAF Mutations and Cancer

Mutations of the BRAF gene have the potential to turn healthy cells into cancerous cells. While BRAF mutations are often associated with melanoma, they can also be connected to several other forms of cancer including colorectal, thyroid, non-small cell lung cancer, and hairy cell leukemia.

What is the BRAF Gene?

The BRAF gene is a proto-oncogene found on chromosome 7. The gene encodes a protein that is also known as BRAF. According to the NIH’s National Library of Medicine, the B-Raf protein plays a role in:

  • Promoting cell growth
  • Promoting cell survival
  • Aiding in differentiation (a process in which cells mature so that they have specific functions)
  • Aiding in the movement of cells
  • Inhibiting cell death or self-destruction

“I didn’t know anything about that. It’s called BRAF. Really important to understand that. And I still don’t know everything. I’m not the expert, but for melanoma, it can be caused by sun damage or it can be caused by mindless cell mutation, not sun damage.”

Rich B | Learn more about the impacts of BRAF mutation on melanoma.

What is a BRAF Mutation?

A BRAF mutation is when there is a change in the BRAF gene that causes it work incorrectly or unexpectedly. When a the BRAF gene is mutated it changes from a proto-oncogene to a oncogene, or a gene that has the potential to transform a cell into a cancer cell under certain circumstances.

What are the Different Types of BRAF Mutations?

While there are many different types of BRAF mutations one of the most common is the BRAF V600E mutation. In this case, V (valine) and E (glutamic acid) represent the mutated amino acids and 600 refers to the location on the mutation. BRAF V600E mutations and BRAF V600K mutations make up approximately 90% of all cases of melanoma caused by BRAF mutations.

Non-V600 BRAF mutations are more commonly seem in cancers other than melanoma. According to a 2018 study, non-V600 variants account for between 50% and 80% of BRAF mutations in lung adenocarcinoma and about 22% to 30% in colorectal cancer.

BRAF Mutation Classes

BRAF mutations are divided into three different functional classes based on kinase activity and signaling mechanism. The three different classes include:

  • Class I – V600 mutant kinase-activating monomers
  • Class II – Kinase activating dimers
  • Class III – Kinase-inactivating hterodimers

According to a 2019 study, classes II and III have more aggressive clinical features that lead to less favorable outcomes.

“The targeted therapy I was on was a BRAF inhibitor. It was just a daily pill I took, and I did that for a year. “

Ellis E. | Learn more about targeted therapy for BRSF mutations

How are BRAF Mutations Connected to Cancer Growth?

Some BRAF mutations can cause cancer cells to grow. The mutation results in the continuous productions of B-Raf proteins ultimately resulting in continuous growth and division of cells. 

In addition, since one of the functions of a B-Raf protein is to promote cell growth, if there is a mutation of the BRAF gene, it can cause other types of cancer to grown quicker than they otherwise would. 

Which Cancers May Involve BRAF Mutations?

According to John’s Hopkins, about half of all melanomas have the BRAF mutations about half of all melanomas have the BRAF mutations. However, BRAF mutations are not associated with just one form of cancer or even limited to one part of the body. 

Cancers associated with BRAF mutations include:

  • Melanoma (50-60%)
  • Colorectal (10%)
  • Thyroid (30-50%)
  • Non-small cell lung cancer (3%)
  • Hairy cell leukemia (100%)

Source: Roswell Park

The BRAF mutation has also been found less commonly in several other types of cancer including ovarian, esophageal, and non-hodgkin’s lymphoma.

How to Test for BRAF Mutations

Testing for a BRAF mutation upon being diagnosed is extremely important as it can help determine if you are eligible for certain treatments that may help control the spread of cancer. In fact, if you have one of the above-mentioned associated cancers, it is highly recommended that you do get tested. 

Even if you don’t think you have a BRAF mutation it’s important to get tested because some targeted treatments may actually increase the progression of a tumor if you don’t have the mutation. 

There are often two different methods used to test for a BRAF mutation:

  • Liquid biopsy – a blood test that looks for fragments of the tumor DNS in your blood.
  • Tissue biopsy – a part of the tumor is surgically removed to test for the mutation.

While a tissue biopsy is considered the gold standard for BRAF testing, it is invasive. Therefore, a liquid biopsy is preferable if a doctor is able to get a definitive result.

It can be used in people with hairy cell leukemia with a BRAF mutation which is found in the majority of people with classic hairy cell leukemia.

Dr. Kerry Rodgers | Learn more about BRAF mutation treatments.

Treatment for BRAF Mutations

Treatment for a patient with a BRAF mutation will vary based on the type of cancer. However, there are several targeted therapy drugs known as BRAF inhibitors that are used in the treatment of BRAF mutation cancers. Some of the common ones include:

  • Dabrafenib – for use with patients with a BRAF mutation and either melanoma, non-small cell lung cancer, and thyroid cancer.
  • Vemurafenib – for use with patients with the BRAF V600 mutation a metastatic melanoma.
  • Encorafenib – for use with patients with the BRAF V600E or V600K mutation with metastatic melanoma and in combination with cetuximab for patients with colorectal cancer.

While BRAF inhibitors are often effective on their own, they are sometimes used in combination with MEK inhibitors and immunotherapy. 

A B-RAF protein is only part of a larger mechanism known as the RAS-RAF-MEK-ERK pathway. Therefore, MEK inhibitors may be used in addition to BRAF inhibitors to further prevent tumor growth. 

Additionally, your treatment team may recommend immunotherapy to help your body fight the cancerous cells on its own. This involves “turning off” checkpoint inhibitors to strengthen your immunes system response to cancer cells.  

Categories
Bladder Cancer

Diagnosis and Treatment for Bladder Cancer

Diagnosis and Treatment for Bladder Cancer

Table Of Contents
  1. How is Bladder Cancer Diagnosed?
  2. Diagnosing the Extent of Bladder Cancer
  3. Grading Bladder Cancer
  4. Bladder Cancer Surgery
  5. Chemotherapy
  6. Immunotherapy
  7. Targeted Therapy
  8. Clinical Trials

How is Bladder Cancer Diagnosed?

One or a combination of several of the following tests may be used to diagnose bladder cancer:

  • Cystoscopy – Your doctor inserts a small tube known as a cystoscope through your urethra to examine your urethra and bladder for signs of cancer.
  • Biopsy (TURBT) – Collecting a cell sample to analyze for cancer. This is sometimes done during a cystoscopy by passing a unique tool called a resectoscope through the cystoscope. 
  • Urine Cytology – A urine sample is analyzed under a microscope to check for cancer cells.
  • Urine Tumor Marker Test – Urine samples are taken to analyze for certain substances (markers) commonly linked to bladder cancer cells.
  • Computerized Tomography (CT) Urogram – A contrast die is injected into a vein in your body that eventually flows through the kidneys, ureters, and bladder. X-ray images are taken during the test to provide a detailed view of your urinary tract and assess potential cancer areas.
  • Retrograde Pyelogram – similar to a CT urogram, but done in reverse to get a better look at your upper urinary tract. A doctor will thread a catheter through your urethra to inject contrast dye into your ureters. While the dye flows to the kidney, x-ray images are taken.

Cystoscopy, in combination with a biopsy, is typically used as the definitive test for bladder cancer. However, different tests may be used depending on your symptoms and personal situation.

[during the cystoscopy] they’re basically slipping a tiny tube with a camera through your urethra to head on into the bladder and have a look-see around. That’s being shown on a screen.

– Margo W. | Read More

Diagnosing the Extent of Bladder Cancer

If it appears that the bladder cancer has spread, your doctor may recommend additional tests to see if it has spread to other parts of your body. This helps when determining the grade of bladder cancer. Some of the tests to diagnose the extent of bladder cancer include:

  • Additional CT scans
  • MRI
  • PET scans
  • Bone scans
  • Chest x-ray

We had the abnormal CT, the extra scope that was abnormal, and then the surgical procedure to biopsy this growth that he saw to see more of what was going on.

