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Old 06-25-2015, 05:58 PM
gdpawel gdpawel is offline
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Default Blood Test To Detect Pancreatic Cancer in Early Stages?

Blood Test May Detect Deadliest Form of Cancer Early

NBC Cancer News

With just a drop of blood doctors may one day be able to detect pancreatic cancer in its early stages, before it has become deadly, a new study suggests.

An international team of researchers was able to identify 100 percent of patients with late-stage pancreatic cancer, as well as those with earlier stage disease, by looking for a protein in the blood that is made in abundance by tumor cells.

That protein turns up in tiny virus-sized particles, called exosomes, which are excreted by all of the body's cells, according to the study published in Nature. But, by good fortune, the protein turns up in exosomes only when there is cancer, so its presence could be an early, and testable, marker for the disease.

It's rare to discover pancreatic cancer early, said study coauthor Dr. Raghu Kalluri, professor and chairman of the department of cancer biology at the MD Anderson Cancer Center. "People don't feel any symptoms that make them want to go to the clinic until their cancer is stage 3 or stage 4," he added. "Using this test we were 100 percent accurate at identifying all cancer patients."

In 2015 48,960 Americans will be diagnosed with pancreatic cancer, according to estimates by the National Cancer Institute. And an estimated 40,560 will die from the disease. It is the most deadly cancer with just 7.2 percent surviving five years.

For perspective, over the course of a lifetime, 1.5 percent of Americans will develop pancreatic cancer.

While quite promising, the new findings will need to be verified and validated by other studies, experts told NBC News. And even if it passes muster, it will take some time before a test could be developed to screen for the disease.

Kalluri and his colleagues examined serum samples from 190 patients with pancreatic cancer, 32 patients with breast cancer and 100 healthy volunteers. They found levels of the protein in exosomes correlated with the severity of the disease so there was more in patients with more advanced disease. It was not present in the healthy volunteers.

Even more promising are the findings from the seven patients with early pancreatic cancer that were detectable through their protein levels. Further, levels dropped when patients had surgery to remove their tumors, so the marker could also be used to follow the progression of the disease, Kalluri said.

Kalluri says that a screening test might be available in as little as a year. But, he said, "this is just a speculation based on the current strength of the study."

Had such a test been available, it might have save the life of Dr. Teresa Flippo-Morton, a prominent breast surgeon from Charlotte, N.C.

"She was an expert in oncology," said Dr. Derek Raghavan, a colleague and president of the Levine Cancer Institute where Flippo-Morton worked. "She did all the things you are supposed to do. She wasn't a smoker. She lived a healthy lifestyle. She had a good work-life balance. She exercised. She took vacations. It is a good example of how this disease sneaks up on people and gives no warning."

A test for pancreatic cancer could save lives, perhaps even Flippo-Morton's, Raghavan said.

"If this study is confirmed, this will make a difference because it's one of the cancers we don't have any reliable screening test for," he added. "It kills people and it kills them quickly."

A screening test could have a huge effect, said Dr. Timothy Donahue, an associate professor of surgery and molecular and medical pharmacology and chief of pancreas and gastrointestinal surgery at the University of California, Los Angeles.

"Pancreatic cancer is the fourth leading cause of cancer death in this country and it's predicted, if the current prevalence and survival rate continues, that it will become number two within the next five to 10 years," Donahue said. "Something like this could potentially flatten that curve and change the epidemiology of pancreatic cancer."

Still, Donahue said, the method needs to be "heavily vetted and validated. But it's as good of an academic start as I've ever seen. It now needs to be taken over by some diagnostic corporation before it can launch into something for widespread use."

What needs to be determined is "what the sensitivity and specificity would be in a screening population of 100,000 people," said Dr. Brian Wolpin, of the Dana Farber Cancer Institute. "In this study the patients were known to have cancer or not to have cancer. In this kind of sample sensitivity and specificity tend to look good."

Gregory D. Pawelski
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Old 06-25-2015, 06:03 PM
gdpawel gdpawel is offline
Join Date: Feb 2007
Location: Pennsylvania
Posts: 4,354
Default Calcified Exosomes

Exosomes are membrane-bound vesicles of endosomal origin, present in a wide range of biological fluids, including blood and urine. Exosomes can act as extracellular vehicles by which cells communicate, through the delivery of their functional cargo to recipient cells, with many important biological, physiological and pathological implications.

As molecules of inflammation enter a cell membrane, they trigger formation of endosomes. An endosome is a tiny transport vesicle, like a self-contained shipping department that springs into existence, sorts out the various molecules, and then either transports them into the interior of the cell or ushers them back out onto the street, depending upon whether or not the molecules are deemed useful to the cell. If the endothelial cell is dying, the endosomes become highly calcified and are expelled from the cell. An endosome that is expelled from a cell changes its name and is called an exosome. Calcified exosomes and pieces of exosomes cluster around dying endothelial cells like bunches of vine fruit. The presence of these highly-calcified exosomes and pieces of exosomes provoke a response in which the usual cast of inflammatory immune cells - monocytes, lymphocytes, neutrophils, etc. - attack what they perceive to be unwanted debris. In the course of the clean-up a substance called tumor necrosis factor (TNF) is secreted into the surrounding area by some of the inflammatory cells. TNF is an inflammatory mediator. Its presence is consistent with and vital to both Massively Calcified Endosomal Death (MCED) and the type of inflammation that causes vessels to narrow. MCED occurs only in endothelial cells and not in any other form of nucleated normal or cancer cells.

We know that elevated C-Reactive protein confers an increased risk of heart attack and stroke. CRP is, however, a non-specific inflammatory marker. Many people have elevated CRP owing to the concurrent presence of some inflammatory process -- an autoimmune disorder, autoinflammatory disorder, infection, cancer, etc. So elevated CRP is a reliable indicator of the presence of atherosclerosis only in the absence of some other cause.

But a great many people totally misunderstand. They think that "inflammation" -- general inflammation -- causes heart disease. In general, non-specific inflammation does not cause atherosclerosis, heart disease, and stroke. The cause is a SPECIFIC inflammation, directed directly against the blood vessel lining, itself. And the root cause of this inflammation are calcified microparticles (endosomes and exosomes), comprised of massively calcified cell membrane invaginations (endosomes), which are intensely antigenic, provoking intense inflammation, and serving as the root cause of the entire atherosclerotic process.

An illustrated executive summary to explain what MCED is all about

Gregory D. Pawelski
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