Introduction
It's hard to believe it's that time of year again, but here we are: September. Staring down the barrel of fall, and who knows, maybe even another winter of severe illness and death. With all the crazy shit going on in and leading up to 2025, I get why folks tune out the critical stuff called "life", and just doomscroll the news. It's easy to get sucked into the drama of the next variant, the next rate hike, the next assassination attempt.
I know - it's a lot.
But this year, like all years, will come and go. Whatever happens in the next few months, most of us will surface on the other side. Global wars, 'climate change', another election cycle - it's always something. My question to you is this: Regardless of the world's state of affairs, what will your human body's state be in when you need it the most?
I hate the word cancer. Don't most people? Good luck finding someone who hasn't personally had or knows someone close who hasn't had a close encounter with it. And let’s be honest, most of those stories aren't sunshine and rainbows of victory. I see it both coming and going – at home and at work. It sucks. What sucks the worst is being the Hail Mary pass at the end of a Superbowl, hinging on six points. Knowing I will likely be the desperate last-ditch attempt to win what will surely be a losing game.
Here's a story you've no doubt heard before:
A patient comes in. She was diagnosed with breast cancer two years ago. She did all the treatment – the surgery, the chemo, the radiation. She lost her hair, the feeling in her fingers and toes, half her body weight. She ran the entire marathon; she fought the World Wars. She did all of it. She thought she was in the clear. She was told she had 'no evidence of disease.' She was just starting to feel like a human again. A mother to her young children. A wife to her husband who loves and needs her more than anything. But a few months later, she felt something – something sickeningly familiar. She felt it with her instincts first - days before she felt it with her fingers. It was her cancer. It was back. It was back, and it was back hard. Shrugs and 'I'm sorry, there's nothing else we can do for you' from the conventional folks. What now? This woman is someone's mother, someone's wife, someone's daughter. She's only 60, or 50, or 40, or worse…
We need to find another answer. Can you please help us? Is there anything else you can do?
I treat these phone calls like triage in an Emergency Room. How soon can you get here? This afternoon? First thing tomorrow morning? Of course, we can help. I haven't reviewed a single solitary cancer case and thought, Sorry, I got nothing either. Our fate hangs in the lurch until it's our time to leave this dimension and move to the next. There's always a chance for a miracle – be that complete remission or one more day to spend with the ones we love. But the time wasted between the day cancer starts and the day we first discover its arrival, is tragic.
How long does that time interval actually take? Days? Months? Years? Couldn’t possibly be years – could it?
Breast cancer is everywhere. So much so that every year, we dedicate the month of October to Breast Cancer Awareness. Pink ribbons, thousands of supporters participate in long walks, fundraiser events, honoring survivors, and remembering those lost to the disease. The United States Preventative Services Task Force (USPSTF) recommends screening mammography for breast cancer every year or every other year for women aged 50-74. Suppose you're a woman adhering to these guidelines. The worst that could happen is breast cancer that miraculously starts on your way out of this year's mammography center - which then goes undetected until your next routine breast cancer screening test 1 to 2 years from now. So worst case scenario, according to current USPSTF breast cancer surveillance recommendations, results in a maximum 1 to 2 year lag of undetected cancer. Right?
Wrong.
Cancer must grow to a specific size before conventional screening methods can detect it. When a cancer cell first forms, it begins as a single abnormal cell that divides and produces other cancerous cells over time. A single cancer cell must divide enough times for a mammogram, colonoscopy, or clinical exam to 'see it’. For example, a breast cancer tumor generally needs to reach about 1 centimeter before it is visible on a mammogram or other imaging study. How long does one breast cancer cell take to divide enough times to be detectable on routine mammography?
5 to10 years.
If you know me, you know I have beef with conventional cancer treatment. But a 5 to 10 year lag in cancer detection from start to 'We’re sorry, but you have cancer'? Come on. How much further behind the eight ball could we be? Our patient described above was diagnosed with breast cancer 2 years ago, but her cancer started seven years ago? Maybe twelve?? Think of what could have been done for treatment in that time. Perhaps caught early enough, the day of detectable cancer would never have come. Despite this painful limitation, mammography has been and still is touted in the United States as the gold standard diagnostic tool for early breast cancer detection since the 1960s.