Ebony G | Read More

Grading Bladder Cancer

When bladder cancer is diagnosed, it is also given a grade. Grading is done on a scale of 0 – IV, with IV being the most severe. Grading for bladder cancer is based on the TNM scale, which essentially assesses how far the tumor has grown through the bladder wall if it has spread to the lymph nodes, and if it is metastatic.

Your doctor may perform additional diagnostic tests to grade the bladder cancer. While all bladder cancer is important to treat and monitor, the higher the grade, the more urgency there is for action. 

Visit our bladder cancer overview page to learn more about staging.

Treatment for Bladder Cancer

There is no one set treatment plan for bladder cancer. Treatment options and recommendations will vary based on several different factors, including:

  • The stage of the cancer
  • Your age
  • Expected impact of the treatment 
  • Other health conditions you may have

When working through the treatment options with your care team, it’s essential to ask questions and understand each treatment’s benefits and potential side effects.

Bladder Cancer Surgery

Transurethral Resection of Bladder Tumor (TURBT)

As you may have noticed, transurethral resection is one of the procedures used to diagnose bladder cancer. However, it can also be used to treat early-stage bladder cancer.

A TURBT uses a resectoscope to go into your bladder through your urethra to remove abnormal tissue or tumors. 

Occasionally, a surgeon will need to perform fulguration after removing a tumor. This involves using a high-energy laser to burn any potentially remaining cancer cells.

A TURBT is considered a surgery, but the side effects are generally mild, and most people can go home from the hospital the same day as the surgery.

Cystectomy

When bladder cancer is invasive (it’s spread into or through the bladder muscle wall), you may need to have a cystectomy to remove either part or all of the bladder. 

  • Partial cystectomy – if the cancer has only spread to one part of the cancer, then your doctor may be able to only remove part of the bladder. Lymph nodes near the tumor may also need to be removed. This helps a patient avoid reconstructive surgery.
  • Radical cystectomy – If the cancer has spread to several parts of the bladder, your doctor may have to remove the entire bladder. In men, the prostate and seminal testicles are also removed. While in women, the ovaries, fallopian tubes, uterus, cervix, and part of the vagina are also removed.

If you have to have your entire bladder removed, you will require reconstructive surgery to allow your body to store and pass urine. The different types of reconstructive surgery include:

  • Incontinent diversion – a portion of the intestine is used to create a passage from your ureter (tubes that carry urine from the kidney) to the skin on your abdomen via a small opening known as a stoma. Urine then flows continuously into a bag stuck on your stomach that is periodically emptied.
  • Continent diversion – works similarly to an incontinent diversion, only there is a valve that prevents the continuous flow of urine. However, the urine must be removed via a catheter several times daily.
  • Neobladder – the surgeon creates a “new” bladder by using a piece of intestine to connect your ureter back to the urethra. This allows you to urinate normally; however, you have to urinate on a schedule as you won’t get the feeling that you need to “go.”
LaSonya D. feature profile

What type of diversion am I going to have? Did I want to have a bag? No, I’m 52 years old. Why would I want a bag if I don’t have to?

LaSonya D. | Read More

Unfortunately, there are several side effects associated with all types of cystectomies, including:

  • Infections
  • Blockages
  • Urine leak
  • Incontinence
  • Absorption issues

Depending on whether it was a partial or radical cystectomy, both men and women can be impacted sexually by the surgery. Men may lose the ability to produce sperm or get an erection, while women may lose the ability to orgasm, and sex may become uncomfortable.

Chemotherapy

Chemotherapy is a form of drug therapy used to kill cancer cells or prevent them from dividing. As a treatment for bladder cancer, chemo is typically given in one of two ways:

  • Systemic chemotherapy – the chemo drug is injected into a vein to enter the bloodstream and reach cancer cells throughout the body. 
  • Intravesical chemotherapy – A tube is inserted through the urethra to flush the bladder with chemo drugs. 

Chemotherapy can be given before surgery to shrink a tumor pre-operation, after surgery to prevent the chances of cancer returning, in combination with radiation therapy, or as the main form of treatment for bladder cancer. 

Vickie D.

The one that I wanted was the dd-MVAC (dense-dose methotrexate, vinblastine, adriamycin, and cisplatin). You go in one day and they give you two of the drugs. Then you go in the second day and they give you the rest of them. That’s for two months, two times a week, every other week for two months.

Vickie D | Read More

Immunotherapy

Immunotherapy is a treatment used to help a patient’s immune system fight cancer. Before starting immunotherapy, your doctor may recommend running biomarker tests to identify the most effective drug.

  • Systemic immunotherapy – immunotherapy drugs commonly used to treat bladder cancer via injections into the vein include avelumab, novolumab, and perbrolizumab. 
  • Intravesical immunotherapy – the main immunotherapy drug used to treat bladder cancer via a catheter insertion is BCG (bacillus Calmette-Guérin). 
Karen R. at home

For this type of cancer (urothelial bladder cancer), BCG is immunotherapy. It’s actually the tuberculosis vaccine and it’s the most effective treatment.

Karen R | Read More

Targeted Therapy

Targeted therapy blocks cancer-causing actions by proteins, enzymes, and other molecules. Some commonly used targeted therapy drugs for the treatment of bladder cancer include enfortumab vedotin, erafitnib, ramucirumab, and cacituzumab govitecan-hziy. 

Clinical Trials

The possibilities for bladder cancer treatment are ever-growing. If there isn’t a viable treatment option for you, there may be a clinical trial that you can enroll in. To find active bladder cancer clinical trials visit the NIH’s Nation Cancer Institute’s supported clinical trial search.

Treating Bladder Cancer by Stage

While there are several options for treating bladder cancer, different approaches may be taken at different stages of the cancer. 

  • Stage 0 – TURBT with fulguration followed by intravesical chemotherapy
  • Stage I – TURBT with fulguration is used to determine the extent of the cancer. If it’s low grade (slow growing), a second TURBT is typically given by intravesical BCG or intravesical chemo. A radical cystectomy may be recommended if it’s high-grade (fast-growing).
  • Stage II – surgical removal of the infected area of the bladder and potentially the lymph nodes is recommended at this point. This may be followed with radiation treatment or rug therapy if there’s a risk of cancer returning. 
  • Stage III – Chemotherapy to shrink the tumor, followed by a radical cystectomy, is typically recommended. Following surgery, the patient is closely monitored and potentially given drug therapy to ensure the cancer doesn’t return.
  • Stage IV – Chemotherapy is the main treatment for stage IV bladder cancer. Surgery at this point won’t likely remove all of the cancer, so treatment is aimed at slowing the growth of the cancer. Your doctor may recommend you for a clinical trial.

While these are the standard treatments for each stage of bladder cancer, your treatment plan may vary based on your situation and how the cancer progresses. 

PREVIOUS: Bladder Cancer Causes & Symptoms

Categories
Bladder Cancer

Bladder Cancer Causes & Symptoms

Bladder Cancer Causes & Symptoms – Described by Real Patients

While the specific cause of bladder cancer may be unknown, there are risk factors and symptoms that may indicate you should take extra precautions to limit your chances of getting bladder cancer or may already have it.

In this article, we look at the gene mutations that cause bladder cancer, some of the risk factors associated with bladder cancer, and the symptoms of bladder cancer. 

What Causes Bladder Cancer?

Bladder cancer occurs when cells in the bladder develop mutations in their DNA and begin to multiply rapidly. DNA is a chemical in our cells that make up our genes, which help control the function of cells. 

