When I was diagnosed with endometrial cancer, I read my biopsy report. There was something on there that said mismatch repair protein analysis. It said my particular tumor was MLH1/PMS2 deficient. I had no idea what this meant and the doctors didn’t tell me.
As a veterinarian, I had enough of a medical background to start researching and what I found was very eye-opening. This led me to the information I am going to summarize for you here.
Tumor profiling is relatively new technology and is a very important part of personalized medicine. It provides an approach to medical care in which cancer treatment is tailored to the genes, proteins, and other substances in your unique tumor.
We are all so different and so are the cancer cells in our bodies. This is why this testing is so important, especially when it comes to uterine cancer.
You will want to read to the end to learn about a revolutionary test that may predict what treatments will work for you!
WHAT IS TUMOR PROFILING?
- Each person’s cancer is different and has a unique pattern of DNA changes.
- Tumor profiling could show that your cancer has certain genetic changes in the DNA that are targeted by a known therapy, whether it is FDA approved, off-label or part of a clinical trial.
- It could also show that you have a tumor profile that may prevent a certain therapy from working for you and spare you from an unnecessary treatment.
- The tests can also help with the diagnosis and monitoring of the cancer during and after treatment.
- Cancer mutates, so these DNA markers can change over time, so if the cancer does come back it would be important to retest.
- Some important tumor profile tests include micro satellite instability status, mismatch repair protein status, tumor mutational burden, PD-L1 expression, and many more. I know this sounds like Greek, but don’t worry, I will explain what these tests mean in more detail in another post.
*Note: Biopsy samples are held in the clinic or hospital where they were obtained for years. If you didn’t get this testing done initially it may still be possible to ask for it.
In my case, they ran a test called Tempus after I requested it. The test looked at the number of genetic mutations in my tumor to see if immunotherapy with the new checkpoint inhibitors would work for me. Based on the results, my oncologist said I was an excellent candidate for immunotherapy, which later became the treatment that put me into remission!
The main take home point is that tumor profiling is important and can help guide therapy and there are a number of different DNA markers they look at to learn more about your particular cancer.
OTHER NAMES FOR TUMOR PROFILING
- Biomarker testing
- Genomic testing or profiling
- Tumor molecular profiling
- Tumor genetic testing
These tests are NOT the same as genetic testing to see if you have inherited germline mutations, making you more susceptible to cancer, like BRCA1 and BRCA2, which are commonly checked in breast cancer patients.
It would be beneficial to get inherited germline genetic testing as well to see if you have these mutations or Lynch syndrome, which can predispose you to endometrial and colorectal cancer.
HOW IS TUMOR PROFILING DONE?
1. TUMOR TISSUE ANALYSIS
This testing is done on the tumor tissue obtained at surgery or during a biopsy procedure. They are looking for genes, proteins, mutations in the DNA and other substances that give more information about your particular cancer.
Common tumor tissue tests
Tempus, Caris, Foundation One
2. CIRCULATING TUMOR CELL TESTS
The second way a tumor profile can be analyzed is through circulating tumor cell tests. These are non-invasive tests done with a blood sample, sometimes called a “liquid biopsy”. They check your blood for circulating tumor cell DNA (ctDNA) or actual circulating cancer cells.
These tests can be useful for monitoring the effectiveness of treatment as well as surveillance for recurrence. They can be a form of early detection of the cancer coming back so that intervention can take place before new tumors grow and spread.
Many of these tests have been developed for the more common cancers, such as breast, prostate, and colorectal, but can also be used for any solid tumor types depending on the test. I first heard about this through my naturopathic doctor.
Circulating Tumor Cell Tests
Signatera, Guardant 360, Foundation One, Tempus, Caris, Datar Exacta
Tempus, Caris, and Foundation One offer both tumor tissue and liquid biopsy options, as well as germline genetic testing to see if you are predisposed to certain cancers.
ARE THESE TESTS COVERED BY INSURANCE?
Many of these tests are covered by insurance, but some of these companies will offer the tests at very low cost if not.
Tempus, Caris, Foundation One and Guardant 360 are typically covered by insurance.
I had the Signatera test ordered through my naturopathic doctor and it was free of charge. Some hospitals will run this test and it will be paid through insurance.
The Datar Exacta will not be covered by your insurance and is expensive, but could be well worth the expense. More on this below.
Different clinics run different tests so ask which one they use.
MORE IMPORTANT DETAILS ABOUT THE DIFFERENT TESTS
SIGNATERA
Signatera is a circulating tumor cell DNA test based on first analyzing your tumor tissue after surgery.
Initially the company gets a sample of your tumor tissue. They do special testing to find your specific tumor cell DNA. Then they draw blood samples on a regular basis to check if that particular tumor cell DNA is circulating in your blood stream. It has been shown to be effective for very early detection of cancer recurrence before it shows up on imaging.
They scheduled a phlebotomist to come to my home and draw my blood samples so it was very convenient. I had the test done every 3 months for the first year, then every 6 months after that. The result you want is negative, meaning there is no detectable circulating tumor cell DNA.
Your doctor may try to tell you this is not accurate for endometrial cancer, but myself and other women in my support group have found it to be very accurate. I would definitely recommend this test for monitoring. Read More
GUARDANT 360
This is a liquid biopsy test. The test finds circulating tumor DNA, which is analyzed to detect alterations in the genes or mutations of the DNA. Mutations of the DNA of proto-oncogenes and tumor suppressor genes especially, are what can lead to uncontrolled division of cancer cells and development of tumors.
This test analyzes 73 genes among other things for mutations. It can help determine which targeted drugs could lead to a positive response and avoid ineffective therapies saving valuable time, money and possibly unnecessary side effects.
