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New Blood Tests, Liquid Biopsies, May Transform Cancer Care

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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)

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.

___

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.

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Activism

Diabetes in Black California: Turning the Tide from Crisis to Control

According to the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System data, nearly 17.9% of Black adults in California have been diagnosed with diabetes — above the national Black adult average of 16.8%, and nearly five points higher than California’s overall adult rate of 12.6% across all races. California ranks 24th out of 39 states with available data for Black adult diabetes rates.

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Dr. Khadijah Lang is a family physician with a clinic in Los Angeles who specializes in several family medical practices, including prenatal care. Lang believes in family medicine. She says it is important to treat all members of a family. Thursday, June 5, 2026. Photo by Solomon O. Smith/California Black Media.
Dr. Khadijah Lang is a family physician with a clinic in Los Angeles who specializes in several family medical practices, including prenatal care. Lang believes in family medicine. She says it is important to treat all members of a family. Thursday, June 5, 2026. Photo by Solomon O. Smith/California Black Media.

By Charlene Muhammad, California Black Media

Crystal Lambert knew something was terribly wrong with her three-year-old granddaughter as she sped down the street trying to get her to the hospital.

“I thought she got a hold of some poison,” Lambert recalled.

Doctors found Lambert’s granddaughter had a blood sugar level over 800, diagnosing her with Diabetic Ketoacidosis(DKA), a state in which the body, starved of insulin, begins to shut down.

Lambert said she was born with a pancreas that was not fully functioning — it lacked the specialized cells required to produce insulin.

Her granddaughter survived and is five years old today.  Now, she gives herself insulin shots, asks endless questions about her condition, and runs like the spirited child she is. But the terror of that night transformed Lambert — and ultimately inspired her to launch the We Fight Back Organization, a mobile health and food access initiative serving underserved communities across California. Lambert is the executive director.

The Crisis by the Numbers

According to the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System data, nearly 17.9% of Black adults in California have been diagnosed with diabetes — above the national Black adult average of 16.8%, and nearly five points higher than California’s overall adult rate of 12.6% across all races. California ranks 24th out of 39 states with available data for Black adult diabetes rates.

Nationally, according to the U.S. Department of Health and Human Services, Black Americans were 24% more likely than the overall U.S. population to have diabetes in 2024. They also died from diabetes 78% more often than the general population in 2022. Black Americans are also more than twice as likely as the overall population to develop kidney failure caused by diabetes.

According to the California Health Care Foundation’s 2024 Health Disparities Almanac, Black Californians have the shortest life expectancy in the state at just 74.6 years — due in part to chronic conditions like diabetes and its devastating complications.

Leon Rock, co-founder of the African American Diabetes Association, believes statistics, though revealing, only tell part of the story.

“There are a whole bunch of Black folks that don’t tell you that they have diabetes — or don’t know,” he said.

And the disease itself, Rock is careful to note, is not what kills. “They die from the complications. That’s heart attack, that’s stroke, that’s amputations of legs, of feet. Going blind. All those complications are inherent in a system that has impacted Black folks with diabetes in California and across America.”

Crystal Lambert, creator and executive director of We Fight Back. She started the organization out of a need to learn more about diabetes on behalf of her granddaughter. Now she is looking to spread the impact of her organization to the valley. Friday, June 6, 2026. Photo by Solomon O. Smith/California Black Media.

Crystal Lambert, creator and executive director of the We Fight Back Organization, started out of a need to learn more about diabetes on behalf of her granddaughter. Now she is looking to spread her organization to the valley, on Friday, June 6, 2026 Photo by Solomon O. Smith/ California Black Media

An Information Gap Fuels the Crisis

For Rock, part of the solution is diagnosis. He says the medical and public health systems are failing Black Californians by the absence of information designed for them.

“That is the bottom line. We need good information. Information that is culturally specific,” said Rock.

Telling people to eat healthy or exercise, he added, falls short when culturally specific alternatives are not provided, and when many residents of urban communities do not feel safe exercising in some neighborhoods – or outside at night.