There are two types of genes that impact cancer by determining when cells grow, divide, and die:

  • Oncogenes – help cells grow and divide
  • Tumor suppressor genes – help repair mistakes in the DNA, control cell division, and cause cells to die

Sometimes gene mutations cause cancer by allowing the oncogenes to stay on constantly or the tumor suppressor genes to remain off. This change can create an abundance of abnormal cells. Eventually, the abnormal cells replace healthy cells and form a tumor.

Can Bladder Cancer be Inherited?

When we think of genes, we often think about the traits that we inherit from our parents. However, when it comes to gene mutations, they can be acquired or inherited.

Most people do not inherit gene mutations that cause bladder cancer. However, it is possible to inherit genes that increase your risk of getting bladder cancer due to a reduced ability to break down cancer-causing chemicals.

Most of the gene mutations related to bladder cancer are from gene mutations that are acquired during your lifetime. While chemicals associated with cancer may cause the mutations, they can also occur from random events occurring within a cell.

What are the Risk Factors of Bladder Cancer?

While researchers don’t know what causes genes to mutate and become cancer cells, there are certain risk factors that have been identified as increasing your risk of getting bladder cancer. According to the Cleveland Clinic, some of these risk factors include:

  • Smoking or exposure to second-hand smoke – inhaled smoke gets processed through your body. As a result, some of the harmful chemicals eventually end up being excreted into your urine, where it sits in your bladder.
  • Radiation exposure – radiation therapy to treat other forms of cancer may increase your risk of getting bladder cancer.
  • Exposure to certain chemicals – since your kidneys filter harmful chemicals from your bloodstream to your bladder, it is believed that some of these chemicals may contribute to an increased risk of bladder cancer. Some chemicals linked to bladder cancer include arsenic and chemicals used in producing dyes, rubber, textiles, leather, and paint products.
  • Frequent bladder infections – those with a history of reoccurring bladder infections due to inflammation may be at increased risk of squamous cell bladder cancer.
  • Being over 55 – the risk of bladder cancer increases as you age. The majority of people diagnosed with bladder cancer are over the age of 55.
  • Being male – men are at a higher risk of bladder cancer than women.
Karen R. at home

“Unbeknownst to me at the time and to a lot of people now, there are plastic softeners in catheters that have DEHP (di(2-ethylhexyl) phthalate) in them and that is, of course, a known carcinogen. It’s a combination of a foreign object repeatedly going in and out of your bladder and then the infections. I’m working now and advocating to get DEHP and other carcinogens out of catheters because we need to be able to eliminate that.”

Karen R. | Read More

Can Bladder Cancer Be Prevented?

While limiting risk factors can help decrease your chances of getting bladder cancer, it doesn’t necessarily mean that you won’t get it. However, aside from living a generally healthy lifestyle, there are a few things that you can do to lower your risk:

  • Avoid smoking – smoking increases your risk for most cancers, but it is especially bad for bladder cancer. If you smoke now and want to quit, smokefree.gov provides some excellent resources to get started. 
  • Limit exposure to chemicals – while some substances linked to bladder cancer can’t be avoided. Limiting exposure to chemicals used in leather, rubber, textiles, and paint is best. If you work with these items daily, practicing proper workplace safety habits is essential.
  • Drink water – heard this one before? Drinking plenty of water is not only good for your health overall, but it may lower your risk of bladder cancer.
  • Eat fruits and veggies – some studies suggest that eating fruits and vegetables may significantly decrease your risk of bladder cancer.

Bladder Care Symptoms

The signs and symptoms of bladder cancer can vary based on how far the cancer has progressed. However, the general symptoms of bladder cancer include the following:

  • Blood in urine
  • Painful urination
  • Back pain
  • Frequent urination or not being able to empty your bladder fully

While the above symptoms don’t necessarily indicate that you have bladder cancer, you should visit your healthcare provider if you are experiencing them.

“I think one of the things that is very common for cancer patients is that we don’t feel anything. Nothing’s up. We don’t have any pain symptoms or discomfort or anything like that. It was the same for me, except for that one day late in November, I noticed that my urine was the color of rosé, like a deep rosé.”

Margo W. | Read More

“My initial symptom was after a visit with my annual gynecologist, and they noticed that there was blood in my urine [at] a microscopic level. I couldn’t even see it, but a microscopic level of blood in my urine. They referred me to a urologist to try to look into what was going on. [It] kind of freaked me out. “

Ebony | Read More

Early Symptoms of Bladder Cancer

In its early stages, bladder cancer can present symptoms associated with abnormal changes in your urination. Some of these symptoms include:

  • Having to urinate more frequently, especially at night
  • Feeling the need to urinate even when your bladder isn’t full
  • A burning sensation or pain when urinating
  • Having a weak urine stream or struggling to urinate

These symptoms often suggest other urinary tract issues like a urinary tract infection (UTI), bladder stones, or an enlarged prostate. However, if you are experiencing these symptoms, getting tested to determine the root cause is essential.

Late-Stage Symptoms of Bladder Cancer

As bladder cancer spreads beyond the bladder into other body parts, those impacted by the disease may experience different symptoms. Some of the symptoms of late-stage bladder cancer include:

  • Lower back pain, especially on one side
  • Loss of appetite
  • Extreme fatigue
  • Unintentional weight loss
  • Swelling in the feet
  • Bone pain

Are There Different Bladder Cancer Symptoms for Men and Women?

The symptoms of bladder cancer are generally the same for both men and women. However, bladder cancer is more prevalent in men than in women, but women tend to get diagnosed at a later stage than men.

Additionally, it may take longer for older women, particularly women of color to be diagnosed, according to Dr. Samuel Washington, a urologist oncologist and assistant professor in residence at the University of California, San Francisco.

He says, “Particularly in women who are past menopause, postmenopausal bleeding is most certainly a concern to make sure we don’t miss a cancer diagnosis or something else that may be going on.”

PREVIOUS: Bladder Cancer Overview

More Bladder Cancer Patient Stories

Vickie D.

Vickie D.



Symptoms: Intermittent pain in the gut and burning sesnsation
Treatment: Chemotherapy (dd-MVAC) and cystectomy (bladder removal surgery)

Margo W.



1st Symptoms: Blood in urine



Treatment: Chemotherapy (methotrexate, vinblastine, doxorubicin and cisplatin) and radical cystectomy
LaSonya D. feature profile

LaSonya D.



Symptom: Blood in urine
Treatment: BCG immunotherapy, cystectomy (bladder removal surgery)
LaSonya D. feature profile
LaSonya D., Bladder Cancer Diagnosis: High-Grade Bladder Cancer Symptoms: Clumps of blood in urine Treatment: Surgery, bladder removal, urinary diversion
Karen R. feature photo

Karen R.



Symptoms: Recurrent UTIs
Treatment: BCG immunotherapy

Ebony G.



1st Symptoms: Blood in urine, weight gain



Treatment: MVAC chemotherapy, bladder removal surgery, neobladder

Diagnosis and Treatment for Bladder Cancer

Learn about the diagnosis and treatment process from bladder cancer survivors and medical experts. Discover diagnosis and treatment options./p>


Bladder Cancer Series



Bladder cancer patients Ebony & LaSonya talk about their cancer journey, including their first symptoms, how they processed their diagnosis, treatment options, and how they found support. Dr. Samuel Washington, a urologic surgeon, also gives an overview of bladder cancer and its treatments.

Bladder Cancer Causes & Symptoms

Understand common bladder cancer causes, urine color, symptoms, and treatments as described by real patients./p>

Categories
Kidney

Real Patient Stories: How I Knew I Had Kidney Cancer

Real Patient Stories: How I Knew I Had Kidney Cancer

Kidney cancer is a form of cancer that begins in the two bean-shaped organs known as the Kidneys. Kidney cancer forms as a result of kidney cells beginning to grow uncontrollably.

