Advanced Cancer Screening

As a Family Medicine Physician, one of the biggest parts of my daily work is performing annual physical examinations and advising on routine cancer screening. This is customized to each patient, and recommendations are based on age, sex, and lifestyle history. For example, everyone over the age of 45 is advised to begin routine colon cancer screening. But the actual test used to screen that particular patient is based on their personal and family history. If they have a family history of colon cancer, we advise a colonoscopy. The same is true if they have a history of another type of cancer, such as melanoma. But if the patient has no personal or family history of colon cancer or other related cancer, then they can choose to have a stool test for their screening.

Going through the list of options and personalizing the recommendations is complex and quite a heavy mental load. Most patients think that the most bang for their buck is the head-to-toe examination they receive as part of their physical, but truthfully the biggest part is the mental gymnastics performed in your doctor's head, figuring out how to best guide you through the myriad of screening tests and options. This is the main reason why your family doctor won't allow you to discuss other problems while you are there, the importance of the physical is paramount and other problems, such as your elbow pain, can be addressed at a separate visit. Your doctor's attention needs to be focused to get your personalized recommendations right. And then of course, the recommendations are continually changing and adding nuance so we repeat this process over and over annually.

Even with all this attention placed on getting your screening and preventive care right, there are several cancers that we don't have screening tests for. Or the screening test won't pick up the abnormality until it has progesed enough to be detected. For this reason it is a good option to consider advanced cancer screening if a person has a strong family history of cancers. This is where we get out of insurance-based care and into the realm of cash-based personalized medicine. Currently we offer advanced cancer screening using whole body MRI and liquid biopsy technology. This blog post focuses on the liquid biopsy.

At MAAM, we use the TruDiagnostic EPISEEK test, which is comparable to the more publicized Galleri test, but is more accurate. You can see the table from the TruDiagnostic website above showing the higher sensitivity and specificity (accuracy) than other options on the market. I personally took this test a couple weeks ago to follow up on nodules that were seen on my whole body MRI- separate post about that experience- and was so pleasantly surprised to get my results in about a week.

Let me tell you the story. I had my whole body MRI done and it found nodules on my thyroid. I have a family history of thyroid cancer, which is the reason I did the MRI in the first place. But my regular lab test, the TSH, was normal. Not very helpful. Now I can read the MRI images myself and I knew based on looking at them that they were a very low likelihood of being cancer. But I paired the MRI with the EPISEEK just to be sure. The kit was ordered online and shipped to my home. I set up a mobile phlebotomist to come to me and draw my blood for the test, and she packaged it all up and returned the kit to UPS for overnight shipping. Then a few days later I received a notice that my report was ready. I ran to log in and check my results and the most reassuring sentence anyone can read was there:

no cancer signal detected. An immediate rush of relief came over me, and that's with my medical experience and knowledge, and my own reading of the MRI. So I can't imagine the amount of reassurance this type of test would bring to a non-medical person looking to be as healthy as possible.

What tests does this screen for? The image below gives a description:

You can certainly check out the website for yourself to dig through all the information, here's the link: https://trudiagnostic.com. With the speed of technology, new cancers will be added as time goes on. This is ADD-ON cancer screening and does not replace your regular cancer screening done at your routine physical. This is an added layer of screening and detection, so you can feel comfortable that you've looked as closely as you can to find anything that may be brewing before it's gone on too long.

If your regular doctor doesn't have access to this advanced screening and you are interested, we are accepting new patients for this specific protocol. We will not try to replace your regular physician, but can add on this service for an additional layer of screening and personalized preventive care. You can call our office to schedule a consultation for advanced cancer screening at 916-817-4132, California residents only.