Liquid and Tissue Biopsies (DNA) Genetic/Genomic Tests
Liquid Biopsy: A test to examine the DNA using only two vials of blood. View a video link for a good visual explanation on how and why liquid biopsies are critical for diagnosis, please Click here.
Tissue Biopsy: A test to examine DNA of the cancer tissue.
The “standard treatment” is to only do a Tissue Biopsy to check if the tissue is cancerous or not, with no genetic/genomic analysis done. For stages 3 and 4 you must add the “Precision Medicine” tests of both Liquid and Tissue biopsies looking at your DNA! Liquid Biopsy (blood) is always available for analysis. Actual tissue biopsy can be transferred to testing facilities for DNA testing. These 2 tests are optional for stages 1 and 2, but you still can request them (genetic/genomic tests) so you to feel more confident about your early cancer diagnosis. These tests go beyond what a doctor and normal tests can see. These tests are the definition of “personalized”. Your doctor can easily order these tests for you at any testing site. These tests are relatively expensive, but the companies listed below either covers the full costs with your insurance, or you could pay a small percentage of the fee typically $100 or less.
Here are some of the Companies doing these today, but not all:
They are a great company to work with. This DNA information is critical to move forward with your treatment. Guardant Health is capable of identifying roughly 73 different DNA mutations such as like EGFR, BRCA1, BRCA2, etc. Then it will recommend every approved treatment option for your specific case. Video link from Guardant if you misses it above Click here.
Another great company known for this type of genetic/genomic testing using both Liquid and Tissue biopsies. Many times people get confused on “Genetic” and “Genomic” testing. Here is the difference (from Foundation One site) – Genetic testing detects hereditary (inherited from parents) alterations in DNA which accounts for about 5 to 10 percent of all cancers, while Genomic testing detects acquired (over the course of a lifetime) alterations in DNA. Acquired alterations (Genomic) are responsible for the majority of cancers and may impact tumor growth, spread, and response to therapy. You, or your doctor, can order a test on-line, Click here to visit on-line request. They also have a great Assistance Program to help cover costs, if necessary.
A Data-Driven precision medicine company for both Liquid and Tissue biopsies. From their site: Tempus is a technology company that is making precision medicine a reality by gathering and analyzing clinical and molecular data at scale. Through the power of artificial intelligence, we believe all patients will eventually be on their own personalized therapeutic path, enabling longer and healthier lives. More information for patients Click Here .
DNA (genetic/genomic) testing is also done at some intuitions also. For example, MSK, Dana-Farber and others. You have many choices on where you can get this done.
Updated! (5-21-2021) More articles discussing Genetic and Genomic Analysis, and Liquid and Tissue Analysis
- NIH (National Institute of Health) more detail on Genetic and Genomic terminology
- Dana-Farber (Genetics and Prevention Clinic)
- MSK Article on Liquid Biopsy
- MSK-IMPACT Another genetic/genomic test looks for mutations in 468 genes. From the MSK site: MSK-IMPACT is much more inclusive and can be used on any solid tumor regardless of its origin, potentially offering better treatment options for thousands of patients in the form of precision oncology. However the test is currently available for MSK patients only.
There are times when you can have cancer with no identified mutations. However, you should still do the liquid and tissue biopsy tests to know whether you have a specific mutation. The list of identified mutations is growing as we speak. Get help reading the output report. There may be no approved FDA options at this time, but they also list clinical trials that are using soon to be approved treatment options. In one case, the soon-to-be-approved immunotherapy drug in a clinical trial was used in saving the life of a cancer patient I was helping.
In my specific case, I had the EGFR mutation and was given an oral medication specifically designed to stop the cancer growth. It worked, and I am gratefully here 16+ years later. These new precision medicine techniques are the way of the future enabling longer and healthier lives.
Had I not known about my specific DNA mutation, the standard chemo and radiation treatments would not have saved my life alone and I would not be here today. This is not a cure but something that can extend your life until someday we can possibly find even better treatment options for your cancer. There are many treatment advances on the horizon and/or in clinical trials that will definitely extend lives and hopefully either contain the cancer, or eliminate the cancer completely. You want to hang around as long as possible for these options to present themselves to you and enjoy life along the way!