In this timely episode of "Cracking Cancer," host Dr. Kyle Concannon, a physician scientist, speaks with patient advocate Ashley Holt about the challenges of navigating new, aggressive cancer surveillance technologies. Ashley, a survivor of Stage I non-small cell lung cancer with a ROS1 mutation, chose to go beyond the standard of care by incorporating the Signatera circulating tumor DNA (ctDNA) blood test into her post-lobectomy monitoring.
Ashley shares her intense, real-time experience after her third ctDNA test came back positive despite all her conventional CT scans and a follow-up PET scan being normal. This outcome catapulted her into an "evidence-free zone," a state of profound anxiety and confusion where she must make critical treatment decisions—such as whether to start a lifelong targeted therapy—without clear medical consensus or established guidelines.
The conversation explores the ethical and emotional trade-offs of aggressive surveillance: the benefit of detecting potential recurrence earlier versus the harm of provoking intense anxiety and forcing patients to choose a path with no definitive right answer. This is essential listening for any patient considering advanced monitoring or struggling to reconcile standard medical guidelines with the flood of new, but unvalidated, technologies.
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Attributions
The music track - Progression Pulse - is provided by Denys Brodovskyi through the Attribution 4.0 International License
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