The most common form of kidney cancer in adults is renal cell carcinoma. According to the American Cancer Society, approximately 90% of all kidney cancers are renal cell carcinoma. The main types of renal cell cancer include clear cell, papillary, and chromophobe.

Kidney cancer can be hard to detect as warning signs are slowly developing. Read on to learn about the early signs, symptoms, and diagnosis of Kidney Cancer from real-life patients.

Table Of Contents
  1. What are Common Early Signs of Kidney Cancer?
  2. What Tests Do Doctors Run for Kidney Cancer?
  3. What Can Kidney Cancer be Misdiagnosed As?
  4. How Did the Doctor Tell You That You Had Kidney Cancer?
  5. What Advice Do Survivors Have for Someone Who Has Just Been Diagnosed with Kidney Cancer?

What are Common Early Signs of Kidney Cancer?

Because kidney cancer begins to form on an internal organ, there are rarely visible signs of cancer during its early stages. Some of the early warning signs of kidney cancer include:

Blood in Urine (Haematuria)

This is the most common symptom of kidney cancer. While this might result from an infection, enlargement of the prostate, or kidney stones, blood in your urine is often a sign that your kidney is not functioning correctly.

I had blood in my urine. I was like, oh, it’s just some blood.

– Nina N. | Nina’s Kidney Cancer Story: Chromophobe Renal Cell Carcinoma, Stage 2

The blood stopped. I started feeling great. Didn’t think anything of it. About a week and a half later or two weeks later I saw more blood in my urine.

Kevin R | Kevin’s Kidney Cancer Story: Transitional Cell Carcinoma, Urothelial, Invasive

Extreme Fatigue

Most people who have kidney cancer experience an extreme amount of fatigue. This is different than feeling tired from not getting a goodnight’s sleep as it often persists and worsens over time. 

The night before I actually went to the hospital, I was feeling super fatigued. I just had low energy. 

– Rachel R. | Rachel’s Kidney Cancer Story: Renal Cell Carcinoma, Stage 2

Anemia

Approximately 21% of all people diagnosed with kidney cancer experience anemia, a low red blood cell count. A healthy kidney signals the body to make new blood cells. However, cancer cells can sometimes block the kidney from sending out the signals.

Alternatively, kidney cancer can also cause an individual to have too many red blood cells. The cancer cells produce a hormone called erythropoietin that signals the bone marrow to overproduce red blood cells.

Blood Clots

Certain types of cancer, like kidney cancer, put patients at high risk for blood clots. This is the result of cancer cells producing chemicals that stimulate the body to produce clotting features.

I was a nurse at the time and I started having these blood clots that I would pass. They were about the size of my pinky, so I knew that wasn’t normal.

– Nina N. | Nina’s Kidney Cancer Story: Chromophobe Renal Cell Carcinoma, Stage 2

I had leg pain that did not go away, so I went to my doctor…he dug up an ultrasound technician who verified the presence of a DVT (clot) in my leg. The danger of such a clot was that it could dislodge and go to my lungs and create a pulmonary embolism (fatal) or to my brain and create a stroke (fatal or debilitating). 

– Bill P. | Bill’s Kidney Cancer Story: Papillary Renal Cell Carcinoma

Unexplained Weight Loss 

A sign that the cancer spreads to other organs within the body is unexplained weight loss. As cancer spreads, kidney cancer patients often experience a loss of appetite. 

Lower Back Pain

Individuals diagnosed with kidney cancer often experience lower back pain where the impacted kidney is located. The pain may be dull or sharp but is often persistent.

“I thought I had kidney stones. It was the typical pains in exactly the same place it would’ve hurt if I had had kidney stones.” 

– Kevin R. | Kevin’s Kidney Cancer Story: Transitional Cell Carcinoma, Urothelial, Invasive

I was in so much pain. I’ve never had pain like that before. I was like, did my appendix burst? What’s going on?

– Nina N. | Nina’s Kidney Cancer Story: Chromophobe Renal Cell Carcinoma, Stage 2

Stomach pains – really sharp pains in my lower abdomen. Then there were shooting lower back pains on that same side.

– Rachel R. | Rachel’s Kidney Cancer Story: Renal Cell Carcinoma, Stage 2

What Tests Do Doctors Run for Kidney Cancer?

As with any medical diagnosis, if a doctor suspects that you may have kidney cancer, they will most likely ask about your medical and family history to identify any potential risk factors. 

In addition, they will potentially prescribe one of or a combination of the following tests:

Blood Tests

While blood tests cannot confirm a cancer diagnosis, they can provide information on signs that something is wrong with a patient’s kidney or that a surgeon can operate. Standard blood tests include:

  • Complete blood count (CBC) – Measures the number of cells in the blood. It can help identify if a person is anemic or has polycythemia (too many red blood cells).
  • Blood chemistry tests – used to measure levels of certain chemicals in the blood like calcium and liver enzyme levels to test for kidney function and safety for imaging tests

Imaging Tests

since it’s difficult to physically feel for a mass on the kidney, doctors rely on imaging tests to look at potential cancerous areas, the spread of cancer, and how the treatment is working. These tests include:

  • CT
  • MRI
  • Angiography (looks at blood vessels)
  • X-ray
  • Bone Scan
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They kept me there at the hospital overnight and while I was there, they had me do another CT scan. The first scan didn’t have any contrast. This second scan was with contrast…a dye where the doctors can see things more clearly and see where the exact outline of the tumor is.

– Rachel R. | Rachel’s Kidney Cancer Story: Renal Cell Carcinoma, Stage 2

I went for the MRI. By the time I got out of the MRI tube, the doctor I was seeing at the other clinic urgent care was on the phone and waiting for me. 

– Laura F. | Laura’s Kidney Cancer Stories: Renal Cell Carcinoma, Stage 4

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They immediately got an ultrasound for me and scanned the area. I knew it was bad when the ultrasound tech was like, “Hold on a minute. I want to get the doctor.” 

– Nina N. | Nina’s Kidney Cancer Story: Chromophobe Renal Cell Carcinoma, Stage 2

Biopsy

If the doctor cannot identify if a mass is cancerous using blood tests or imaging tests, then a biopsy might be required. A biopsy is typically used as a last resort.

What Can Kidney Cancer be Misdiagnosed As?

Kidney cancer can be challenging to diagnose because it presents similar symptoms to several other conditions that impact the kidney. Conditions that can be misdiagnosed as kidney cancer include:

  • Kidney infection
  • Kidney cyst
  • Bladder infection
  • Urinary tract infection
  • Renal infraction 
  • Irritable bowel syndrome (IBS)

It’s essential that your doctor performs all the necessary tests to rule out the above conditions prior to performing a biopsy or starting you on a treatment plan. If you are concerned about a misdiagnosis, it’s best to get a second opinion before moving forward with treatment.

So I went in and had an initial screen, a cystoscopy, which is where they check your bladder just to see if something is wrong. There wasn’t anything there. They said well just in case, why don’t we schedule you for a CT scan.

– Kevin R. | Kevin’s Kidney Cancer Story: Transitional Cell Carcinoma, Urothelial, Invasive

How Did the Doctor Tell You That You Had Kidney Cancer?

The urgent care doctor said, “Listen, there’s something in your brain and it needs to come out. A neurosurgeon has already seen your film while you were in the [MRI] tube. He’s on his way to meet you at the hospital.”

– Laura F. | Laura’s Kidney Cancer Stories: Renal Cell Carcinoma, Stage 4

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He was the one that said, “It looks like the mass is about 7.5 to 8 centimeters large.” He said there was no way they could say absolutely it was cancer, but he said there was a 99.9% chance it was cancer.

