Abstract

Background: Circulating-Tumour-Cells (CTC) provide a blood biomarker for early carcinogenesis, cancer progression and treatment effectiveness. An increase in CTCs is associated with cancer progression, a CTC decrease with cancer containment or remission. Several technologies have been developed to identify CTC, including the validated Isolation-by-Size-of-Epithelial-Tumour (ISET, Rarecells) technology, combining blood filtration and microscopy using standard histo-pathological criteria.
Methods: This study compared CTC count to cancer status and cancer risk, by monitoring treatment effectiveness in cancer patients and by screening for CTC in asymptomatic patients with risk factors, including family history of cancer.
Results: Between Sept-2014 and Dec-2016 we undertook 600 CTC tests (542 patients), including 50% screening requests of patients without cancer diagnosis but with risk factors. CTC were detected in all cancer patients (n=277, 100%), and in half of the asymptomatic patients screened (50%, 132 out of 265 patients). Follow-up tests including scans were scheduled within 1-6 months of CTC tests. In up to 50% of male patients with normal PSA (prostatespecific- antigen) levels but detected CTC, PET scans using PSMA (Ga-68-prostate-specific-membrane-antigens) revealed increased uptake in the prostate, indicative of early prostate cancer. Other types of cancer, including early breast, ovarian, lung, or renal cancer were detected in a small number of asymptomatic men or women with a positive CTC count.
A subgroup of patients with detected CTC underwent interventions, including nutritional therapy with immunestimulating and anti-carcinogenic nutrients. CTC repeat tests were available in 10% of patients with detected CTC (40 out of 409 patients, n=98 CTC tests) to assess treatment effectiveness.
Conclusion: CTC screening provided a highly sensitive biomarker for the early detection of cancer, with higher CTC counts being associated with higher risk of malignancy. CTC monitoring over time indicated treatment effectiveness. Nutrients with anti-carcinogenic properties could reduce CTC count, and included curcumin, garlic, green tea, grape seed, modified-citrus-pectin, and medicinal mushroom-extract.

Keywords: Circulating tumour cells (CTC); Cancer screening; Early detection; Treatment effectiveness; Prostate cancer; Breast cancer; Integrative nutritional therapy