The test can also be used for surveillance and monitoring during and after treatment to determine how well treatment is working. If the cancer is not responding to therapy, the test can be rechecked to see if further mutations have come along. Read More
TEMPUS
Tempus has several testing options. The first one is very important, where they test the tumor tissue from a biopsy for genetic mutations. The test analyzes the DNA, RNA, and specific proteins of the cancer cells to identify personalized treatment options for you.
Tempus also offers a liquid biopsy test for continued monitoring and surveillance after treatment to see how effective treatment is and an inherited genetic test to look at your cancer risk factors. Read More
CARIS
Caris is another comprehensive molecular profiling test like Tempus. It tests your tumor sample for DNA, RNA, and specific protein mutations to target therapy.
Caris goes one step further using artificial intelligence to interpret the data. They can compare your unique tumor profile to thousands of relevant clinical studies to match your tumor’s biomarkers to treatment options. They can also use this to connect you and your oncologist to available clinical trials.
The AI algorithms can predict patient responses to standard treatments such as immunotherapy and/or chemotherapy. Read more
DATAR EXACTA
I saved the best for last.
Datar Exacta is a new liquid biopsy test that will likely revolutionize cancer care going forward.
It is cutting edge technology that analyzes 100s of millions of molecular data points to find all the possible targets for precision drug therapy. It also uses an AI database algorithm to determine the drugs and drug combinations that have the highest effectiveness against your particular cancer with the least toxicity!
They do this by putting your circulating tumor cells in a test tube and testing which drugs and alternative substances have the highest “kill rate” given as a percentage. This test can be done for all solid tumor cancers and is especially helpful for more aggressive or resistant cancers or cancer that has recurred following conventional treatments.
If you would like to know what chemotherapy and natural substances work best and avoid unnecessary drugs and supplements that won’t work then this is the test for you.
Oncologists will almost always choose the same standard of care chemotherapy drugs for uterine cancer, carboplatin and paclitaxel, but what if your particular tumor is not sensitive to these drugs? You could go through all that treatment and side effects only to have the cancer either not disappear or rapidly come back.
DATAR EXACTA HAS BEEN SHOWN TO BE 97% ACCURATE!
The only downside of the Datar Exacta testing is that it will not be covered by your insurance and is expensive, but it is worth asking your oncologist or primary care doctor about.
Datar Exacta is just one of many different testing options offered by the parent company, Datar.
Besides the Datar Exacta test, Datar Company also offers the following tests:
- Screening for early detection of cancer
- Blood based diagnosis of cancer
- Efficacy and resistance guidance for chemotherapies and natural therapies such as mistletoe, intravenous vitamin C, curcumin, and more
- Advanced genomic tumor analysis of your particular cancer
- Monitoring for response to treatment and recurrence
Examples of actual (partial) datar exacta test results for two women I know with the same diagnosis. If you look closely you will see how different they are!
IN SUMMARY
Precision tumor profiling is now becoming more well known and will likely become the new standard of care in oncology going forward. It is especially important for uterine cancer.
Personalized medicine is so important as everyone’s cancer is different. Even if two people have the same diagnosis, one may respond to a particular treatment and the other one won’t.
Top Advances of the Year: Uterine Cancer.
The molecular characterization of endometrial cancer has been critical in informing novel treatment strategies. Over the past year, significant gains have been made via the incorporation of immunotherapy, hormonal combinations as well as antibody drug conjugates. Read More
For me personally, I want to know what therapies will be most effective, including natural therapies, and not be exposed to harmful drugs that won’t work.
Please discuss these tests with your oncologist right away and don’t be afraid to get a second, third or fourth opinion if your oncologist is unfamiliar with this testing or will not do it.
It is crucial to your treatment plan to have tumor profiling done!
WHAT CAN YOU DO TODAY TO FURTHER YOUR HEALING JOURNEY?
Today I am going to recommend that you start working towards a clean, healthy water source if you don’t already have one.
Unfortunately, our water is often contaminated with PFAS (per-and polyfluoroalkyl substances), heavy metals, chlorine, organisms and petroleum chemicals making it unsafe.
If you have city water you are getting exposed to these things and sometimes even medications that have been disposed of and entered the water supply! Well water can also be filled with heavy metals, infectious organisms, rust and silt.
Bottled water contains micro-particles of plastic and often bisphenol A (BPA). BPA is an endocrine disruptor mimicking estrogen, which is the last thing you want to have in your body if you have uterine cancer. Drinking water out of plastic bottles is not a good idea.
2 WAYS TO FILTER YOUR WATER
1. REVERSE OSMOSIS SYSTEMS
The best way to filter your water for purity is through reverse osmosis systems. There are whole house filtration systems (expensive) or under the sink systems for drinking water only. There are many different kinds so do your research to find what will work best for you. This is the system I personally use and love.
Home Master Hydroperfection RO System
2. BOROUX COUNTERTOP WATER FILTRATION SYSTEM
I formerly used a Berkey water filter before I switched to reverse osmosis, which was great. However, the company is no longer doing business and the new company where you can get an excellent water filter is Boroux.
They have a water filtration system that sits on your countertop with 2-4 filters. You fill it up as needed for fresh, clean, purified water.
This filtration system is equivalent to the former Berkey system and the Boroux black filters are compatible with Berkey units if you already have a Berkey and you want to keep it.
WHAT DOES THE BOROUX FILTER OUT?
Lots of stuff!!!
Heavy metals and Plastics
Pesticides, Herbicides, PFAS
Volatile organic compounds
Pharmaceutical drugs
Always use glass or stainless steel water bottles from now on. Make sure to drink 1/2 – 1 ounce of water per pound of body weight per day.
Glory to God, who is able to do far beyond all that we could ask or imagine by His power at work within us. – Ephesians 3:20