– Rachel R. | Rachel’s Kidney Cancer Story: Renal Cell Carcinoma, Stage 2

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After two days at Johns Hopkins Hospital, I was in the shower, cleaning up.  The hospitalist asked, “Where are you?”  I said, “Getting ready to go home.”  He said, “Maybe not.” I came out and he showed me my brain and kidney cancers.  I then taped his description.

– Bill P. | Bill’s Kidney Cancer Story: Papillary Renal Cell Carcinoma

 

What Advice Do Survivors Have for Someone Who Has Just Been Diagnosed with Kidney Cancer?

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Be present and don’t shut your emotions out. I went through a lot of denial in the beginning. Because of that, all of my emotions came later. It would’ve been helpful for me to really try to understand what was going on – not to try to fix the situation or look for solutions. Things are out of our control in a lot of ways.

– Rachel R. | Rachel’s Kidney Cancer Story: Renal Cell Carcinoma, Stage 2

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Find whatever that is, that place within you that allows you to pick up your head and face the next day. That’s kind of a big thing, but it’s an important thing. That’s what I’ve learned.

– Laura F. | Laura’s Kidney Cancer Stories: Renal Cell Carcinoma, Stage 4

There’s so many different kinds of kidney cancer. On all these things I think I tell people listen to your body. If I had listened to my head I wouldn’t have done anything.

– Kevin R. | Kevin’s Kidney Cancer Story: Transitional Cell Carcinoma, Urothelial, Invasive

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Just take care of yourself, seriously. If you can find a little bit of hope, a little bit of joy each day, that’s all you need to keep going. Too often we focus on the negatives because it’s very easy to focus on the negative, and we need to fix our mindset and have a little faith. Focus on a little bit of hope, little bit of love, a little bit of joy, and I think that will help. 

– Nina N. | Nina’s Kidney Cancer Story: Chromophobe Renal Cell Carcinoma, Stage 2

Categories
FAQ Metastatic

What is Metastatic Cancer?

Portrait of female patients and mature doctor interacting at medical consultation in hospital

What is Metastatic Cancer?

When receiving a cancer diagnosis your doctor can often use highly technical terms to describe your cancer. While doctors and people in the cancer community are often familiar with these technical terms, an individual with a new diagnosis may not understand the prognosis. One of the terms that are used to describe a more serious form of cancer is “metastases”. What is metastatic cancer?

Metastatic cancer is cancer that has spread from the primary site (the part of the body where cancer started) to other parts of the body. The cancerous cells migrate from one part of the body to another through the bloodstream or the lymph system. 

In this article, we will dive deeper into what metastatic cancer is and how its spreads throughout the body. Additionally, we will take a look at some of the most commonly asked questions about metastatic cancer including which common sites, symptoms, and treatments for metastatic cancer.

Table Of Contents
  1. How Does Metastatic Cancer Spread?
  2. What Are Common Sites that Metastatic Cancer Spreads?
  3. Are Certain Types of Cancer More Likely to be Metastatic?
  4. How is Metastatic Cancer Diagnosed?
  5. What are the Symptoms of Metastatic Cancer?
  6. How is Metastatic Cancer Treated?
  7. How Can I Prevent Cancer from Metastasizing?
  8. Is Metastatic Cancer the Same Type of Cancer Once it Spreads?
  9. How is Metastatic Cancer Different from Advanced Cancer?
  10. Where Can I Learn More About Cancer Symptoms and Treatments?

How Does Metastatic Cancer Spread?

It takes a lot for a cancer cell to spread to another part of the body. As we mentioned earlier there are two means of transportation for cancer cells:

  • The bloodstream
  • The lymph symptom (a network of tissues, vessels, and organs that carries watery fluid 

However, it takes a lot more than a means of transportation for metastatic cancer to spread. In fact, in order to spread to a new part of the body a cancer cell must:

  • Breakaway from the original tumor and enter the bloodstream or lymph system 
  • Attach to the wall of a blood or lymph vessel and move to a new body part
  • Continue to grow and thrive in the new location
  • Avoid attacks from the body’s immune system during this process

It’s important to note that metastatic cancer can also result from growth into tissue directly surrounding the original tumor. However, when this occurs the cancer is typically more localized, especially if it is caught early.

What Are Common Sites that Metastatic Cancer Spreads?

Cancer has the capability to spready to any part of the body. Generally, cancer cells are most likely to spread to the bones, lungs, and liver. However, certain types of cancers tend to spread to specific parts of the body. For example:

  • Breast Cancer – Typically spreads to the liver, bones, brain, lungs, and chest wall.
  • Lung Cancer – Typically spreads to the adrenal glands, liver, bones, and brain.
  • Prostate Cancer – Typically spreads to the bones.
  • Colon Cancer – Typically spreads to the liver and the lungs.

Occasionally cancer can spread to the skin, muscles, or other organs, but this is much less frequent. As a general rule, cancer tends to spread “downstream” from the primary cancer site.

Are Certain Types of Cancer More Likely to be Metastatic?

Unfortunately, any type of cancer can metastasize. Certain factors that increase the potential for the spreading of cancer cells include:

  • The type of cancer (breast, prostate, kidney, melanoma, ovarian, and thyroid cancer are most likely to develop bone metastasis according to the American Cancer Society)
  • The speed of cancer growth
  • Other factorial behaviors identified by your doctor

Much more research is needed on how different types of cancer metastasize, which is why it’s important to have regular check-ins with your doctor

How is Metastatic Cancer Diagnosed?

The monitoring and diagnosis of metastatic cancer involve a wide array of tests. Your doctor may perform one of the following tests depending on your symptoms.

Blood Tests

Certain types of blood tests can indicate if the cancer is active or progressing after the initial diagnosis. Increasing levels of the below tests may indicate that you have metastatic cancer:

  • CEA (carcinoembryonic antigen) – Colon cancer
  • CA-125 – Ovarian cancer
  • PSA (prostate specific antigen) – Prostate cancer
  • AFP (alpha-feto-protein) – Testicular cancer
  • HCG (human chorionic gonadotropin) – Testicular cancer

If you have elevated liver enzymes during a routine blood test it may indicate that you have liver metastasis. However, these tests often come back normal even in those with advanced forms of cancer.

Imaging

Depending on the type of cancer you have, your doctor may also order imaging to verify or identify the spread of cancer. Some commonly ordered images include:

  • Ultrasound – helpful in identifying cancer in the abdomen or liver.
  • CT Scan – used to identify masses within lymph nodes, lungs, and the liver.
  • Bone Scan – useful in identifying if cancer has spread to the bones.
  • MRI – helps to identify bone metastasis in the spine or brain metastasis.
  • PET scans – cancer cells can often fall into the category of hypermetabolic.

While these tests are useful in helping your care team understand what is going on in your body, they are not always definitive. In some circumstances, your doctor may need to complete a biopsy to confirm the presence of metastatic cancer.

“They ran a lot of tests and found that there were going to be some things that needed to be done that weren’t standard, so they scheduled some appointments for her to gets CT scans and all the other scans.”

Read More about Willie’s wife’s struggle with metastatic thyroid cancer.

What are the Symptoms of Metastatic Cancer?

Individuals with metastatic cancer don’t always experience symptoms. However, you may experience any of the following symptoms depending on where cancer has spread:

  • Headache or dizziness
  • Loss of energy
  • Shortness of breath or trouble breathing
  • Pain in the infected area of the body
  • Jaundice

Symptoms can be an effective way to identify where cancer has spread. For example, if you experiencing jaundice, it’s a key indicator that cancer has spread to your liver. Therefore, it’s essential, to be honest, and share your symptoms with your doctor.

How is Metastatic Cancer Treated?

Your doctor may recommend several different treatment plans depending on the progression and type of cancer. 

If your cancer is localized to one part of your body, your doctor may suggest local therapy or treatment of just the cancerous area. Most often this includes surgery to remove the tumor or radiation therapy.

