Health
New Blood Tests, Liquid Biopsies, May Transform Cancer Care

Dr. Massimo Cristofanilli, oncologist and director of the Breast Care Center, speaks during an interview at Jefferson University Hospital in Philadelphia on Tuesday, April 28, 2015. With a tissue biopsy, “our treatments lag behind and they’re still based on limited information,” Cristofanilli says. With a liquid biopsy, “the power of this test has been to really find out how the disease changes, even in a short period of time.” (AP Photo/Jacqueline Larma)
MARILYNN MARCHIONE, AP Chief Medical Writer
A new type of blood test is starting to transform cancer treatment, sparing some patients the surgical and needle biopsies long needed to guide their care.
The tests, called liquid biopsies, capture cancer cells or DNA that tumors shed into the blood, instead of taking tissue from the tumor itself. A lot is still unknown about the value of these tests, but many doctors think they are a big advance that could make personalized medicine possible for far more people.
They give the first noninvasive way to repeatedly sample a cancer so doctors can profile its genes, target drugs to mutations, tell quickly whether treatment is working, and adjust it as the cancer evolves.
Two years ago, these tests were rarely used except in research. Now, several are sold, more than a dozen are in development, and some doctors are using them in routine care.
Gurpaul Bedi had one for colon cancer that spread to his lungs. About 10 percent of patients with metastatic colon cancer at the University of Texas MD Anderson Cancer Center now get liquid biopsies.
“I think it’s wonderful,” said Bedi, who lives in Atlanta and goes to Houston for his care. “A lung biopsy, many doctors told me, is not easy.”
In Philadelphia, a liquid biopsy detected Carole Linderman’s breast cancer recurrence months before it normally would have been found.
“Had this test not been available, we may not have known I had cancer on my spine until symptoms showed up,” which may have been too late for good treatment, she said.
The huge potential for these tests is clear. The problem: There are no big, definitive studies to show they help patients, how accurate they are, which type is best or who should get them and when.
Still, patients do better when drugs are matched to their tumors, and liquid biopsies may give a practical way to do that more often.
“I’m really excited about all of this,” said Dr. Razelle Kurzrock, a University of California, San Diego cancer specialist. “I spent most of my life giving drugs that were useless to people” because there was no good way to tell who would benefit or quickly tell when one wasn’t working, she said. “This is so much better.”
WHO GETS TESTED NOW
The tests are mostly used when a tissue biopsy can’t easily be done, when the cancer’s original site isn’t known, or when drugs have stopped working and doctors are unsure what to try next, said Dr. Scott Kopetz, a colon cancer specialist at MD Anderson. The tests are catching on “faster than I anticipated,” he said.
At Philadelphia’s Thomas Jefferson University, Dr. Massimo Cristofanilli has used them on about 120 breast cancer patients, including two dozen like Linderman with a high risk of recurrence.
A tissue biopsy typically samples one section of a tumor, and tumors can vary widely, with different genes and hormones active in different parts, he said. Also, cancer that has spread often differs from the original site, and tumors change rapidly in response to treatment.
With a tissue biopsy, “our treatments lag behind and they’re still based on limited information,” Cristofanilli said. With a liquid biopsy, “the power of this test has been to really find out how the disease changes, even in a short period of time.”
HOW THEY WORK
Early versions looked for whole tumor cells in blood. Newer ones look for free-floating cancer DNA, enabling gene profiling to see what mutations drive the cancer. Kopetz and Cristofanilli use one from Guardant Health Inc. of Redwood City, California, that has been sold in the U.S. since June 2014 and in parts of Europe and Asia.
Many companies are working on similar tests including Sequenom, a San Diego biotech that already sells one for prenatal screening, using fetal DNA in maternal blood. Many companies tried prenatal screening with fetal cells but it didn’t work, said chief science officer Dirk van den Boom. “Cell-free DNA really was the breakthrough” that enabled wide use, and the same could happen with these cancer tests, he said.
THE COST
Whether liquid biopsies will be cost-effective is unknown. Guardant’s test costs $5,400; some insurers cover it for certain types of patients. Gene profiling from a tissue biopsy costs about the same. The promise of liquid biopsies is that they can be done periodically to monitor care, but more tests means more cost.
They may save other costs, though. A traditional lung biopsy is thousands of dollars. Money could be saved by skipping cancer drugs that ultimately don’t work; many cost $10,000 to $15,000 a month.
