How tests that detect cancer DNA fragments in blood can kickstart earlier treatment


Cancer doctor and researcher Siddhartha Mukherjee describes how surprised scientists were to discover DNA drifting freely in blood plasma almost 80 years ago.

โ€œThe finding defied biological orthodoxy,โ€ he writes in his Pulitzer Prize-winning 2010 book, The Emperor of All Maladies: A Biography of Cancer.

โ€œDNA was thought to remain locked inside the nuclei of cells, and not float around on its own. Stranger still, these werenโ€™t whole genomes but broken pieces โ€“ genetic flotsam cast adrift from an unknown source.โ€

That unknown source, it was later discovered, are genetic mutations and tumours, the fragments of which are known as circulating tumour DNA (ctDNA).

CtDNA is seen in healthy individualsโ€™ blood too โ€“ due to normal cellular processes โ€“ but only at low levels. Higher ctDNA levels flag the likely presence of a tumour. This is why ctDNA tests are potentially so valuable as a diagnostic tool for cancer.

A study published in May by Johns Hopkins University in the US found that a new laboratory test in trial โ€“ multi-cancer early detection (MCED) โ€“ was able to identify ctDNA up to three years before traditional testing methods would have picked them up.

In a ctDNA test, plasma is extracted from a blood sample to check whether there are DNA fragments harbouring cancer. Illustration: Shutterstock
In a ctDNA test, plasma is extracted from a blood sample to check whether there are DNA fragments harbouring cancer. Illustration: Shutterstock

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