If your cancer has spread past a localized area your doctor may suggest systemic therapy or treatment of the entire body. This often includes the use of chemotherapy and the use of various medications.

How Can I Prevent Cancer from Metastasizing?

Currently, there are no reliable ways to prevent cancer from metastasizing. The most effective defense that we have against metastatic cancer is early detection.

It is crucial to complete a cancer screening as early as possible. You know your body best. Therefore, if you have cancer symptoms it’s better to be safe and get screened than wait until the issue gets worse.

Is Metastatic Cancer the Same Type of Cancer Once it Spreads?

You may be wondering if metastatic cancer gets a different name once it spreads to other regions of the body. The cancer type remains the same; however, the word metastatic is added to the classification of your cancer.

For example, if you are diagnosed with breast cancer and it manages to spread to the lungs it does not become lung cancer and breast cancer. Instead, it becomes metastatic breast cancer.

“He said he needed to do some testing. He needed to biopsy the lung tumor. That would tell him for certain that that was breast cancer that had spread to my lung rather than lung cancer.”

Learn more about Erin C’s struggle with metastatic breast cancer.

How is Metastatic Cancer Different from Advanced Cancer?

You will sometimes hear the word advanced cancer and metastatic cancer used interchangeably. However, they don’t always mean the same thing.

Advanced cancer is usually used to describe cancer that cannot be cured. In these instances, your doctor will focus on treating your symptoms and prolonging your life rather than aggressively attacking cancer itself. 

Metastatic cancer is not always advanced. For example, according to the American Cancer Society, distant testicular cancer has a five-year survival rate of 73%, while regional testicular cancer has a five-year survival rate of 96%.

To put this into perspective, almost 3 out of 4 men with distant metastatic testicular cancer live at least five years past their initial diagnosis. In this case, metastatic testicular cancer would not qualify as advanced cancer.

The healthcare establishment doesn’t like to use the word “cured” because there is no cure for metastatic cancer. But I’m not a medical doctor, I can say whatever I want. I want to say I’m cured, because I haven’t had any evidence of disease since 2011.  If I have it now, it’ll probably be a second cancer.

Read More about Lee’s journey with Metastatic Colon Cancer

Where Can I Learn More About Cancer Symptoms and Treatments?

If you are looking to learn more about the symptoms and treatments for your specific type of cancer head over to our FAQ page.

Additionally, if you are looking for stories of people who had the same type of cancer as you, check out our ever-growing list of cancer stories.

Categories
FAQ Finances

What Benefits are Available for Cancer Patients?

What Benefits are Available for Cancer Patients?

Cancer treatment in the United States healthcare system can be extremely expensive. Depending on your treatment plan and the severity of your cancer, you may need to cut back hours at work and possibly take a brief leave of absence. In times like these, both the federal and state government offer financial assistance to help with your treatment. So what type of benefits are cancer patients entitled to?

Typically, patients who are diagnosed with cancer have access to one of the following government programs:

  • Social Security Disability Income (SSDI)
  • Supplemental Security Income (SSI)
  • Medicare
  • Medicaid

In this article, we will cover each program in depth including how to tell if you qualify, what will be covered, and how to apply. Additionally, we will provide you with resources if you need non-federal or non-state funds for your cancer treatment.

Table Of Contents
  1. What Benefits are Available for Cancer Patients?

What is Social Security Disability Income (SSDI)?

SSDI is a social security program that will pay income to individuals who are unable to work due to a disability. In some instances, SSDI will also pay certain family members who are affected by the disability.

The program typically covers individuals who are unable to work as a result of a disability for a year or more. SSDI will also cover certain expenses and healthcare as you transition back to work.

How Do I Qualify for SSDI?

Unfortunately, SSDI has very stringent restrictions on who qualifies for financial aid. In order to qualify for SSDI you must:

  • Worked in a job covered by Social Security for “long enough”
  • Meet Social Security’s strict definition of disability

While to qualifications for SSDI provided by the Social Security Administration (SSA) may seem vague, they do provide detailed information of each qualifying factor on their website. However, to save you time we’ve summarized the requirements for the qualifications below.

How Much Work Do You Need to Qualify for SSDI?

The Social Security Administration determines if you’ve worked long enough to qualify for SSDI based on two factors:

  • Total yearly wages or self-employment income
  • Length of time working in a job covered by Social Security

The SSA assigns you credits based on how much you earn in a given year. They assign a value for one credit and you have the potential to earn up to four credits per year. 

The value of a credit varies yearly; however, in 2022 you need to make $1,510 for one credit and $6,040 for all four credits. 

Additionally, you generally need 40 credits to qualify for SSDI with at least 20 of those being earned in the last 10 years. However, there are sometimes exceptions for younger individuals.

If you are interested in learning more about how to earn credits you can look over the SSA’s guide on how to do so.

How Much Money Can I Expect to get on SSDI?

SSDI is paid on a monthly basis. As of 2021, the average monthly benefit was $1,128 and the maximum benefit was $3,148.

“I educate people about how insurance policies generally work and refer them to help them understand exactly what their plan will cover.”

Read more about how Lia A. helps cancer patients with their finances after being diagnosed.

What is Supplemental Security Income?

Social Security Income (SSI) provides basic financial assistant to older adults and those with disabilities who have very limited income. SSI is typically supplemented by state benefits, in addition to federal assistance.

How Do I Qualify for Social Security Income?

The two qualifying factors for SSI are:

  • Meeting the SSA’s strict definition of a disability or being over the age of 65
  • Having limited income and assets

You have to meet the SSA’s definition of having “limited” income and assets to qualify for SSI. Individuals have to have less than $2,000 in assets and couples must have less than $3,000.

Additionally, you have to be at or below the federal benefit rate (FBR) in terms of income. In 202, the FBR was $794 for individuals and $1,191 for couples. However, not all income counts when the SSA calculates your income.

What Counts as Income Under SSI?

Social Security has a large list of items that do not count towards your income when assessing if you qualify for SSI. The list of items can be found on their website along with more information on how they calculate your income.

How Much Money Can I Expect to Get on SSI?

The average monthly benefit under SSI is $577 per month. The maximum in 2021 was $791 for an individual and $1,191 for a married couple.

“I was able to apply for disability because acute leukemia is one of those conditions with compassionate allowances within social security, so I started getting money from that in month four or five.”

Read more about Christine’s experience with the SSA

How are Social Security Disability Income and Social Security Income Different?

SSDI and SSI differ in two major ways: the amount of money that is paid to the recipient monthly and the determination for receiving the benefits. 

SSDI pays recipients a lot more on a monthly basis than SSI. This is in part because SSI is supposed to be complemented by state benefits.

Additionally, the determination for receiving SSDI benefits is based on the length of time worked, while SSI is based on income and resources. Therefore, SSDI benefits those who have been in the workforce for an extended period of time, while SSI is meant to help low-income individuals.

However, unless you are over the age of 65, both benefits require you to meet the SSA’s definition of disability.

How Does Social Security Define Disability?

Social Security has a three-part definition for disability in its SSI and SSDI programs:

  • You are unable to work and engage in a substantial gainful activity because of your medical condition.
  • You cannot do work that you previously did or adjust to other work because of your medical condition.
  • Your condition has lasted or is expected to last longer than a year or result in death. 

It’s important to note that SSDI does not cover partial or short-term disability.

What is a Qualifying Disability Under SSDI and SSI?

Even if you meet the definition for disability, you do not automatically qualify for SSDI or SSI. You need to have what the SSA refers to as a “qualifying disability.” 

To have to be considered a qualifying disability you must meet the following five criteria:

  • You cannot be working
  • Your condition must be considered severe
  • Your disability must be on the list of disabling medical conditions
  • You cannot be able to do the work that you previously did
  • You cannot do any other type of work

Which Forms of Cancer Qualify for SSDI and SSI?