What could be better? What could find cancer sooner? Well, we would need a blood test. A blood test that could measure and analyze something years smaller than a tumor. A test that could measure abnormal genes present in the delivery room of the very first cancer cells - years before, they've replicated enough to be found on physical exams or imaging studies. This testing might sound like science fiction, but it's already here. The 'liquid biopsy' blood test that detects cancer cells YEARS before a mammogram or colonoscopy ever could, is here. This test has been scientifically and clinically validated for over 20 years.
It's RGCC's Onco-D-clare test.
RGCC stands for Research Genetics Cancer Center Group, located in Florina, Greece. Some call this the 'Greek test,' but they do more than just test. They also develop personalized cancer treatments. I'll get into that later. For now, let's talk about conventional cancer screening tests.
Mammography (Breast Cancer)
After non-life-threatening skin cancer, breast cancer is the most common cancer in women in the United States, accounting for roughly 30% of all new female cancers each year. The risk of developing breast cancer increases with age, but it can occur at any age. Recent data published from the UK demonstrated death rates from breast cancer were trending steadily downwards from 2010 to 2019. Excess deaths from malignant breast tumors were down 5% in 2020, as demonstrated by data published by the Humanity Projects.
Then something strange happened. After a decade of breast cancer deaths steadily decreasing, they started to go back up. In 2020, excess deaths from breast cancer were down 5%. In 2021, they went up by 12%. In 2022, they were up even higher: 28%. These data weren't from women aged 50-74, the group the USPSTF recommends routine screening for. These numbers are from women aged 15-44, the women least likely to develop breast cancer. And again - these are women who aren't undergoing breast cancer surveillance at all...
The most brilliant statisticians in the world have scrutinized these numbers. Some people want to call this noise, others want to call it misclassification due to the recent pandemic. It doesn't matter. The data is real, and it's frightening. Why? Obviously, because breast cancer rates appear to be on an exponential swing upwards, but more alarmingly, these are cancers being diagnosed in women for whom regular surveillance isn't even recommended.
In the U.S., we primarily promote mammography for breast cancer screening. The campaign for yearly mammograms is massive – particularly in October. I wrote about the shortcomings of mammography last year. I'll include a link to that post below. I don't need to rail on just mammograms – the main drawback exists with all conventional screening methods. Mammograms, MRI, ultrasound, biopsy, self-breast exams – it doesn't matter. Every single one of these modalities requires a mass for detection. And remember, a detectable mass means an undetectable cancer has been lurking in the shadows for 5 to 10 years.
Breast Cancer (Mammography)
Overview of the USPSTF recommendations: Biennial screening mammography for women aged 50-74.
Costs: Average cost in the U.S. for mammography ranges from $105 to $1,022 (depending on facility, location, and type of mammogram), with potential out-of-pocket expenses depending on insurance.
False Positive and Negative Rates: Approximately 10% false positive rate, with a significant number of unnecessary biopsies and anxiety; false negatives estimated at around 20% due to dense breast tissue or other factors.
Risks and Complications: Exposure to radiation, over diagnosis, psychological distress, and physical discomfort.
Colorectal Cancer (Colonoscopy)
Overview of the USPSTF recommendations: Screening starting at age 45 for average-risk adults.
Costs: Can range from $1,250 to $4,800 depending on the facility, sedation, and geographic location.
False Positive and Negative Rates: False negative rates around 5-10%; false positives can lead to unnecessary repeat procedures.
Risks and Complications: Perforation, bleeding, infection, and adverse reactions to sedation.
Prostate Cancer (PSA Testing, Digital Rectal Exam/DRE)
Overview of the USPSTF recommendations: Individualized decision-making for men aged 55-69.
Costs: PSA test costs range from less than $100 to more than $300, but follow-up tests, treatments, and physician fees can significantly escalate costs.
False Positive and Negative Rates: False positive rates are extremely high - 60 to 70% leading to unnecessary biopsies; false negatives miss approximately 15% of cancers.
Risks and Complications: Over diagnosis, overtreatment, infection, bleeding, and psychological impact.
Lung Cancer
Overview of the USPSTF recommendations: Annual screening for lung cancer with low-dose computed tomography (LDCT) for adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.
Costs: An LDCT scan ranges from $300 to $500 per scan. If abnormalities are detected, some patients may incur additional costs for follow-up scans or treatments.
False Positive and Negative Rates: LDCT screening has a false positive rate of approximately 20-25%, which can lead to unnecessary follow-up tests, including invasive procedures such as biopsies.
