Here in America, if you are contemplating chemotherapy, you may or may not be offered the chemosensitivity test.
In Germany, chemosensitivity tests are routinely conducted in order to determine which chemotherapy drugs should be utilized for a specific cancer patient.
Because some tumors may resist certain chemotherapy treatments, some oncologists are choosing to test tumor cells in advance of treatment rather than prescribe a standard chemotherapy combination without knowing whether it would be effective for your particular tumor.
Tailor-Made Treatment
The tests, called chemotherapy sensitivity and resistance assays (CSRAs) are relatively new and are carried out for many types of cancer.
The CSRA is a laboratory test that is done on a single cell in a test tube (in vitro) or on a clump of tumor cells (in vivo), usually taken from a biopsy tissue sample. The test assesses how many cancer cells are killed by a particular drug, or by a combination of drugs, and how many cancer cells are unaffected by the treatment.
When your oncologist examines these test results, he/she can then treat you more effectively, knowing which chemo drugs your cells respond to. Two more added benefits are that you don’t lose any time being blasted with drugs that don’t work for you and you don’t have to be debilitated by the side effects of drugs that won’t kill your cancer.
There Are 5 Qualifying Factors
As of writing this article, I am aware of 5 qualifying factors before you will be considered for a chemosensitivity test.
- You have to find an oncologist that will order the test
- You need to be strong enough to undergo chemotherapy
- You need to have access to a lab or facility that does the assay
- You must have a solid or fluid tumor
- You must be willing to undergo a new biopsy to get a fresh tissue sample for testing
Insurance Companies and Clinical Trial Results – Two More Problems
Not all insurance companies will cover the cost of the chemosensitivity test, which as close as I could tell runs around $800. Aetna Insurance considers chemosensitivity assays “experimental and investigational because there is insufficient evidence that these assays influence management decisions such that clinical outcomes are improved.” I guess Germany doesn’t count.
It appears that independent clinical trials are still underway here in America and because of that this test is not standard, and it will not be offered to every patient until doctors are convinced of its accuracy and value.
It’s Just My Opinion, But…
If the chemosensitivity test assists oncologists to tailor make a chemo regimen that is going to be the most effective for our specific cancer, why wouldn’t the insurance companies pay for this? It could conceivably lead to less chemo treatments and a patient who is actually ALIVE at the end of the treatment regimen (as opposed to one who won’t be paying any more insurance premiums due to being 6 feet under!).
I think that if toxic chemotherapy is going to continue to be the standard of care (which many consider outdated and prehistoric) they need to step up the clinical trials and get these results back as quickly as they can so that ALL can be given these tests and ensure they have the best response rate to the chemotherapy drugs and the greatest chance at beating cancer.
Finally, take 7 minutes out of your busy day and watch this interesting You Tube video – Burton Goldberg interviews Professor Michael Geising, a German Molecular Oncologist from Munster, Germany. Dr Geising advises “only 15-20% of chemotherapies are successful. The other 80% not only don’t work, but 60% of them actually make the cancer more aggressive by allowing it to develop resistance mechanisms.”
Research strongly suggests that when patients receive the most effective treatment, matched to their cancer profile, they survive longer. Ask your oncologist about the chemosensitivity test. In fact, insist on it.
References:
http://www.aetna.com/cpb/medical/data/200_299/0245.html
http://breastcancer.about.com/od/newlydiagnosed/a/chemosensitive.htm
http://csn.cancer.org/node/237389
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More and more we hear about personalized medicine, and this chemosensitivity test seems to fit right into that approach. Thanks for sharing – I wonder whether this will be incorporated internationally with time?
Catherine
Catherine, chemosensitivity tests are already being used in Europe and, to a small degree, here as well. It makes so much sense. I believe more patients should start to insist upon it when they speak to their oncologists and their insurance companies.
Warmest regards,
Marnie
Hi marnie
Please advise us of recommended labs that carry out chemotherapy sensitivity testing preferably in the uk . Somewhere near Kenya we live in Mombasa would be practical but I guess the uk / India are options my dad has had 75 doses of chemo with different drugs he’s on the border of recurrence and remission … Who knows as a last throw I thought this might be helpful as i feel we’ve literally been throwing darts in the dark , the oncologists here do not know of any clinics that carry this test out.
Kind regards
Ketan
Hi Ketan,
I have sent you a private message responding to this. Hopefully the links I sent you will be useful for you. Wishing you much success in finding something to help your father and if I can help with that, please let me know.
Warmest regards,
Marnie