The SSA does consider some forms of cancer to be a qualifying disability especially particularly disabling or hard-to-treat cancers. These include:

  • Any small-cell cancers
  • Brain cancer of all types
  • Esophageal cancer
  • Gallbladder cancer
  • Inflammatory types of breast cancer
  • Liver cancer
  • Pancreatic cancer
  • Salivary gland cancer
  • Sino-nasal cancer
  • Non-small-cell cancers that survive three months of chemo or spread to other organs

Even if your cancer is not on this list, the SSA may still consider it a qualifying disability.

How Do I Apply for SSDI and SSI?

You can apply for SSDI and SSI at a Social Security office or on the SSA’s website.

It’s important to note that several people don’t receive and approval for SSDI on their first application. If the rejection was due to a clerical error you have the opportunity to reapply. Alternatively, you can also submit an appeal if your application was denied for some other reason.

“It was a lot of internalized emotions and stress. To be away from there was just a relief. I felt better the day the doctor said you can be off work. I felt amazing that day, you know what I mean?”

Read more about how Maurissa was able to take time off from work because of her benefits.

How Can Medicare and Medicaid Help with My Medical Expenses?

While SSDI and SSI can help provide supplemental income if you end up needing to leave your job due to cancer you still have to find a way to cover your medical expenses. Medicare and Medicaid can help cover a large portion of those expenses if you end up losing your healthcare benefits from your employer.

What is the Difference Between Medicare and Medicaid?

Medicaid and Medicare are intended for different people just like SSDI and SSI.

Medicaid is for low-income individuals. It is primarily funded by the state, so requirements and benefits will vary from state to state. However, in most states, if you qualify for Medicaid the majority of your medical expenses will be covered.

To learn more about how Medicaid may be able to help you cover your medical expenses read our article about Medicaid coverage.

Most people associate Medicare with individuals over the age of 65. However, Medicare is also available to anyone who has a qualifying disability and is sponsored by the Federal Government. Medicare is fairly similar to your work insurance. You pay a monthly premium and pay for certain costs until you hit a deductible. After that, Medicare helps with the bill.

It’s important to note that Original Medicare (Part A & B) only covers the bare minimum and cancer patients will often need to purchase additional insurance. Government-approved private insurance companies offer Medicare Advantage (Part C), which will allow you to choose additional coverage that meets your needs. 

To learn more about how Medicare can help cover your medical expenses read out article on Medicare and cancer coverage.

How Do I Apply for Medicare and Medicaid?

You can apply for Medicare online here. You also have the option to visit a local SSA office or call Social Security at 1-800-772-1213.

The application process for Medicaid varies by state. Your state government should have a website dedicated to information about the application process.

How Do Identify the Different Type of Benefits for Cancer Patients?

While we have covered four of the most commonly used benefits for individuals with cancer, you may qualify for several other benefits based on a multitude of factors. 

The SSA has a questionnaire dedicated to helping you determine which benefits you qualify for. It asses your eligibility for over 1,000 federal and state-sponsored benefits.

What If I Don’t Qualify for Federal or State Benefits?

If you don’t qualify for state or local benefits to help cover the costs of your cancer treatment or cost of living don’t fret! Several organizations can assist you with your finances. Some of these include:

This only begins to scratch the surface of the organizations dedicated to helping assist cancer patients with the financial burden of cancer treatment. 

What if I Have Other Questions About Cancer and Finances?

A cancer diagnosis can be a scary and stressful time in anyone’s life. The last thing you want to stress about is the financial burden of the treatment and medications needed to help you fight the disease.

If you have more questions about cancer and finances or just cancer in general, visit our FAQ page.

Categories
FAQ Lung Cancer

Biomarker Testing

Biomarker Testing

You may have heard your care team mention the possibility of biomarker testing when trying to develop a plan of action for diagnosis or a potential diagnosis of cancer. While biomarker testing has been around since the 1950s, it’s not a term you come across often if you aren’t in the medical field. 

Biomarker testing is an effective tool for doctors to help identify targeted therapies for driver mutations or issues with the immune system for cancer patients. 

In this article, we will help you better understand what biomarker testing is and answer any questions that you may have about biomarker testing. This way you can make an informed decision about what is best for you and your body. 

Table Of Contents
  1. What is Biomarker Testing?
  2. Why is Biomarker Testing Useful for Cancer Patients?
  3. When Should I Consider Biomarker Testing?
  4. Which Types of Biomarker Testing Should I Be Asking For?
  5. Are There Different Types of Biomarker Testing?
  6. How is Biomarker Testing Done?
  7. Biomarker Testing Patient Stories
  8. Medical Experts on Biomarkers

What is Biomarker Testing?

Biomarker testing, also known as molecular or genomic testing, is the use of a laboratory test to measure biomarkers found in your bodily fluids or tissue. A biomarker is a biological molecule found in any bodily fluid that may indicate a sign of abnormality as in a disease or a condition. 

Doctors are able to use the tissue of a tumor to test for abnormalities in its DNA and levels of specific proteins in the tumor in order to identify what is causing the tumor to grow. In turn, they can then apply targeted therapy that will help remove the cancerous cells without damaging healthy cells. 

Why is Biomarker Testing Useful for Cancer Patients?

Biomarker testing is a great tool for cancer patients because it allows your care team to diagnose the type of cancer. This in turn can help your doctor determine the best treatment plan.

According to the National Cancer Institute (NCI), biomarker testing can also be used to identify genes the may lead to cancer or see how your treatment plan is progressing. 

“It’s helped us on three different occasions not only with diagnosis, but on each time that he had progression of his cancer, the liquid biopsy was able to say, here’s the mutation, here’s the new mutation, and here’s the direction the clear plot path that you need to take for survival.”

Read more about Rhonda’s success with Biomarkers

When Should I Consider Biomarker Testing?

The National Institutes of Health recommends biomarker testing for all patients with non-small cell lung cancer. Biomarker testing can also be useful for several other types of cancer including melanoma and breast cancer.

Three key times you should consider asking your doctor about biomarker testing are:

  • When your doctor suspects cancer and you are getting a biopsy done.
  • If you have been diagnosed with cancer but did not get biomarker testing done.
  • If lung cancer reoccurs after treatment

Essentially, if you are diagnosed with lung cancer you should discuss the potential for biomarker testing with your doctor.

“I wish I had actually asked for the full biomarker testing to see what their report was and ask questions about it. Cancer runs in my family, but I had done genetic testing. I didn’t understand this was different testing.”

Read More about Terri’s lung cancer story

Which Types of Biomarker Testing Should I Be Asking For?

There are two types of biomarker testing that should be done if you’ve been diagnosed with or your doctor suspects lung cancer:

  • Driver Mutations – an error in a gene’s DNA
  • Expression of PD-L1 – an immunotherapy biomarker

Let’s dive further into the two types of biomarker testing to understand what they indicate and how they impact your treatment plan.

Driver Mutations

In order to understand driver mutations, it’s important to understand the basics of how genes and DNA work. 

DNA makes up genes. When everything is working normally each gene has its proper DNA code which then results in the production of proteins. 

A mutation occurs when a gene has an error in its DNA. Mutations are normal and happen often. A single mutation likely won’t cause cancer; however, the accumulation of multiple mutations over time is what typically results in cancer. 

Mutations are often sorted into two general categories:

  • Somatic (acquired) – The mutation is limited to just the tumor and is not passed to offspring.
  • Germline (inherited) – The mutation is present in all cells of the body and can be passed to offspring. 