Risks and Complications: Repeated radiation exposure, over diagnosis, under diagnosis, potential complications from follow-up invasive procedures, such as bleeding, infection, or pneumothorax following a biopsy, psychological impact.
Cervical Cancer (Pap Smear)
Overview of the USPSTF recommendations: Pap smear every three years for women aged 21 to 29. For women aged 30 to 65, a Pap smear every 3 years or high-risk human papillomavirus (hrHPV) testing every 5 years or co-testing (Pap smear + hrHPV testing) every 5 years.
Costs: Costs range from $100 to $250, while hrHPV testing can cost an additional $50 to $100. Co-testing (Pap smear and hrHPV testing) may range from $150 to $400. The costs can increase significantly if follow-up tests, such as colposcopy or biopsy, are needed due to abnormal results.
False Positive and Negative Rates: The false positive rate for Pap smears is around 15-30%, and the false negative rate is estimated at 20-30%.
Risks and Complications: Discomfort and bleeding, psychological impact, potential complications from follow-up procedures, such as colposcopy or biopsy, over diagnosis and overtreatment.
Shortcomings of Conventional Cancer Screening
High costs and the financial burden on patients and the healthcare system, the psychological and physical impact of false positives and false negatives, over diagnosis leading to unnecessary treatments/surgeries/complications – these are all unfortunate shortcomings of our current cancer surveillance system. But the most significant and glaring issues lie in our definitions of who should and shouldn't be screened, and the inexcusably long time it takes to detect. Cancer must make itself detectable in order to be detected – and you're not going to see it if you're not looking.
What about the men and women who fall outside the 'guidelines' for screening? The 34-year-old machinist who lived with two smokers most of his life but never smoked himself? The 38-year-old nurse who took synthetic hormones in the form of birth control for two decades and never had children of her own? The 56-year-old accountant who drinks way more alcohol than he should to self-medicate his anxiety - all while eating fake food, spraying Round Up on his dandelions, using fluoridated toothpaste, aluminum based anti-perspirants and wireless earbuds?
These people will fall through the cracks of the already flawed system for cancer surveillance. First, no one is looking for their cancer. Second, our detection methods often land us in a 'the house is already on fire' situation. I know I'll get blowback from the 'Get your yearly mammogram!' crowd, but I don't care. There are countless missed early-stage cancers due to the massive limitations of traditional imaging and screening paradigms.
It's time for a new system.
Advancements in Cancer Screening: Introducing RGCC's Onco-D-clare
Liquid Biopsy
Ok – that was mostly doom and gloom, but you know I wouldn't leave you hanging on a bad note like that:) The new and improved system is already here. It fixes all the flaws. Which is why you've probably never heard of it – unless you read everything I write. In my recent cancer blogs, I touched on RGCC's next-generation sequencing techniques for early cancer detection. Let's get into their flagship test:
The Onco-D-clare liquid biopsy.
What is Onco-D-clare?
RGCC is a research company in Greece that has developed and validated many different testing and treatment tools for cancer. Their 'screening test' for people with no known history of cancer is called Onco-D-clare. The Onco-D-clare is a liquid biopsy, or blood test, that analyzes the gene expression of specific white blood cells in the presence of cancer. White blood cells play a critical role in the body's immune response. When cancer is present, our immune cells are the first to see it – and if you know how to listen, they'll tell you all about it.
This close encounter of the third kind between immune cells and cancer cells is like a police officer sitting leisurely in his patrol car during a routine speed trap and someone committing a traffic violation (no offense, officers, for the upcoming analogy – I salute all of you). OK – so our police officer is like an immune cell. He's got his speed gun on, but he doesn't have his eyeball glued to it. Maybe he's doing some paperwork, drinking his coffee – whatever they do in there. Then suddenly, a car comes out of nowhere and races by his radar gun, going 150mph. What the? That's our cancer cell. Our police officer jumps to attention; papers fall to the floor, coffee spills everywhere, his breathing and heart rate accelerate, attention focuses, lights on, sirens on, transmission gets thrown into drive, gas pedals to the metal – and in seconds, he's on a high-speed chase.
All of that for one little car racing down the highway. This isn't a 50-car pile-up, a 737 crashing into a runway, or a nuclear bomb attack. It's one speeding car. But that's all it took. We know by the lights, the sirens, the scattered papers, spilled coffee, the heart rate, the breathing, the tire marks on the road, and the dropping needle on the fuel tank that our police officer witnessed a crime. And hopefully, he witnessed it in time to prevent a significant accident, a child abduction, or dangerous drug trafficking from happening. You didn't need to see that speeding car with your own eyes to know what happened. The response from our officer tells us everything.