Dr. Khadijah Lang, a family medicine physician and president of the Golden State Medical Association, agrees that the roots of the crisis run deeper than individual behavior — and blaming patients misses the point.

“We are not genetically predisposed to diabetes,” Lang said. “But the system under which we live increases the likelihood that we will develop it.” 

What the Body Needs — What Communities Are Denied

Type 2 diabetes, which accounts for 90 to 95% of all diabetes cases, according to the CDC, develops when the body can no longer use insulin effectively to regulate blood sugar. Left unmanaged, it damages nerves, kidneys, eyes, and the cardiovascular system. The hemoglobin A1C test is a blood draw that reveals how the body has processed sugar over the previous three months — not just at the moment of the test. It is the standard tool for both diagnosis and ongoing monitoring.

That distinction matters, Lang emphasized, because patients cannot manipulate three months of blood sugar history the way they might fast for a day before a single blood draw.

“The pill is not meant to undo or control a sugar level that’s being constantly stressed,” Lang said. “It’s meant to work in conjunction with a low-carbohydrate diet and exercise.” She recommended at minimum 30 minutes of physical activity five days a week — breakable into 10-minute sessions for those who need it.

Lang stressed that education must be delivered in language people recognize and can relate to. The goal is to inform them of the choices that serve their health best, she said.

But for many Black Californians, even those informed choices remain out of reach, Lambert said.

“They need access to healthy foods and medication, too” she said.

California has made some critical policy advances. The state has expanded access to the Continuous Glucose Monitor (CGM), which has transformed diabetes care for state residents. Assembly Bill 365, introduced in 2024, proposed requiring Medi-Cal to cover the costs of CGM and other related medical equipment but it failed in the State Senate. Since then, the California Department of Health Care Services (DHCS) reports that the core Medi-Cal CGM benefit now available to eligible patients was solidified through previous budget actions and pharmacy policy updates.

These measures, while meaningful, have not closed the gap for the communities most at risk, according to advocates.

Control Through Community

Health care advocates conclude that the solution must be communal, culturally grounded, and sustained — not a fad, not a celebrity moment, not a single clinic visit. For example, observed Lang, lifestyle shaped by shared values and collective accountability can move the needle where individual prescriptions have not.

Rock is building infrastructure to match the urgency, establishing local chapters of the African American Diabetes Association across the country, with California next.

“We have to do for self, period,” he said. “Health is wealth. We have to eat to live.”

And Lambert, whose granddaughter unknowingly started all of this for her, keeps showing up.

“Diabetes advocacy is about dignity, education, prevention, and hope,” she said.

Video: Diabetes Disparity Exposed in California

This article is supported by the California Health Care Foundation 

(CHCF). Visit www.chcf.org 

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Commentary

Doctors Seeing More Cases of Preventable Childhood Illnesses

OAKLAND POST — Physicians have said vaccine skepticism has expanded beyond childhood immunizations. Doctors also reported growing resistance to other preventive treatments.

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By Stacy M. Brown

Doctors across the United States say they are treating children for illnesses that routine vaccinations once made increasingly uncommon, raising concerns that years of declining immunization rates are beginning to reverse decades of public health progress.

Pediatricians have described seeing more cases of whooping cough, rotavirus infections, bacterial pneumonia and other potentially life-threatening illnesses that vaccines have long helped suppress. Some physicians reported treating conditions they had rarely encountered during their careers, while others said that growing vaccine hesitancy is changing how emergency rooms and hospitals care for children.

The reports come as measles outbreaks continue to spread across multiple states and vaccination coverage remains below federal public health targets.

Johns Hopkins University’s International Vaccine Access Center reported 2,077 confirmed measles cases nationwide as of May 29. Researchers warned that outbreaks reported across the country have raised concerns about continued transmission, additional hospitalizations and deaths, and the possible loss of the nation’s measles elimination status.

