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Biomarkers: New Heroes in the Earliest Detection of Breast Cancer Bone Mets

Detection devices provide early warnings

First responders are people who are professionally trained for the earliest intervention in emergency situations. They are found in such jobs as police, firefighters, drug agents, homeland security, animal wardens, armed forces and National Guard, etc. Sometimes, the emergency is catastrophe that creates a potentially deadly environment, e.g. a gas leak or chemical spill. Rushing into such a disaster often puts these heroic people in harm’s way. Now, there are wearable devices that detect trace amounts of dangerous substances as they approach the emergency area. Not only do the devices give the earliest possible warning, they also identify the what the substance is to allow planning the best strategy. If you are interested in an example, check out the Chameleon armband that was developed for the Marines.

Biomarkers: natural alerts

Several types of tumor cancers (breast, prostate, lung, etc.) have a preference for spreading to the bone (bone metastasis or bone mets). When breakaway tumor cells first travel to the bone, this is microscopic and can’t be seen on imaging. It can take weeks or months for them to implant in the bone take over the bone’s healthy processes for their own selfish, malignant purpose. While this is secretly going on, there are no symptoms to alert patients and their doctors to the situation. Sadly, by the time symptoms occur, the case has become more complex.

Hope for earlier detection of bone mets lies in the use of biomarkers. The word “biomarker” is a short form of “biological marker.” It means a measurable bodily substance or process that reveals the presence of a disease, infection, toxin, response to treatment, etc. For example, a blood test can measure cholesterol levels, while a fever can indicate a bacterial infection. The earlier intervention occurs, the more effective it is likely to be. Thanks to today’s science, very sophisticated biomarkers now include “specific cells, molecules, or genes, gene products, enzymes, or hormones.”i 

New biomarkers for bone mets

A 2017 study (Shaker & Helmyii) has identified two biomarkers that, when found together in the blood, can indicate BCa bone mets long before problematic tumors form. The first, RANKL, is a molecule secreted during normal bone processes that binds to a corresponding receptor. The second, HER2, is a human growth factor that supports bone development. Remember, BCa cells in bone take over the bone’s healthy resources for their own tumor growth, so the presence of these biomarkers in the bloodstream shows that cancer cells are up to “illegal activity” in the bone. In the Shaker & Helmy study, out of 122 BCa patients and 25 healthy controls, the presence of both RANKL and HER2 in blood samples correctly identified which BCa patients had bone mets and which did not, with 98.9% accuracy.

Why earliest bone mets detection matters

Although metastatic breast cancer is not yet curable, early treatment of bone mets is essential for maximum management through exercise (which keeps bones strong and deters tumor growth), drugs, and focal tumor destruction. All of these strategies add to life span and good quality of life.

The Sperling Medical Group offers MR-guided Focused Ultrasound (MRgFUS) for the focal destruction of bone mets regardless of the primary cancer location. Contact us to learn more.

iiShaker OG, Helmy HS. Circulating bone-related markers and YKL-40 versus HER2 and TOPO2a in bone metastatic and nonmetastatic breast cancer: diagnostic implications. Clin Breast Cancer. 2017 Jun 7. pii: S1526-8209(17)30150-7. doi: 10.1016/j.clbc.2017.05.011. [Epub ahead of print]

Bone mets