Doctors have spotted cancer coming back up to a year before normal scans in an “exciting” discovery. The UK team was able to scour the blood for signs of cancer while it was just a tiny cluster of cells invisible to X-ray or CT scans. It should allow doctors to hit the tumour earlier and increase the chances of a cure.  They also have new ideas for drugs after finding how unstable DNA fuels rampant cancer development. The research project was on lung cancer, but the processes studied are so fundamental that they should apply across all cancer types.  Lung cancer kills more people than any other type of tumour and the point of the study is to track how it can “evolve” into a killer that spreads through the body. In order to test for cancer coming back, doctors need to know what to look for.  In the trial, funded by Cancer Research UK, samples were taken from the lung tumour when it was removed during surgery.  A team at the Francis Crick Institute, in London, then analysed the tumour’s defective DNA to build up a genetic fingerprint of each patient’s cancer.  Then blood tests were taken every three months after the surgery to see if tiny traces of cancer DNA re-emerged.
The results, outlined in the journal Nature, showed cancer recurrence could be detected up to a year before any other method available to medicine.  The tumours are thought to have a volume of just 0.3 cubic millimetres when the blood test catches them. Dr Christopher Abbosh, from the UCL Cancer Institute, said: “We can identify patients to treat even if they have no clinical signs of disease, and also monitor how well therapies are working. “This represents new hope for combating lung cancer relapse following surgery, which occurs in up to half of all patients.” So far, it has been an early warning system for 13 out of 14 patients whose illness recurred, as well as giving others an all-clear.  In theory, it should be easier to kill the cancer while it is still tiny rather than after it has grown and become visible again. Prof Charles Swanton, from the Francis Crick Institute, told the BBC: “We can now set up clinical trials to ask the fundamental question – if you treat people’s disease when there’s no evidence of cancer on a CT scan or a chest X-ray can we increase the cure rate.  “We hope that by treating the disease when there are very few cells in the body that we’ll be able to increase the chance of curing a patient.” Janet Maitland, 65, from London, is one of the patients taking part in the trial.

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