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Signatera positive - while still undergoing chemo?!?
November 2021, I had surgery for appendix cancer and my surgeon has been actively surveilling with blood tests and scans. Cancer markers were up in October and colonoscopy was done. I had had a colonoscopy about 20 months earlier.
Stage III-C adenocarcinoma of descending left colon was discovered. I had surgery and 13 inches of colon removed in February 24. Began Folfox chemo in April with 12 cycles prescribed.
CEA was 3.2 since test in May. Signatera in May was negative. Second Signatera test in August was positive- 2.59
I have had 3 rounds of chemo postponed because of low platelets and neutropenia, including this week's which would have been round 10.
My oncologist does not know where the circulating cancer DNA cells maybe trying to get a foothold.
My CT scans in July showed large thyroid nodes. I had a fine needle biopsy of the thyroid last week. Not enough cells were harvested to give a definitive answer and the slides have been sent for further analysis.
I also have had long COVID since 2022, chronic fatigue syndrome and fibromyalgia (diagnosed in 2015). Extreme fatigue. Anxiety and dread are also exhausting.
Any insights would be greatly appreciated!
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@lianat, I wanted to check in to see how you are doing. Have you been able to resume chemo now? Any updates?
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1 ReactionUnfortunately a positive Signatera indicates metastatic residual cancer, somewhere. By the way The test is identifying DNA from tumor cells somewhere but not cancer cells themselves, In other words cancer cells are not circulating in your blood. Is your doctor ordering a CT and MRI to try to find the location? In the meantime chemo is probably the best course. Data shows that Signatera can detect cancer up to 8 months before it can be seen on a CT or MRI. So if you can get back on chemo you may be able to head this off.
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3 ReactionsI wanted to add....Natera offers free consultation to discuss your Signatera results, call 650446-4657 to schedule
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4 ReactionsI thought Signatera does detect your tumor’s dna in the bloodstream🤔
I resumed chemo round 10 last week. One new side effect was a day of low level pain in the area of liver and gallbladder which has subsided now.
I've had some recurring aching on my left abdomen where the colon was resected and on the right side in the area of the pull-through incision. I had a scan in June which did not address this and have asked another radiologist to review it.
I am scheduled for another Signatera of blood draw on October 21st and am in a clinical trial with researchers at KU cancer center to find an even more sensitive test than Signatera, and that blood will be drawn at the same time.
I'm also scheduling a scan and wondering which type is more likely to produce good information about where the cancer may be hiding?
My question about the Signatera is that I have had two types of cancer - appendix (November 2021) and adenocarcinoma of the left descending colon (November 2023), and tissue from only one was sent to Signatera. But I don't know which... or does it matter?
I am in dread of HIPEC surgery ... but more so of recurring cancers.
I appreciate your checking with me and informative feedback.
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1 ReactionDefinitely think you should take advantage of the consult with Natera and review your situation with them as well as your oncologist. Especially since you had 2 different neoplasms. The Signatera "tumor informed" test utilizes up to 16 different clonal mutations from the tumor tissue that was submitted I understand that tumors can have a thousand different mutations but they have the ability to choose the top 16 for which to screen. But to your point they are only going to make decision on which mutations to search based on the tissue that was sent in. Then of course, a new neoplasm with different mutations could also arise which Signatera would not detect. Guardant Reveal does not require tumor from your cancer and maybe a better test for you I suggest you ask your oncologist about this assay
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1 ReactionWe should connect , I also had Appendiceal cancer, followed by a HIPEC. 2 year later my Signatera showed a value.
What was the outcome for you?
@lianat, I'm tagging @monty1234 to make sure they saw your question about outcomes.
Lianat, how are you doing?
Please try Rábano juice with Ginseng to tackle a bit fatigue. Ask before your medical advisor.