When the blood test is positive, hunt for the lesion with sensitive imaging
A positive blood test tells you cancer is back but not where. Combining whole-body MRI with modern PET tracers may find a single spot that can be zapped.
Patients who are ctDNA-positive but scan-negative are currently given systemic therapy or nothing. Whole-body MRI plus a lineage-appropriate PET tracer (PSMA, somatostatin receptor, FAP or fibroblast-directed imaging) detects lesions well below conventional CT thresholds, which would allow ablative treatment of true oligorecurrence and spare the rest systemic therapy.
- Dormant cells and minimal residual disease · After a 'successful' treatment, cells can sleep for years then relapse. We can barely detect them and cannot target them.
- Metastasis is understood least and studied last · Metastasis causes about nine in ten cancer deaths but gets a small fraction of research money and almost no trials of its own.
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not linked directly; found by shared links- IdeaA test to tell true oligometastatic disease from hidden widespread spread
Shares PSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancer, Oligometastatic disease, Metastasis is understood least and studied last, SBRT / SABR (stereotactic radiotherapy).
- IdeaKeep dormant cells asleep instead of trying to kill them
Shares Metastasis is understood least and studied last, Dormant cells and minimal residual disease, MRD / molecular residual disease testing, Prostate cancer.
- IdeaA regulatory endpoint for drugs that block spread, not tumours
Shares Oligometastatic disease, Metastasis is understood least and studied last, Prostate cancer, HR-positive / HER2-negative breast cancer.
- IdeaBlunt the inflammation that wakes sleeping cancer cells
Shares Metastasis is understood least and studied last, Dormant cells and minimal residual disease, MRD / molecular residual disease testing, HR-positive / HER2-negative breast cancer.
- IdeaStrip the platelet coat off travelling tumour cells in ctDNA-positive patients
Shares Metastasis is understood least and studied last, Dormant cells and minimal residual disease, MRD / molecular residual disease testing, HR-positive / HER2-negative breast cancer.
- IdeaFlush dormant cells out of bone marrow, then kill them
Shares Metastasis is understood least and studied last, Dormant cells and minimal residual disease, MRD / molecular residual disease testing, HR-positive / HER2-negative breast cancer.
- IdeaCheap perioperative beta-blocker plus anti-inflammatory to blunt surgical stress
Shares Metastasis is understood least and studied last, MRD / molecular residual disease testing, HR-positive / HER2-negative breast cancer, Colorectal cancer.
- IdeaBreak the neutrophil DNA nets that catch tumour cells after surgery
Shares Metastasis is understood least and studied last, Dormant cells and minimal residual disease, MRD / molecular residual disease testing, Colorectal cancer.