I have been given an option to take the Signatera residual disease test. I have heard mixed opinions that it is not a good source for pancreatic cancer specifically. Has anyone else been given this option and what their doctors have said about it.
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I am that person who prefers to know my status on an on-going basis. I had the Signatera at my request shortly after I finish chemotherapy and it was comforting to know that I was ctDNA negative. I was also negative 6 months later. That gave a good baseline. My third, most recent test, turned positive, so I know that I am probably having a recurrence. From everything I've read, I think it is at least as good and maybe better than CA 19-9 but not recognized yet officially as an important test. Personally, I think it is quite important. It is being used in many, many clinical trials now as an outcome measure. That is my opinion.
This was offered to me yesterday and I said yes! I asked why would anyone not do it since it could foretell something in its infancy stage and allow closer surveillance or even starting chemo to fight it.
My doctor said for some, ignorance is bliss but also it’s about being able to manage the anxiety it could create. It is not proof positive, but CA19-9 is not either. I agree with Beth’s; I want to know all I can as soon as I can so I have the potential to do something about it.
I have been having my ctDNA measured since 2014 when I entered a clinical trial and had the additional opportunity to provide samples for a study to monitor for minimal residual disease. The clinical trial was successful and I continue to have ctDNA measurements done on a quarterly basis. ctDNA has been around for some time having been introduced for monitoring minimal residual disease in lymphomas and leukemias. It is now moving in to solid tumor monitoring after technical hurdles were overcome and is being adopted by GI oncologists for monitoring colon cancer. It is being evaluated for pancreatic tumors and there is a working group at ASCO (American Society of Clinical Oncologists) evaluating studies addressing false positive and negative results. It is a matter of time when ctDNA for pancreatic cancer surveillance will become accepted and a standard for more sensitive monitoring. In the meantime, I m pleased that I am able to take advantage of this additional surveillance technology that is significantly more sensitive than current imaging techniques.
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I so appreciate your feedback and praying next steps are mild for you.
May I ask if you have ever had any type of surgery associated with your cancer?
I totally agree with you. I’d like to know and fight it head on. The sooner we know the sooner next steps can be administered.
Yes, I had the Whipple in May 2021 about 5 weeks after my diagnosis. All of my chemotherapy was after the surgery when I did Folfirinox. for 12 sessions, 6 months, starting in August 2002 and ending in January 2003. I have been NED for 10 months and minimal residual disease for the past 2 months.
2022 and 2023, not 2002
I was just scheduled for surgery 4/14 for a distal pancreatectomy. They began and found another small spot under the pancreas attached to the wall of abdomen. They took a biopsy immediately and it was found to be cancerous so they aborted the operation. Now we are on to plan B. Will take Signatera , CA 19, and CT scan in mid May to see next steps.
@teriabruzzo8 , there is a little more discussion (including my experience with Signatera) in the thread titled "What exactly is NED (no evidence of disease)" of this forum.
It's far from perfect with regard to pancreatic cancer, but a valuable component of a multi-pronged monitoring strategy. My experience (disclaimer: Sample of ONE!) is that CA19-9 was the most significant, most affordable, and most easily tested early sign of my PC recurrence.
@teriabruzzo8 here is the link to the discussion that @markymarkfl refers to.
– What exactly is NED (no evidence of disease https://connect.mayoclinic.org/discussion/what-exactly-in-ned-no-evidence-of-disease/
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