October 2021 • DALLAS MEDICAL JOURNAL 7
stages – often before patients experience
symptoms. For many cancer types,
including lung, breast, colorectal, and
cervical cancers, advancements in
screening and treatment offer promise
for earlier detection and more positive
outcomes. New, emerging screening
methods could change the way we find
cancer in its earliest stages.
One of the newest screening methods
for lung cancer is the low-dose CT (LDCT)
scan. Studies have shown that using the
LDCT scan in high-risk patients could
save more lives than using chest X-rays.
According to the American Cancer Society,
unlike chest X-rays, LDCT scans can more
accurately find abnormal areas in the lungs
that could be cancer. In fact, after several
years, studies have found that patients
who received LDCT scans annually had a
20% lower chance of lung cancer death
than those who received chest X-rays.
While breast cancer is the seconddeadliest
cancer among American
women, steady declines in mortality
among women in the past 30 years
can partially be attributed to early
detection of the disease. Today, largescale
research is underway for the use
of 3D mammography – also known as
digital breast tomosynthesis (DBT) – to
screen for cancerous tissue or other
abnormalities, and we’re seeing promising
results. The 3D mammography takes thin
“slices” of images of the breast using
an X-ray machine and reconstructs the
image to look for any cancerous tissue or
abnormalities. As more study is completed
and its use widens, we’re hopeful for
the possibilities of 3D mammography in
diagnosing breast cancer early and more
accurately in women and men.
We know that the earlier cancer is
detected through screenings and selfexams,
the better chance of successful
treatment. But what about finding cancer
where there is no available screening
test? Multi-cancer early detection blood
tests are an area where researchers are
making progress. Galleri is one such
test, developed by GRAIL, with Texas
Oncology participating in the research.
It’s a multi-cancer early detection test
that offers detection for more than 50
types of cancers through a simple, single
blood draw. In clinical studies, when the
Galleri test detected cancer, its prediction
of the cancer signal origin was correct
approximately 89% of the time. Multicancer
early detection tests, including the
Galleri test, hold incredible potential in
finding more cancers at earlier stages and,
ultimately, improving survival rates.
However, these advancements mean
nothing if our patients aren’t getting
screened. As physicians, we share in
the responsibility to communicate the
importance of cancer screenings and
make it easy, approachable, and safe for
our patients to take this important step in
protecting their health.
Precision Medicine and the
Future of Clinical Trials
We’re seeing groundbreaking
possibilities for the use of precision
medicine across the healthcare landscape.
For cancer care, precision medicine has
the potential to transform how we organize
and administer clinical trials.
Clinical trials traditionally organized
patients in a central location by similar
cancer type. Precision medicine offers
the ability to decentralize trials into
community-based cancer centers and
group patients with a drug therapy that can
better target the genetic changes in their
tumor identified in genomic testing. We’ve
learned that the same cancer-causing
genetic changes may be found in different
types of cancer. As a result, patients with
unique tumors from one another, but
that share the same genetic change, can
receive the same drug that targets the
change, regardless of the type of cancer.
This allows us to target the cancerous
cells down to a single-patient level and
treat the cancer precisely based on the
genetics of their tumor.
Though some cancer centers, including
Texas Oncology, are already using precision
medicine in this way, it will take time for
smaller, community-based cancer centers
to adapt and leverage this new clinical
trial design. But with more research into
genetic changes that drive cancer cells
to divide and grow, more patients in the
future will be able to receive personalized
cancer treatments based upon the
genetics of their tumor, all within their own
community.
The future of cancer care is bright and
promising. Challenges lie ahead, but we
will never stop learning from our past and
evolving for our future based on what new
research and this disease are teaching
us. With more breakthroughs come more
victories for cancer patients. DMJ