Signatera results: Does the increase mean cancer is back?

Posted by varg4258 @varg4258, Nov 13, 2023

Signatera Test was done after rectal cancer surgery. May & July test 0.00 MTM/ML and Nov 2023 test 0.05 MTM/ML(positive below Analytical Range).

Does the November Positive 0.05 result mean my cancer is coming back? CT scan for chest/abdomen/pelvis scheduled for end of November this year. Please share your thoughts.

Interested in more discussions like this? Go to the Colorectal Cancer Support Group.

Profile picture for cjay @cjay

No, I get them every 4 weeks

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I noticed in your post you mentioned you hope the circulating DNA is residual not new occurrence. I was wondering what that means? I have been so scared since my natera came back 1.5 from 0. My surgery was Dec 2021 so right at 3 year mark I got positive test. I had a lung scan which radiologist said nodule doc has been following is stable, I was releaved, till my lung doctor called me yesterday said he viewed my scans & wants me to come in right away instead of my schedule appointment February 27th. So now I’m really scared the radiologist missed something my doctor sees. Why would he not tell me on phone & want me in right away if nothing wrong? Being in breast is easier to take out lungs are totally different. I pray I don’t have anything in my lungs. My diagnosis in October 2021 was invasive mammary carcinoma with lobular features. I had 2 tumors & 7 lymph nodes removed

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Profile picture for cjay @cjay

My 4th Signatera test results just came back, and for the first time since my resection surgery it’s a positive result of 1.02
I have my first CT scan (since my treatment ended) next week.
Trying to stay calm and positive until the scan results come back, but of course that’s difficult.
Does anyone have any experience similar? And what happened after that positive test?
🤞🙏

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Realistically, any positive result is indicative of cancer recurrence or progression, surpassing traditional methods, and informing treatment decisions through the analysis of circulating tumor DNA (ctDNA). Although ctDNA is generally used to detect residual or remaining cancer following surgery or treatment, It is also capable of detecting new arising cancer. Any positive result should prompt you to seek more intense surveillance and possibly treatment because CTDNA tests can detect cancers 6 to 8 months before it can be seen on a CT or MRI. Although not widely advertised, The CTDNA test from Natera used for breast cancer detects new cancers in only 50% of cases. So if you have a positive result You should consider that it reflects new or residual cancer even after 2 years. Ask your doctor about newly available tests from Natera competitor Exact Sciences, since technology is very rapidly increasing and testing is continuing to improve almost month by month.

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Profile picture for cjay @cjay

My 4th Signatera test results just came back, and for the first time since my resection surgery it’s a positive result of 1.02
I have my first CT scan (since my treatment ended) next week.
Trying to stay calm and positive until the scan results come back, but of course that’s difficult.
Does anyone have any experience similar? And what happened after that positive test?
🤞🙏

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I believe this was mentioned in similar posts recently, but remember that Signatera is able to detect cancer 6 to 8 months before it is capable of being seen on a CT or MRI. So you could have a positive result and a negative scan.... But at least you're oncologist will focus on surveillance and be looking intently for a tumor. And then treatment can begin at a stage when the tumor is much more treatable than an advanced stage. So try to look at a initial positive ctDNA result as a plus In the overall perspective.

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Profile picture for reidroberts @reidroberts

After chemo, radiation and surgery, I think I had 6 months of Signatera tests that were zero showing no signs of cancer. Then the signatera tests became positive .03, .06, 1.1, 4.2 and up. Scans did not detect any cancer until the 4.2 reading. By the time we did the cryoablation, the Signatera result went to a 15. After the cryoablation I was put back on FOLFOX for 6 rounds. By the 3rd round my Signatera was back to zero. After these 6 rounds they dropped the chemo that causes neuropathy but continued with the other 2 chemo chemicals for another 12 rounds. I have done 4 of these with 8 more to go. The hope is that any residual cells that may try to pop up over a longer term will be killed off with these additional treatments and not become a problem and gone forever. I am on a 2 week Chemo schedule. I don't feel too good after treatments for 4 to 5 days and then start feeling better over that second week. Workwise I do what I can to help out but I am not as directly involved in day to day operations anymore. I have quite a bit of nausea and fatigue for the first week after chemo treatments. Constantly taking the nausea medication helps quite a bit. Hang in there and keep reaching out to people for all the info you can get.

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I got my first +Signatera test this morning. Had a resection last January and 4 rounds of CAPOX into June. My team has sped up my screenings to keep an eye on things. I only just joined the forum, and it’s inspiring to hear all your stories of fighting and staying positive! After two 0’s my test came back today at .13…I’ll continue reaching out and keep you all informed! Good vibes, prayers and thoughts go out to you all!

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Profile picture for cjay @cjay

My 4th Signatera test results just came back, and for the first time since my resection surgery it’s a positive result of 1.02
I have my first CT scan (since my treatment ended) next week.
Trying to stay calm and positive until the scan results come back, but of course that’s difficult.
Does anyone have any experience similar? And what happened after that positive test?
🤞🙏

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Are you seeking an MRI of lung and abdomen? S+ recurrence (SR) occurred at median > 8 months (mo) prior to radiographic disease, So don't be surprised if an MRI or CT does not pick up the tumor. Suggest you try to find an ecologist who has experienced dealing with S+ cases. Let us know!

