Chemosensitivity, Genomic, and Alternative-Natural Agent Sensitivity Testing Overview
This emerging field has great promise for improving patient outcomes. It takes us beyond the one-size-fits-all approach. The sad reality is, the majority of patients are never offered these new approaches.
The National Cancer Institute describes a chemosensitivity assay as
A laboratory test that measures the number of tumor cells that are killed by a cancer drug. The test is done after the tumor cells are removed from the body. A chemosensitivity assay may help in choosing the best drug or drugs for the cancer being treated.
Drug efficacy (or response) testing has been around since the 19th century, through the work of Drs. Louis Pasteur and Paul Ehrlich, used for determining which antimicrobial (antibiotic) will kill a certain strain of bacteria.
Today, for example, patients with bladder infections give a urine sample to the lab, where it is tested with various antibiotics used for urinary tract infections. The doctor then writes a prescription for the antibiotic shown to do the best job of knocking out that particular infection. Likewise, doctors can use the results of a chemosensitivity test to formulate the most effective and targeted cancer treatment plan.
If chemosensitivity testing is not done, you fall victim to the one-size-fits-all, broad-based approach of conventional oncology. Standard drugs from the National Comprehensive Cancer Network (NCCN) guidelines will be prescribed; a more effective drug may remain on the shelf. Chemosensitivity testing can prevent your exposure to a drug that not only would be ineffective at fighting your cancer, but could be extremely damaging to your immune system.
Integrative oncologists have been using such testing for years. In my experience, many conventional oncologists are reluctant to embrace this new testing. It may be up to you to tell them about it. The one-size-fits-all testing and treatment plans are old school—a thing of the past.
Suzanne Somers interviewed many cancer doctors and wrote several books on cancer therapy after her firsthand experience with breast cancer. She said,
Now that I realize chemo sensitivity tests exist, it feels unconscionable that chemotherapy would ever, ever be administered without testing first to find out if the chemo is even compatible with the specific cancer.
If these tests could help us to take less chemo, or a better chemo for our specific cancer, why wouldn’t we ALL be given these tests?
Somers is absolutely right. A personalized, targeted approach is a much better way to proceed.
The first method utilizes living tumor tissue. The tumor sample is surgically removed, and usually arrives at the lab within 24–36 hours of collection, where living cells are exposed to different chemotherapy drugs and the best drug reactions are identified. Cell lines or genes are not evaluated. This type of test is not considered “early detection” because you must have a known tumor to get the test. Rational Therapeutics in Long Beach, California, is a leading lab offering this type of testing; there is more detail in the Rational Therapeutics test chapter.
The second method falls a bit outside the National Cancer Institute’s definition of chemosensitivity testing. This is because the laboratory, Research Genetic Cancer Center (RGCC), is based outside of the United States and uses the patient’s individual cancer cells from a blood sample. These cells are exposed to different chemotherapy drugs and the best reactions are identified. This changes things quite a bit because the test can be performed on cells extracted from a patient years before a tumor is located and biopsied. This test is combination of chemosensitivity testing and genomic testing. lab also looks at genetic markers on the cancer cells. RGCC is working with hundreds of integrated physicians treating cancer at its earliest stages.
Just as everyone’s fingerprints are different, cancer cells are different, too, and the information obtained from chemosensitivity testing can be invaluable. Also, tumors have the ability to develop drug resistance. This means patients need repeat sensitivity testing and adjustments to the treatment plan. Fortunately, insurance companies are beginning to pay for such testing.
A new buzzword in oncology is “genomics,” which is advertised as the very best in personalized treatment. We hear terms such as gene testing, genetic profiling, molecular testing, target profiling, whole cell cytometric profiling, and genomic testing.
This method uses tumor tissue, or more recently, blood, to identify chemo drugs that should produce the best potential treatment outcome. The goal of this type of test is to match known characteristics of a chemotherapy drug with the identified characteristics or “gene patterns” of the patient’s cancer cells. In gene testing, chemotherapy drugs are not physically tested against the patient’s cancer cells, as they are in chemosensitivity testing. Genomic testing provides a “theoretical potential” for the drug’s success. Other biological mechanisms of the cancer cell, like drug resistances, are often not considered.
Labs offering this are Biofocus, Biocept, FoundationOne, and RGCC. There is more detail in their respective chapters.
Alternative-Natural Agent Sensitivity Testing
This testing can identify the most effective natural substances for treating cancer cells and boosting immune system function. Therapeutic doses of vitamin C, for example, have been shown to kill cancer cells.
There are only two labs I have identified which offer any type of testing for natural substances, even though there are increasing numbers of patients who are seeking natural therapies. Many of the tested substances support the immune system while reducing the number of cancer cells through the process of “angiogenesis,” or “apoptosis.”
Angiogenesis is the process the body uses to signal the growth of blood vessels to a tumor to provide it with nutrition for growth. The Angiogenesis Foundation in Cambridge, Massachusetts reported that all cancerous tumors release angiogenic growth factor proteins to stimulate their blood vessel growth and that antiangiogenic therapies literally starve the tumor of its blood supply by interfering with this process. This test identifies natural substances that are antiangiogenic to the individual patient’s tumor cells.
Apoptosis is the process of inducing cell death. However, cancer cells have lost their natural programming to die—they keep duplicating endlessly. This test identifies natural substances that cause cell death to the individual patient’s tumor cells.
The following labs provide natural substance sensitivity testing:
Research Genetic Cancer Center (RGCC), Greece
The lab tests for roughly 50 natural substances ranging from mistletoe to curcumin and new ones are added periodically. The full current list is available on their website.
The Biofocus test looks for a smaller list of different natural substances.
If you have chosen the chemotherapy route, beginning treatment with a personalized targeted plan of attack is much better than starting with the standard generic rounds of chemo. The upfront costs may seem high, but it is a much better approach in the long run.
It is unfortunate but true—many people do more research when buying a camera than when purchasing a cancer treatment. They research brands of cameras, consider the number of pixels, and refer to online reviews before buying. We all want to be knowledgeable consumers; however, when it comes to being a medical consumer, most of us relinquish our rights. People in white coats are coaches; the final decisions are yours. Be informed and validate the efficacy of the treatments you are considering or have received.
If you have been diagnosed, please do not retreat if your insurance company or Medicare will not pay for this testing. Your life is very important and the proverbial buck stops with you—not with someone in the medical establishment. Keep an open mind. If you can afford to get tested, do it.
This is your life.
 National Cancer Institute. NCI Dictionary of Cancer Terms. Chemosensitivity Assay. Retrieved January 18, 2015 at: www.cancer.gov/dictionary?cdrid=45990
 Canetti G, Froman S et al. Mycrobacteria: laboratory methods for testing drug sensitivity and resistance. Bull World Health Organization. 1963; 29:565-578
 Somers S. Knockout: Interviews with Doctors Who Are Curing Cancer and How to Prevent Getting It In the First Place. Crown Publishing, 2009:127