Public health experts have long viewed measles as a warning sign because of its ability to spread rapidly through communities with lower vaccination coverage. The New York Times reported that physicians increasingly fear the resurgence of measles may be followed by the return of other vaccine-preventable diseases.

Doctors say that is already happening.

Dr. Meghan Hofto, a pediatric hospitalist at the University of Alabama at Birmingham, said she has already treated roughly as many children with rotavirus this year as she saw during the previous decade. Rotavirus once caused tens of thousands of hospitalizations annually before vaccines sharply reduced its spread. None of the children she treated this year had been vaccinated.

Hofto also described caring for infants with pertussis, commonly known as whooping cough.

“It’s hard to know when they’re safe to go home,” Hofto told The Times.

The rise in whooping cough cases has been particularly striking. More than 28,000 cases were reported nationwide last year, compared with approximately 7,000 in 2023, according to figures cited by The Times. Many of the affected infants were too young to receive vaccinations themselves and relied on broader community protection to reduce their exposure.

Other doctors described similarly troubling cases.

Dr. Jessica Kirk, a pediatric hospitalist in Alabama, recently treated an unvaccinated toddler hospitalized with pneumonia caused by simultaneous infections of Haemophilus influenzae and Streptococcus pneumoniae. Vaccines exist to protect against both illnesses. The child required oxygen and antibiotics to recover.

Researchers at Johns Hopkins have been tracking vaccination trends nationwide and found continuing signs of vulnerability.

At the same time, vaccine policy has become increasingly contentious in state legislatures.

Johns Hopkins researchers reported that lawmakers across the country continue to introduce bills affecting childhood vaccination requirements, vaccine access and non-medical exemptions. Researchers also noted that state policies governing exemptions remain a significant factor in vaccination coverage and disease transmission risks.

Physicians have said vaccine skepticism has expanded beyond childhood immunizations. Doctors also reported growing resistance to other preventive treatments.

For doctors confronting the return of illnesses that vaccines once pushed to the margins of American medicine, the challenge is becoming increasingly personal.

“It just feels like you’re a tiny little boat with a giant tidal wave coming at you,” Dr. Erin Charles, a regional pediatric hospitalist at Seattle Children’s Hospital, told reporters. “And you might convince one family here and there.”

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Community

Asm. Isaac Bryan’s Environmental Reparations Bill Passes on Assembly Floor

“All this bill does is allocate resources from that repair fund and direct cash assistance to families that have had negative health impacts as a result of living next to that oil field,” said Bryan during remarks on the Assembly floor.

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Asm. Isaac Bryan (D-Ladera Heights). File photo.

By Bo Tefu, California Black Media

On May 26, the California State Assembly passed legislation to provide direct financial assistance to families harmed by pollution from a major urban oil field in South Los Angeles.

Assembly Bill (AB) 1661, introduced by Assemblymember Isaac Bryan (D-Ladera Heights), cleared the Assembly floor with a 44-10 vote after lawmakers concluded debate on the measure.

The bill would direct money from a community repair fund toward families who suffered negative health effects from living near what Bryan described as the state’s largest toxic urban oil field. The repair fund was created under legislation approved two years ago that shut down the oil field and required polluters to contribute financially to community recovery efforts.

“All this bill does is allocate resources from that repair fund and direct cash assistance to families that have had negative health impacts as a result of living next to that oil field,” said Bryan during remarks on the Assembly floor.

Bryan called the proposal “the largest environmental reparations opportunity for South LA” and told lawmakers the bill had not received opposition during the legislative process.

The legislation is part of California’s broader push to address environmental justice concerns in communities historically exposed to industrial pollution. South Los Angeles residents and environmental advocates have long raised concerns about health risks associated with oil drilling operations near homes, schools and parks.

Supporters say the measure represents a new approach to environmental accountability by ensuring that communities affected by pollution directly benefit from funds collected from responsible companies.

After debate concluded, Assembly leadership opened the roll call vote, and the measure passed with majority support from lawmakers.

AB 1661 now moves to the Senate for further review.

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