It may sound like science fiction or the meanest scam of all time, but a new report goes on the record saying that we have reached the point where a simple blood test could sniff out over 50 cancers before they even cause any trouble.
That's the idea behind multi-cancer early detection (MCED or MCD) tests, the new rockstars in cancer screening. They're still early days, but some are already available in the US, says JAMA – the Journal of the American Medical Association.
Right now, there’s only five cancers — breast, colorectal, lung, prostate, and cervical — that have recommended screening methods. And that’s the beauty of this crack-the-sky moment. According to the American Cancer Society, cancers that lack screening methods are expected to account for about half of new cancer diagnoses this year.
“From the consumer perspective, these tests are going to be very attractive,” Robert Volk, a decision scientist at the MD Anderson Cancer Center, told JAMA in an interview. “It’s a single blood test. It’s easy to do.”
The question mark is…
Before you call your doctor and schedule an appointment, hold on a minute because there is one question mark hanging over this advancement: Does one of these tests actually help you beat cancer? We don't know for sure yet if finding cancer earlier translates to better outcomes.
Early detection is essential to defeating cancer and if a doctor can catch a tumor when it’s small and hasn’t started to spread, then they can use gentler treatments that are often more effective. This means a better chance of beating cancer, feeling great, and avoiding those nasty side effects like losing your hair.
The uncertainties – like the FDA and getting things perfect
Nor are the tests developed enough to be fully marketed. JAMA reported that we need to wait until the test has been approved or cleared by the U.S. Food and Drug Administration (FDA) and the FDA has been known to move cautiously with laboratory-developed tests (LDTs).
MCD tests aren't perfect, either. Sometimes false positives come into play and a test will say there's cancer when there isn't. Then, that leads to more stress, more tests, and even biopsies. However, they might miss an existing cancer – a false negative – and that would be a bummer, too, because you might walk away with a false sense of security and delay treatment you might need.
Another worry is that these tests might find slow-growing cancers that wouldn't cause any problems in your lifetime. Treating these could mean unnecessary surgery, radiation, or chemo!
Plus, insurance usually doesn't cover MCD tests, so they can be expensive. Like $900 according to the National Cancer Institute. Another question mark the Institute throws out is that there is little known about whether the cost of a diagnostic workup for a positive MCD result would be covered by insurance.
The short answer for those who can pay for it is if it will pay for itself. The smart money suggests chatting with your doctor to weigh the pros and cons, based on your own health history and cancer risk.
Only that way can you get some objectivity about whether an MCD test is right for you and, if so, which one might be best. They’re probably the best person to talk first-hand about all that’s involved emotionally and financially if you decide to go forward with this type of screening.
“It’s safe to assume that primary care clinicians are not ready to have those kinds of conversations,” Volk said. And as for patients who are curious about taking an MCD test, “We just don’t know at this time if this is a good idea or not.”