There are several different types of driver mutations that can result in cancer. Some of the most common ones include:

  • Activating Mutation – The protein is always active.
  • Fusion – The fusion of one gene with another.
  • Amplification – More copies of a gene than normal.
  • Deletion – Part of or the entire gene is missing. 

Research has so far found 20 different driver mutations commonly found in non-small cell lung cancer treatment and small cell lung cancer treatment. Much more research is needed to continue identifying the potential mutations and develop targeted therapies. 

Expression of Programmed Death Ligand 1 (PD-L1)

The testing of your PD-L1 levels is what helps identify if you need immunotherapy. According to the National Library of Medicine, a PD-L1 test helps measure the amount of PD-L1 on cancer cells. 

This is important because PD-L1 proteins are what prevent your T-cells, otherwise known as immune cells, from attacking the cancer cells. Essentially, the abnormal cancer cells are hiding behind the PD-L1 proteins to stop your body from doing its job.

To learn more about immunotherapy visit our FAQ page.

“If you catch a patient stage one, you can have a greater than 90% chance of curing that patient from lung cancer. So that’s what it’s all about.”

– Dr. Michael Gieske

Read more about Dr. Gieske’s fight for early lung cancer screening.

Are There Different Types of Biomarker Testing?

Yes, there are several different biomarker tests that can be done. The type of biomarkers and test that is performed depends on the type of cancer that you may have. 

Some common tests include:

  • Single Biomarker Test – Only looking for one single biomarker.
  • Multigene Test – Looking at a panel of several different biomarkers.
  • Whole-Exome Sequencing – Looking at all of the genes in your cancer.
  • Whole-Genome Sequencing – Looking at all of the DNA in your cancer.
  • Tumor Mutational Burden Testing – Looking at genetic changes in your cancer to determine if you need immunotherapy.
  • Liquid Biopsies – Assessing blood or other bodily fluids for biomarkers.

The type of biomarker that is run depends on your cancer type and what your doctor is trying to learn from the test. 

How is Biomarker Testing Done?

An important part of deciding if biomarker testing is right for you may be how the actual test is performed. The test can be done in one of three ways depending on the type of biomarkers that are being tested for:

  • If you are having surgery, the surgeon can take a sample of your tumor during the operation.
  • They may need to take a biopsy of your tumor if you aren’t having surgery.
  • Some biomarker tests can be completed using just a blood draw.

In some instances, you may need to get an additional biopsy done if the cancer is reoccurring, or they didn’t get enough tissue to complete the test.

What Will My Biomarker Test Reveal?

The results of your biomarker test may help identify the best course of treatment by indicating what type of mutation is causing your cancer or if you are a candidate for immunotherapy. If there is an FDA-approved drug to treat your results you may be able to avoid chemotherapy or even potentially surgery.

“Research is going to biomarker testing that’s going towards targeted therapy. That’s the future of cancer care. That’s not just about lung cancer. So as we make it more people more aware of biomarker testing that goes across all cancers, that’s an education that is critical research.”

Read more about Chris Draft’s experience with lung cancer and his efforts to build awareness.

Biomarker Testing Patient Stories

Learn about how biomarkers impact a cancer diagnosis and treatment from real-life patients.

Lung Cancer


Chris Draft



Background: Chris' wife Keasha passed away from stage 4 lung cancer one month after they married. He's been a passionate lung cancer advocate ever since.
Focus: Leading with love, making connections to grow lung cancer community, NFL liaison

Rhonda & Jeff Meckstroth



Background: Jeff was diagnosed with stage 4 lung cancer and given months to live, but his wife, Rhonda, fought for a specialist that led to biomarker testing and better treatment options
Focus: Education of biomarker testing for driver mutations, patient and caregiver self-advocacy

Terri C., Non-Small Cell, KRAS+, Stage 3A



Cancer details: KRAS-positive, 3 recurrences → NED
1st Symptoms: Respiratory problems
Treatment: Chemo (Cisplatin & Alimta), surgery (lobectomy), chemo, microwave ablation, 15 rounds of SBRT radiation (twice)

Stephen H., Non-Small Cell, ALK+, Stage 4 (Metastatic)



Cancer details: ALK+ occurs in 1 out of 25 non-small cell lung cancer patients
1st Symptoms: Shortness of breath, jabbing pain while talking, wheezing at night
Treatment: Targeted therapy (alectinib), stereotactic body radiation therapy (SBRT)

Shyreece P., Non-Small Cell, ALK+, Stage 4



Cancer details: ALK+ occurs in 1 out of 25 non-small cell lung cancer patients
1st Symptoms: Heaviness in arms, wheezing, fatigue
Treatment: IV chemo (carboplatin/pemetrexed/bevacizumab), targeted therapy (crizotinib, alectinib)

Montessa L., Small Cell Lung Cancer



Cancer details: Small cell lung cancer
1st Symptoms: Chest pain, lingering cough
Treatment: Chemotherapy (Cisplatin switched to carboplatin, etoposide), chest radiation, brain radiation (prophylactic)

Ivy E., Non-Small Cell, EGFR+, Stage 4 (Metastatic)



Cancer details: EFGR-positive
1st Symptoms: Pain & stiffness in neck, pain in elbow
Treatment: Two targeted therapies (afatinib & osimertinib), lobectomy (surgery to remove lobe of lung)

Dave B., Non-Small Cell, Neuroendocrine Tumor, Stage 1B



Cancer details: Neuroendocrine tumor
1st Symptoms: 2 bouts of severe pneumonia despite full health
Treatment: Lobectomy (surgery to remove lobe of lung)
Dan W. profile

Dan W., Non-Small Cell, ALK+, Stage 4



1st Symptoms: Cold-like symptoms, shortness of breath, chest pains
Treatment: Radiation, targeted therapy (Alectinib)

Ashley R., Non-Small Cell, EGFR+ T790M, Stage 4
Diagnosis: Stage IV Non-Small Cell Lung Cancer
1st Symptoms: Tiny nodules in lungs
Treatment: Tagrisso (Osimertinib)
Amy G.

Amy G., Non-Small Cell Squamous, MET, Stage 4



1st symptoms: Lump in neck, fatigued
Treatment: Pembrolizumab (Keytruda), SBRT, cryoablation, Crizotinib (Xalkori)

Breast Cancer


Abigail J., Stage 4, Metastatic



Cancer Details: HER2-low, node negative, PIK3CA mutation



1st Symptoms: Back and leg pain, lump in breast



Treatment: Surgery, chemotherapy, radiation, CDK4/6 inhibitors

Leukemia

Mary Clare

Mary Clare B., Acute Myeloid Leukemia (AML)



Cancer details: Relapsed but in remission after 2nd transplant
1st symptoms: Extreme fatigue, upset stomach, bad & persistent headaches
Treatment: Chemotherapy, radiation, 2 bone marrow transplants

Medical Experts on Biomarkers

Dr. Saad Usmani

Saad Z. Usmani, MD



Dr. Saad Usmani, Chief of Myeloma Service at Memorial Sloan Kettering, talks about CAR T-cell therapy, bispecific antibodies, novel therapies and combination therapies.

Deciding Best Myeloma Treatment for a Patient Using a New Strategy



Focus: Possible way of determining optimal treatment for patients without them having to go through treatment first, via using new approaches of studying tumors outside the body, gene expression, and computational data.
Featuring: Praneeth Sudalagunta, Ph.D, Moffitt Cancer Center

Tim Fenske, MD, MS



Role: Hematologist-Oncologist
Focus: chronic lymphocytic leukemia (CLL) & leukemia and lymphoma | CAR T, targeted therapy
Provider: Medical College of Wisconsin

Irene Ghobrial, MD



Role: Clinical investigator and professor of hematological oncology
Focus: Multiple myeloma, Waldenström’s Macroglobulinemia, early screening, clinical trials
Provider:Dana-Farber Cancer Institute (Boston)

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