What experience has anyone had with the Signatera blood test?

There is no 100% certainly in ctdna. Did a biopsy determine the kidney mass is identical to the early biopsy or a new UTUC or diversified clone of the early biopsy? Did you have mutilocal CIS? Did you have positive ureters if you had RC? Recurrence in lower track is not the objective for ctdna. Imaging cytology and urethra washing is. Recurrence in RC patients is from 0.75% to 6.4%.

Early tissue ctdna panels also have less likely the drivers included such as tp53, tert, sox4 and such that are more commonly found in clones and therefore more likely detected also at low volumes. But that would require sequencing and comparison of the new renal mass tissue.

At 2 years clear ctdna still has 12% recurrence in consistently negative patients. Hopefully you can resolve this and move on. BCAN Inspire has patients who went through this years ago and are still here. No guarantees of course.

@jaxfl I'm questioning the accuracy of my tests. Natera had trouble with my sampled from my biopsies. They had to revert to an earlier sample. So far, all my results have been 0. But, I was diagnosed with bladder cancer in my kidney 3 weeks after my last signatera test.

Before starting treatment for MIBC my Signatera was 3.9 MTM/ml. After four cycles of Keytruda and Padcev my Signatera was 0.

What progress? I am NED so there is no progress. I have been NED so far since RC. And hopefully, it will remain this way.

Did you get a printed graph of your progress? Usually there is a few lines of interpretation from your oncologist on the same sheet.

Update: I was in the ER in Charleston, SC, this past Sunday. I quasi fainted at CHS. So EMTs took me to the hospital. Turned out to be dehydration, sleep deprivation and low electrolytes. I received oral potassium and recovered. Made the flight just in time and drove back from MCO to Fleming Island, FL.

Today it appears I have low potassium again because I started leaning leftward and almost collapsed. Then I discovered the tiny blisters I noted this past weekend, are in fact a specific eczema: https://www.firstderm.com/dyshidrotic-eczema-dyshidrosis. Great: a different skin IRAE. And 4 months after wrapping up nivo.

Here we go. 2026-06-16 signatera = clear (first since 2025-12). 2026-06-16 CT: breast and axillary node enlargement near port. Biopsy. Then cultures. Biopsy radiologist suspected lymphoma. Finally last Saturday (2026-07-11) WBC cloning came back: negative. Axillary node: benign. Breast mammogram, ultrasound: benign. Quite bizarre experience to grow an A-cup involuntarily. MRI: pelvic nodes mild increase again, identical iliac node as reactive through biopsy in 2025-12. Oncologist unconcerned: follow up in 2026-09 to see.

For someone reason I have new stuff all the time. Twice so far I have had my eyes go wild with silver flakes and weird vision changes. IRAE? If so, probably endocrine glands fried by nivo: thyroid is almost gone. Mayo Oncology told me: see an opthamologist.

Hematology wants me to do another panel DNA test to figure out what life long anemia I have.

In summary: never ending. But I am still here.

Went to AC, NJ last week: fun! Nice weather! Good food! In a prayer I promised that I would visit Santee, SC, if I came out clean. So this weekend I will fly there (through Orlando and Charleston) to have a prayer of gratitude. Why Santee? Well: I went there for work and was inspired by the small faithful community.

@jaxfl, how are you doing?

I had a stomach acid attack but did not know so I called the Mayo MD on call. She told me: local ER immediately. Turns out it was acid so Pepcid fixed it. Then the CT showed kidney stones (tiny) on the left side. The past week three came out. Caught one on camera and zoomed in.

Plus, the Nivo rash is back in full force on my arms and hands and chest. 10 weeks after finishing nivo. My eosoniphils were 4X baseline last month and 3.4X baseline yesterday. So that explains it. Mayo gave me another Rx for a topical steroid tub.

Walking is improving, then going back to difficult and then back to improvement. Very odd.

Had my last adjuvant nivolumab last Friday (2026-03-13). The 13th on the 13th. MD cleared me for a 5 month signatera hiatus and next imaging is 2026-06. So he appears to consider me low risk at this point. Time will tell. Going on vacation today through next Sunday to celebrate.