The Onco-D-clare test measures our immune system's response when it witnesses a cancer car speeding by. Immune cells don't turn on literal lights and sirens but do something very similar to our police officer. When cancer is present, our immune cells are the first to detect and interact with it. This encounter triggers a cascade of changes in immune cell gene expression patterns – more than 90 of which are measured by the Onco-D-clare test. So light years before that cancer car has a chance to cause a massive accident of a tumor mass on the highway, you know that it is there and needs to be dealt with.
One could argue that we all have cancer cells, and we probably do. We expect a certain amount of cat and mouse between bad actors like cancer cells and our immune system. However, if your immune system is robust, all the offenders are pulled over and sent to jail. Problem solved. The Onco-D-clare sets a threshold for this. If, for example, we expect a healthy immune system to have no more than 5 speeding cancer cells in circulation, anything below that gets read as 'No Cancer Signal Detected'. However, if the test finds 6 or more, we know we have a potential problem.
Benefits of Using Onco-D-clare for Cancer Surveillance
Early Detection
The Onco-D-clare liquid biopsy indicates the presence of cancer when it's just a single cell. Or a few cells. Recall, this is 5 to 10 YEARS before our conventional screening tools can see it. I don't need to reiterate what you've heard a million times before, but I will anyway: Early detection is KEY. A few cancer cells are a minor problem to deal with. A ton of cancer cells is a potentially catastrophic one.
Ease of Testing
The Onco-D-clare is a simple, regular old blood test. That's it. No smashing of the boobs, no exposure to radiation, no colon prep or a trip to the hospital. There is essentially NO RISK to a blood test – outside of, I suppose, you could have a bruise on your arm for a few days. Unless one of my nurses draws you and then that never happens. They are all gangster phlebotomists.
Highly Accurate
If you have cancer, the Onco-D-clare has a 93% chance of detecting it. Nothing else currently available on the market anywhere in the world today has that degree of sensitivity. There are other liquid biopsy tests, but their sensitivity rates are much much lower. In addition, the Onco-D-clare is the only test measuring changes in gene expression of immune cells – the very first cells in our bodies to encounter cancer. Other liquid biopsies – although still superior to conventional testing – measure the DNA of circulating tumor cells that are shed by cancerous tumors. That means we already have a tumor. Those tests are still far ahead of traditional scans and tests but do not compare to the Onco-D-clare.
Cost
The Onco-D-clare costs $1000 to $1500 USD. Pricing is set by the Euro, exchange rates fluctuate daily, and there's a cost in drawing and processing the blood sample, so taking all of that into account, the Onco-D-clare costs $1000 to $1500 at our office, depending on whether you are an established patient or not. Roughly one thousand dollars to skip yearly mammograms, MRIs, colonoscopies, rectal exams, PSAs, lung CTs, etc. A thousand dollars is a lot of money for most people, but I encourage you to add up what your potential out-of-pocket costs would be for conventional screening tests, as outlined above. Not to mention your maximum out of pocket expenditure which will no doubt be immediately met with a cancer diagnosis.
What about "My insurance covers mammograms at 100%, so why would I pay anything out of pocket?" Remember, your insurance only covers 'screening' if you fall under the USPSTF guidelines. Or the Affordable Care Act (ACA) guidelines. Any way you slice it, if you're a woman under 40 wanting a screening test for breast cancer, that expense is 100% on you.
If we compare apples to apples, a thousand dollars every 6, 12, or 24 months pales in comparison to the cost of conventional cancer screening.
Limitations of Onco-D-clare
Aside from the out-of-pocket expense, there isn't much shade to throw here - save one. Like all currently available liquid biopsies, the Onco-D-clare cannot screen for cancers that arise from the central nervous system (CNS). Our Almighty Creator wisely thought to extra-protect our brain and spinal cord from damage and disease with a Kevlar vest known as the Blood Brain Barrier (BBB). The BBB does not readily allow communication from within the central nervous system to the outside world. For now, tumors that arise from brain tissue are not routinely detected by any kind of liquid biopsy. Alternative screening tests for brain tumors are relegated to computed tomography (CT) or magnetic resonance imaging (MRI). Although more cost-effective (average cost $825-$4,800), CT scans don't have the best in terms of image sensitivity and, unfortunately, deliver a boatload of radiation, which is associated with an increase for cancer risk. Elective MRI scans provide superior imaging and no radiation. They costs anywhere between $600-$12,000, but the national average, as far as I could find, is $1,325. Those numbers come from patients requesting 'cash pricing' from their local hospital or imaging center.