With cell-free DNA tests, even doctors in rural areas can offer precision medicine because they can ship a blood sample to a lab. “We think that’s the future,” said Dr. Charles Baum, a former Pfizer cancer drug chief who now heads Mirati Therapeutics, a San Diego biotech company developing gene-targeting drugs
DO THEY WORK?
Many studies suggest that liquid biopsy results largely mirror those from tissue ones, and sometimes find more mutations. A study Kopetz presented in April at an American Association for Cancer Research meeting found the blood tests detected cancer mutations in the vast majority of 105 colorectal cancer patients. For 37 percent of them, doctors thought a drug could target a mutation that was found.
Still, no big studies show that liquid biopsies give better care or extend lives. Without that proof, how much they will be used by doctors and covered by insurers remains to be seen.
THE FUTURE
A San Diego company, Trovagene, is working on an even faster, easier liquid biopsy — a test to detect tumor DNA in urine. One scenario: a patient collects a urine sample every day for a week after starting a new drug and ships them to a lab.
“In as little as three to five days, you can observe dramatic changes” that suggest a response to treatment, said Trovagene’s chief executive, Antonius Schuh.
Work on this test is still very early.
Ultimately, liquid biopsies might offer a way to screen for cancer besides the mammograms, colonoscopies and other methods used now. That raises even more questions, including when to call something “cancer” and whether it needs treatment if there are only abnormal cells in the blood.
“Why does there have to be a tumor? The tumor is the symptom. The disease is the DNA,” Schuh said.
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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP
Copyright 2015 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Advice
BOOK REVIEW: Let Me Be Real With You
At first look, this book might seem like just any other self-help offering. It’s inspirational for casual reader and business reader, both, just like most books in this genre. Dig a little deeper, though, and you’ll spot what makes “Let Me Be Real With You” stand out.
By Terri Schlichenmeyer
Author: Arshay Cooper, Copyright: c.2025, Publisher: HarperOne, SRP: $26.00, Page Count: 40 Pages
The hole you’re in is a deep one.
You can see the clouds above, and they look like a storm; you sense the wind, and it’s cold. It’s dark down there, and lonesome, too. You feel like you were born there — but how do you get out of the deep hole you’re in? You read the new book “Let Me Be Real With You” by Arshay Cooper. You find a hand-up and bring someone with you.
In the months after his first book was published, Cooper received a lot of requests to speak to youth about his life growing up on the West Side of Chicago, his struggles, and his many accomplishments. He was poor, bullied, and belittled, but he knew that if he could escape those things, he would succeed. He focused on doing what was best, and right. He looked for mentors and strove to understand when opportunities presented themselves.
Still, his early life left him with trauma. Here, he shows how it’s overcome-able.
We must always have hope, Cooper says, but hope is “merely the catalyst for action. The hope we receive must transform into the hope we give.”
Learn to tell your own story, as honestly as you know it. Be open to suggestions, and don’t dismiss them without great thought. Know that masculinity doesn’t equal stoicism; we are hard-wired to need other people, and sharing “pain and relatability can dissipate shame and foster empathy in powerful ways.”
Remember that trauma is intergenerational, and it can be passed down from parent to child. Let your mentors see your potential. Get therapy, if you need it; there’s no shame in it, and it will help, if you learn to trust it. Enjoy the outdoors when you can. Learn self-control. Give back to your community. Respect your financial wellness. Embrace your intelligence. Pick your friends and relationships wisely. “Do it afraid.”
And finally, remember that “You were born to soar to great heights and rule the sky.”
You just needed someone to tell you that.
At first look, this book might seem like just any other self-help offering. It’s inspirational for casual reader and business reader, both, just like most books in this genre. Dig a little deeper, though, and you’ll spot what makes “Let Me Be Real With You” stand out.
With a willingness to discuss the struggles he tackled in the past, Cooper writes with a solidly honest voice that’s exceptionally believable, and not one bit dramatic. You won’t find unnecessarily embellished stories or tall tales here, either; Cooper instead uses his real experiences to help readers understand that there are few things that are truly insurmountable. He then explains how one’s past can shape one’s future, and how today’s actions can change the future of the world.
“Let Me Be Real With You” is full of motivation, and instruction that’s do-able for adults and teens. If you need that, or if you’ve vowed to do better this coming year, it might help make you whole.
Advice
Support Your Child’s Mental Health: Medi-Cal Covers Therapy, Medication, and More
Advertorial
When children struggle emotionally, it can affect every part of their lives — at home, in school, with friends, and even their physical health. In many Black families, we’re taught to be strong and push through. But our kids don’t have to struggle alone. Medi-Cal provides mental health care for children and youth, with no referral or diagnosis required.
