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. 2017 Aug 27;18(8):2275-2285.
doi: 10.22034/APJCP.2017.18.8.2275.

Screening for Circulating Tumour Cells Allows Early Detection of Cancer and Monitoring of Treatment Effectiveness: An Observational Study

Karin Ried  1 , Peter Eng, Avni Sali
Affiliations

Screening for Circulating Tumour Cells Allows Early Detection of Cancer and Monitoring of Treatment Effectiveness: An Observational Study

Karin Ried et al. Asian Pac J Cancer Prev. .

Abstract

Background: Circulating-Tumour-Cells (CTC) provide a blood biomarker for early carcinogenesis, cancer progression and treatment effectiveness. An increase in CTCs is associated with cancer progression, a CTC decrease with cancer containment or remission. Several technologies have been developed to identify CTC, including the validated Isolation-by-Size-of-Epithelial-Tumour (ISET, Rarecells) technology, combining blood filtration and microscopy using standard histo-pathological criteria. Methods: This observational study compared CTC count to cancer status and cancer risk, by monitoring treatment effectiveness in cancer patients and by screening for CTC in asymptomatic patients with risk factors, including family history of cancer. Results: Between Sept-2014 and Dec-2016 we undertook 600 CTC tests (542 patients), including 50% screening requests of patients without cancer diagnosis but with risk factors. CTC were detected in all cancer patients (n=277, 100%), and in half of the asymptomatic patients screened (50%, 132 out-of 265 patients). Follow-up tests including scans, scheduled within 1-10 months of positive CTC tests, found early cancerous lesions in 20% of screened patients. In 50% of male patients with CTC and normal PSA (prostate-specific-antigen) levels, PSMA-PET scans revealed increased uptake in the prostate, indicative of early prostate cancer. Other types of cancers detected by CTC screening and subsequent scans included early breast, ovarian, lung, or renal cancer. Patients with CTC were advised on integrative approaches including immune-stimulating and anti-carcinogenic nutritional therapies. CTC repeat tests were available in 10% of patients with detected CTC (40 outof 409 patients, n=98 CTC tests) to assess treatment effectiveness, suggesting nutritional therapies to be beneficial in reducing CTC count. Conclusions: CTC screening provided a highly sensitive biomarker for the early detection of cancer, with higher CTC counts being associated with higher risk of malignancy. CTC monitoring over time indicated treatment effectiveness. Nutrients with anti-carcinogenic properties could reduce CTC count, and included curcumin, garlic, green tea, grape seed, modified citrus pectin, and medicinal mushroom extract.

Keywords: Circulating Tumour Cells (CTC); cancer screening; treatment effectiveness; integrative nutritional therapy.

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Figures

Figure 1
Figure 1
Trial Flow Chart. Cancer patients (group 1), asymptomatic patients (CTC screening, groups 2+3); CTC were detected in all cancer patients (group 1), and in 50% of asymptomatic patients (groups 2+3).
Figure 2
Figure 2
Histo-Pathological/ Cyto-Morphological Detection of CTC Using the ISET Method. CTC are stained blue, filter pores of 8 microns appear black. Panel A: breast cancer, B: prostate cancer, C: colorectal cancer, D: renal/ bladder cancer
Figure 3
Figure 3
CTC Monitoring of a) cancer patients (group1) and b) asymptomatic patients without detectable tumour (group3) before and after integrative therapies including immune-stimulating nutrients. Cancer patients (group 1) with mild disease did not undergo surgery, chemo- or radiotherapy due to variety of reasons.
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