Thankfully, more and more medical facilities offer elective scans at reasonable cash prices to patients wanting or needing a scan for whatever reason. Here in Green Bay, WI, I want to give a shout out to an amazingly spectacular first-rate hospital and E.R. that offers brain MRIs (radiology read included) for a flat fee of $600 at the time of this writing. GBER bills insurance but also provides cash pricing plus a superbill (usually less out of pocket this way) to submit to insurance for reimbursement or to be applied to your deductible. Gangster. Love them – 5 stars. If you want elective testing or imaging, I recommend giving these folks a call.
I hesitate to call this a drawback, but I'll include it here anyway. Because the Onco-D-clare test is measuring a cancer signal so early, it can not tell us what kind of cancer it is detecting. If the test comes back negative - awesome. Let's repeat it again in 6, 12, or 24 months depending on your risk and personal preference. If it is positive, however, RGCC can reflexively run another test called the 'OncoTrace' which tells us what kind of cancer we're dealing with, what the tumor load is, how aggressive the cancer is, and how likely is it to metastasize. If someone has a history of cancer, the OncoTrace is the test we use for surveillance. Here's the verbiage we give to patients prior to testing:
Understanding the Onco-D-clare Test
The Onco-D-clare is an advanced cancer screening test that uses cutting-edge technology to detect cancer before symptoms appear. This blood test analyzes the expression of over 90 genes to determine if cancer cells (with the exception of CNS cancers) may be present in your body. With a high accuracy rate of approximately 93%, Onco-D-clare provides vital information to help you make informed decisions about your health and future care.
What Your Onco-D-clare Results Mean:
Negative Result: If your Onco-D-clare test result is negative, it means that no cancer markers were detected at the time of testing. We recommend repeating the Onco-D-clare test annually for routine cancer surveillance to continue monitoring your health.
Positive Result: If your test results show positive for changes in your blood cells that may indicate the presence of cancer, we offer the Oncotrace test for further examination. This test can be automatically ordered within 48 hours of a positive Onco-D-clare result without requiring another blood draw. This reflex testing helps confirm the presence and type of circulating tumor cells (CTCs) and provides more detailed information about potential cancer.
What is the Oncotrace Test?
The Oncotrace test is a specific follow-up test that detects circulating tumor cells (CTCs) and evaluates the type and activity level of these cells. It helps determine the presence of cancer and provides insights into its potential behavior, such as aggressiveness, likelihood of spreading, or resistance to treatment. If your Onco-D-clare test is positive, you have the option to reflexively order the Oncotrace test for further clarity.
Next Steps Based on Your Results:
Onco-D-clare Positive, Oncotrace Negative: If your Onco-D-clare test is positive but the Oncotrace test is negative, this could indicate early or low-level disease, a false positive Onco-D-clare result, or transient/non-cancerous changes. Our office will reach out to you to discuss the implications of these results and provide further recommendations.
Both Onco-D-clare and Oncotrace Positive: If both tests yield positive results, our office will contact you to schedule an appointment to discuss the findings and plan the next steps for your care and treatment.
Conclusion
When it comes to cancer, time is everything. The earlier we detect it, the better our chances of beating it. Traditional screening methods like mammograms, colonoscopies, and other imaging tests have their place, but they are limited by the fact that they only detect cancer after it has grown large enough to be seen. Onco-D-clare offers a powerful new tool for early detection by measuring changes in the gene expression of immune cells that occur as soon as cancer cells begin to form. This means we can potentially detect cancer years before it becomes visible on traditional screening tests, giving us a critical head start in the fight against this disease. By embracing advanced technologies, we can move beyond the limitations of conventional methods, offering hope for better outcomes and, ultimately, saving more lives.
Maybe you give your boobs a break this year and treat them to a blood test instead:)
If you're interested in the Onco-D-clare or OncoTrace blood test for cancer, please give our office a call (920) 737-1625.
Resources
Humanity Projects
Early Detection is Key
RGCC
Green Bay ER & Hospital
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