Through California Advancing and Innovating Medi-Cal (CalAIM), the state is transforming how care is delivered. Services are now easier to access and better connected across mental health, physical health, and family support systems. CalAIM brings care into schools, homes, and communities, removing barriers and helping children get support early, before challenges escalate.
Help is Available, and it’s Covered
Under Medi-Cal, every child and teen under age 19 has the right to mental health care. This includes screenings, therapy, medication support, crisis stabilization, and help coordinating services. Parents, caregivers, and children age 12 or older can request a screening at any time, with no diagnosis or referral required.
Medi-Cal’s Mental Health and Substance Use Disorder Program
For children and youth with more serious mental health needs, including those in foster care or involved in the justice system, Medi-Cal offers expanded support, including:
- Family-centered and community-based therapy to address trauma, behavior challenges, or system involvement.
- Wraparound care teams that help keep children safely at home or with relatives.
- Activity funds that support healing through sports, art, music, and therapeutic camps.
- Initial joint behavioral health visits, where a mental health provider and child welfare worker meet with the family early in a case.
- Child welfare liaisons in Medi-Cal health plans who help caregivers and social workers get services for children faster
Keeping Kids Safe from Opioids and Harmful Drugs
DHCS is also working to keep young people safe as California faces rising risks from opioids and counterfeit pills. Programs like Elevate Youth California and Friday Night Live give teens mentorship, leadership opportunities, and positive outlets that strengthen mental well-being.
Through the California Youth Opioid Response, families can learn how to avoid dangerous substances and get treatment when needed. Song for Charlie provides parents and teens with facts and tools to talk honestly about mental health and counterfeit pills.
DHCS also supports groups like Young People in Recovery, which helps youth build skills for long-term healing, and the Youth Peer Mentor Program, which trains teens with lived experience to support others. These efforts are part of California’s strategy to protect young people, prevent overdoses, and help them make healthier choices.
Support for Parents and Caregivers
Children thrive when their caregivers are supported. Through CalAIM’s vision of whole-person care, Medi-Cal now covers dyadic services, visits where a child and caregiver meet together with a provider to strengthen bonding, manage stress, and address behavior challenges.
These visits may include screening the caregiver for depression or anxiety and connecting them to food, housing, or other health-related social needs, aligning with CalAIM’s Community Supports framework. Notably, only the child must be enrolled in Medi-Cal to receive dyadic care.
Family therapy is also covered and can take place in clinics, schools, homes, or via telehealth, reflecting CalAIM’s commitment to flexible, community-based care delivery.
Additionally, BrightLife Kids offers free tools, resources, and virtual coaching for caregivers and children ages 0–12. Families can sign up online or through the BrightLife Kids app. No insurance, diagnosis, or referral is required.
For teens and young adults ages 13–25, California offers Soluna, a free mental health app where young people can chat with coaches, learn coping skills, journal, or join supportive community circles. Soluna is free, confidential, available in app stores, and does not require insurance.
CalHOPE also provides free emotional support to all Californians through a 24/7 support line at (833) 317-HOPE (4673), online chat, and culturally responsive resources.
Support at School — Where Kids Already Are
Schools are often the first place where emotional stress is noticed. Through the Children and Youth Behavioral Health Initiative (CYBHI), public schools, community colleges, and universities can offer therapy, counseling, crisis support, and referrals at no cost to families.
Services are available during school breaks and delivered on campus, by phone or video, or at community sites. There are no copayments, deductibles, or bills.
Medi-Cal Still Covers Everyday Care
Medi-Cal continues to cover everyday mental health care, including therapy for stress, anxiety, depression, or trauma; medication support; crisis stabilization; hospital care when needed; and referrals to community programs through county mental health plans and Medi-Cal health plans.
How to Get Help
- Talk to your child’s teacher, school counselor, or doctor.
- In Alameda County call 510-272-3663 or the toll-free number 1-800-698-1118 and in San Francisco call 855-355-5757 to contact your county mental health plan to request an assessment or services.
- If your child is not enrolled in Medi-Cal, you can apply at com or my.medi-cal.ca.gov.
- In a mental health emergency, call or text 988, the Suicide and Crisis Lifeline.
Every child deserves to grow up healthy and supported. Medi-Cal is working to transform care so it’s accessible, equitable, and responsive to the needs of every family.
