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Chris Woolmams / Catherine Woollams
Chemosensitivity Testing

An article on the benefits of ´chemosensitivity´ testing, where a blood test checks for circulating cancer cells, CTCs, and then measures their sensitivity to drugs and natural compounds before they are used.

Chemosensitivity - Will the drugs work with my personal cancer?

If you could take a sample of your cancer, put it into a dish, and then show which drugs worked best against your personal cancer cells and, importantly, which did not work at all, you’d want to know, wouldn’t you? In an ideal world you’d then know which drugs were going to work best, before you used any. Any you wouldn´t bother taking those that showed no signs of working at all.

Well, that is chemosensitivity testing.

In 2016 researchers in the Jules Bordet Clinic in Brussels showed that about 15 per cent of breast cancer drug use at the outset of treatment was simply unnecessary. They developed a genetic test, the mamaprint, so women with low risk of a breast cancer returning after surgery could avoid the trauma of chemotherapy. 

Is the mamaprint used? Is chemosensitivity used by mainstream doctors? Never.

Scientists understand the problem. Unfortunately, many doctors and oncologists simply do not.  Worse, they are bound by ´Best Practice´ principles and statistics in their hospitals to treat all patients with a pre-planned protocol of drugs. Breast cancer? Give her FEC-T. If these prove ineffective they will simply then ´try´ other drugs, even using clinical trial drugs with no idea whether or not them might work on you and your very personal cancer. You are a guinea pig. To put this in context, one study of 4,700 women with DCIS breast cancer showed that no two women had the same cancer - they were ALL histologically different! No wonder some people simply respond better to a drug than others.

And there are hundreds drug combinations that are used for different cancer patients often many such cocktails have never been through a Clinical Trial. Yet patients are used as guinea pigs frequently. That didn´t work so we´ll try this one. Months of side-effects with no gain.

Many drugs were approved decades ago but are still used today. Old drugs like 5-FU (Fluorourocil) are still widely used to treat cancers like breast and colorectal, but it was approved in 1956 and, whilst it might kill a cancer cell or two, it is known to be very harmful to your healthy cells.

And, over time, a drug´s ability to work in some patients diminishes more rapidly than in others. 

Thus the benefit of chemosensitivity testing is that INDIVIDUAL patients can be assessed at any moment in time to discover which drugs will maximise their PERSONAL cancer cell and tumour death, kicking out those that haven´t a chance. Thus ineffective, unnecessary exposure to drugs and their side-effects is minimised.

Also, some patients go to private clinics for expensive ´alternative´ treatments like IPT (Insulin Potentiation Treatment) where only a fiftieth of the drug volume is used. It has to be a really good idea to test whether a drug has any chance of working, before you pay the clinics fees!

Chemosensitivity - will the natural compounds I´m taking do any good?

Many people take ´supplements´. Some take up to 3.2 grams of curcumin. Other people think about Intravenous vitamin C injections, B-17 or artemesinin (Sweet wormwood). 

If you could also test for the sensitivity of your cancer cells to specific bioactive natural compounds like curcumin, indole 3 carbinol and B-17, you would find that useful too, wouldn´t you? Especially if that effectiveness were ranked against the drugs proposed!

Many chemosensitivity centres will also provide a similar assessment of the effectiveness of up to 35 bioactive natural compounds too. 

The Politics of chemosensitivity testing

If chemosensitivity tests show certain common drugs are not worth using or simply do not work, Pharmaceutical Companies could lose serious volume and profit. Fact.

The new kid on the block is the Liquid Biopsy. It measures circulating cancer cells (CTCs) AND circulating tumour DNA (ctDNA) and from the state of the DNA, can tell doctors whether the drugs are working or not, AFTER they have been used. Doctors are excited - they say it heralds the advent of precision medicine.

GO TO: Liquid Biopsies and tests for circulating cancer cells, circulating tumour DNA and the effect of existing treatments

Doctors want the best for their patients, and they should not be afraid of recommending the use of chemosensitivity, while they are waiting for Liquid Biopsies to be part of everyday cancer treatment.

Government Health Bodies like the NHS in the UK need to save money; this would be a great way to do it. It would save money by not using drugs that don´t work!

Patients want to be cured and have less side-effects. 

But Big Pharma has always seen chemosensitivity testing as a threat to profits.

Chemosensitivity testing – accurate or not?

Two decades on, and Chemosensitivity tests are hardly more polished than they were at the outset, largely because of a sort of damning faint praise. The Internet is full of experts saying they are full of potential, but there’s an element of ‘Fool’s Gold’ in the criticisms.

For example, the National Cancer Institute believes they have potential importance in clinical trials. The American Society of Clinical Oncology produced a review of seven years of studies on chemosensitivity testing and again ran the ‘full of potential, but confine them to clinical trials’ message.

We also know of patients who have asked their oncologists to use chemosensitivity testing only to be told ´Just because it works in a dish, doesn´t mean it will work in real life´. This is absolutely true. But if it doesn´t work in the dish, it certainly isn´t going to work in real life, and most patients would like to know that up-front!!

One study was very clear that Chemosensitivity Tests could already help. In a study from Northwestern University in the Journal of the National Comprehensive Cancer Network (2011) chemosensitivity testing ‘closely predicted patients’ real life experience and “accurately predicted progression-free and overall survival.”

Chemosensitivity – use and costs

One problem is that different laboratories test in different ways. 3D testing is the new kid on the block.

The three important factors are:

1. You should only measure cell death – not the inhibition of growth

2. You should take tumour cells and test them immediately. Growing cultures in a dish can give false results as the new cells may not represent the metabolism of the original tumour.

3. The environment may also affect results, so the tumour environment must be maintained. Chemosensitivity testing is not cheap, especialy where a patient might be offered 4 different drugs over a few years. Each assay can be $3,500 to $4,500 (up to £3,000 pounds). This may be covered by insurance.

Chemosensitivity testing - getting you a cheaper deal

If you can get chemosensitivity testing at a sensible price it is well worth doing. And CANCERactive in the UK is trying to sort something out right now for its readers. Chris Woollams, founder of CANCERactive and former Oxford University Biochemist said, "We are determined to bring this to our patients at a sensible price. Chemosensitivity testing can give you help and more insight. No one wants to suffer extreme side-effects from a drug that is never going to work!. 

And many people would like to know, in advance, if those expensive intravenous injections of vitamins and natural compounds are going to do any good, or will they be a waste of money? This is a no brainer. We just want to get the price down for people."


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