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Profile picture for roywalton @roywalton

Are you seeking an MRI of lung and abdomen? S+ recurrence (SR) occurred at median > 8 months (mo) prior to radiographic disease, So don't be surprised if an MRI or CT does not pick up the tumor. Suggest you try to find an ecologist who has experienced dealing with S+ cases. Let us know!

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Hi - I just wanted to add this reference to a recent study which shows a correlation between positive signature and recurrence which you may want to share with your doctor
https://ascopubs.org/doi/10.1200/JCO.2025.43.4_suppl.15

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Profile picture for cjay @cjay

My 4th Signatera test results just came back, and for the first time since my resection surgery it’s a positive result of 1.02
I have my first CT scan (since my treatment ended) next week.
Trying to stay calm and positive until the scan results come back, but of course that’s difficult.
Does anyone have any experience similar? And what happened after that positive test?
🤞🙏

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@cjay, @reidroberts Thank you both for your post on your Signatera test results. My prayers are with you both, in your journey. I found your post today as I am 7 months out from surgery for Endometrial Adenocarcinoma Stage IIIC. I did not opt for Chemo after surgery as my immune system was quite low at the time and I needed time to seek help on getting that back on track. I did not want it knocked down any further with Chemo at that point, and they were telling me that they had gotten all of the Cancer during my radical hysterectomy.

My 1st Signatera test came back at 0.00 negative for any CT cells. I was ecstatic to say the least. My CT Scan came back with NED which made me even more encouraged. Meanwhile I have been working with a Naturopath / Nutritionist, and this has helped my immune system tremendously. Unfortunately, my 2nd Signatera test came back with a slight bump up to .07. I wasn't concerned about that because I had read residual cells that were dying off could also cause a reading this low. My 3rd test just came back at .14, another slight bump up, but still positive. My oncologist also did a CA 125 cancer marker test which came back in the low normal range (normal being 0 - 35) and mine was 5.5. I will have another CT Scan in July.

I realize these numbers are very low but I can't find anything on the Signatera Site about when to be concerned. At one point I thought I saw online anything over a 2.0 but now I can't find it. Your conversations concerning your results are very helpful. Could you please tell me how to go about getting a consult with a Signatera Genetic Counselor? I don't think I need it now, but if mine jumps like Reid's did I would like to be able to contact them. I don't seem to be able to find that on the Natera site either.

I appreciate all of the information you have shared and you are both in my prayers.
God Bless,
Kathy

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Profile picture for reidroberts @reidroberts

Yes I have lots of Signatera info. After my resection my signatera test went from zeros to .03, .06, 1.1, 4.2. My cancer spots did not show up until this time with a 1/4 inch spot on my lung and a 1/2 spot on my liver. I did cryoablation to remove the spots. This procedure is a lot less invasive than radiation or surgery. My signatera went to 15 and we found a couple more spots that were also cryoablated. After this they put me back on chemo and my signatera is back to zero. After 8 treatments, they want me to continue 8 more to hopefully knock out any residual cancer cells that may have been left behind. The unknown is just scary with cancer. Knowing that cancer is coming back with the signatera tests is quite stressful. However, the signatera tests have been very helpful finding cancer spots very early to eliminate and keep from spreading elsewhere. Feel free to message me if you would like more detail or have more questions. It sounds like our cancers are similar but I have a year or so more experience dealing with this stuff. Stay positive! Reid

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Reid: did they do biopsies on those spots or just did
Cryoablations ?

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Profile picture for kkathysan @kkathysan

@cjay, @reidroberts Thank you both for your post on your Signatera test results. My prayers are with you both, in your journey. I found your post today as I am 7 months out from surgery for Endometrial Adenocarcinoma Stage IIIC. I did not opt for Chemo after surgery as my immune system was quite low at the time and I needed time to seek help on getting that back on track. I did not want it knocked down any further with Chemo at that point, and they were telling me that they had gotten all of the Cancer during my radical hysterectomy.

My 1st Signatera test came back at 0.00 negative for any CT cells. I was ecstatic to say the least. My CT Scan came back with NED which made me even more encouraged. Meanwhile I have been working with a Naturopath / Nutritionist, and this has helped my immune system tremendously. Unfortunately, my 2nd Signatera test came back with a slight bump up to .07. I wasn't concerned about that because I had read residual cells that were dying off could also cause a reading this low. My 3rd test just came back at .14, another slight bump up, but still positive. My oncologist also did a CA 125 cancer marker test which came back in the low normal range (normal being 0 - 35) and mine was 5.5. I will have another CT Scan in July.

I realize these numbers are very low but I can't find anything on the Signatera Site about when to be concerned. At one point I thought I saw online anything over a 2.0 but now I can't find it. Your conversations concerning your results are very helpful. Could you please tell me how to go about getting a consult with a Signatera Genetic Counselor? I don't think I need it now, but if mine jumps like Reid's did I would like to be able to contact them. I don't seem to be able to find that on the Natera site either.

I appreciate all of the information you have shared and you are both in my prayers.
God Bless,
Kathy

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@kkathysan - were you able to contact Natera and speak to a genetic counselor?

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Profile picture for roywalton @roywalton

@kkathysan - were you able to contact Natera and speak to a genetic counselor?

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@roywalton thank you for the response. No I have not been able to do that yet. I thought I would wait and see if my numbers continue to rise on the next test. My oncologist is taking them every 3 months and they are still under the quantitative analysis level at this point at .14. I was just researching and trying to figure out the process so I could contact them for a consult, should they continue to rise. Thank you in advance for any help in that area.

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