Activism
ESSAY: The Hidden Toll — Federal Rollbacks Threaten Black Women’s Health in California
Nutrition assistance programs, which many Black women rely on to keep their families healthy and out of the hospital, are similarly endangered. Nearly half of Black women in California receive WIC, and 47% percent use CalFresh. Cuts or cost-shifts in those programs would worsen food insecurity, especially during pregnancy and postpartum. Malnutrition or diet instability can lead to adverse birth outcomes, weakened immunity, and worse recovery from medical interventions.
By Kellie Todd Griffin, Special to California Black Media Partners
If recent proposals in Congress to cut funding for federal social programs succeed, the downstream effects will not be abstract or distant.
They will be immediate and blunt — and felt in every clinic, every hospital, and most homes where Black women are struggling to maintain our health, care for her children, and stay afloat. In California, where Black women already navigate a terrain of deep systemic inequities, these cuts would be catastrophic.
As a lifelong advocate for Black women in California — through my research and lived experience – I’ve seen firsthand the entrenched medical and social disparities that leave too many Black women struggling to live healthy, fulfilling lives.
Across the spectrum of care — from mental, maternal, and perinatal health to chronic diseases like diabetes, hypertension, cancer, and uterine fibroids — Black women in California continue to bear a disproportionate burden.
Implicit bias in maternity care, for example, continues to be a challenge. It is a documented contributor to the fact that, in California, Black women die from pregnancy-related causes at three to four times the rate of White women.
Now, federal proposals on the table to slash funding for the very programs Black women rely on most: Medicaid (Medi-Cal in California) SNAP/CalFresh, WIC, and federal housing and income supports. As reported in the California Budget and Policy Equity on the Line report, about one in three Black women and children in California currently depend on Medi-Cal. If federal cuts were to force reductions in eligibility, benefits, or provider reimbursements, many Black women would lose access to primary care, chronic disease management, reproductive care, mental health and substance-use treatment, cancer screenings, and prenatal/postnatal services.
In a state already grappling with stark racial health disparities, removing coverage is not just harmful — it magnifies injustice. Black women in California face higher rates of poor health overall, lower life expectancy, and worse prenatal care statistics. When the safety net frays, they will be forced into impossible trade-offs: skip medications, delay care, or incur medical debt.
Nutrition assistance programs, which many Black women rely on to keep their families healthy and out of the hospital, are similarly endangered. Nearly half of Black women in California receive WIC, and 47% percent use CalFresh. Cuts or cost-shifts in those programs would worsen food insecurity, especially during pregnancy and postpartum. Malnutrition or diet instability can lead to adverse birth outcomes, weakened immunity, and worse recovery from medical interventions.
Compounding the harm is the assault on social determinants of health. The Equity on the Line analysis shows that housing assistance, income support, and childcare subsidies are already stretched thin. Any rollback will accelerate housing instability, homelessness risk, and family stress — all of which manifest in worse health outcomes: higher hypertension, depression, chronic illness, and reduced ability to adhere to medical regimens.
California has taken important steps to protect Black women’s health. One good example is Assembly Bill, AB 2319, authored by Assemblymember Lori D. Wilson (D-Suisun City). That law strengthens the Dignity in Pregnancy and Childbirth Act by expanding and enforcing implicit bias training for providers in perinatal settings, and requiring reporting and penalties for noncompliance.
The state is also taking legal and policy action to mitigate the impact of cuts to SNAP/CalFresh food stamp benefits – like mobilizing $80 million in state funds to support food banks. It is also taking action to shore up against federal cuts to Medi-Cal.
In our communities, organizations like California Black Women’s Health Project and Black Women for Wellness are already doing the groundwork — advocating for culturally centered care, education, and infrastructure to mitigate harm.
As Californians, we must all roll up our sleeves and amplify and bolster their efforts. These organizations serve as our voice. They are our watchdogs, too, documenting where bias persists, where systems fail, and where state enforcement is weak.
The stakes are too high for complacency. As we strategize to keep Black women healthy, we must also document and share our stories with others — every death, every untreated illness, every delayed pregnancy.
Let us be resolute, organized, hopeful, and persistent. California can be a model of how a state defends Black women’s health amid significant challenges, presenting a full vision to America, and the world, of how we can make health justice a reality and make California healthier for all our communities.
About the Author
Kellie Todd Griffin, President and CEO of the California Black Women’s Collective Empowerment Institute. With a deep commitment to equity and justice, she champions initiatives that amplify the voices and influence of Black women across California. Known for her strategic insight and passion for community empowerment, Kellie is a driving force in fostering systemic change and collective progress.
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