Mar 13, 2025

In this episode, Dr. JYP welcomes medical oncologist and hematologist Dr. Daisy Escobar to discuss her background and her expertise in cancer diagnosis and treatment. Dr. Escobar shares her journey to the Mitchell Cancer Institute and talks about her family. The conversation focuses on cell-free DNA technology, also known as liquid biopsy, which is used primarily for cancer surveillance and monitoring. Dr. Escobar explains the benefits and limitations of this technology, including how it compares with traditional biopsies and its potential in early cancer detection. The conversation also covers the emotional aspects of cancer surveillance and the importance of patient autonomy in treatment decisions. Dr. Escobar emphasizes the importance of continual research and advancements in cancer diagnostics to improve patient outcomes.

3 Key Listener Takeaways

1. Introduction and implementation of liquid biopsy: Dr. Daisy Escobar explains that liquid biopsy, or cell-free DNA (cfDNA) technology, involves a simple blood draw used primarily to monitor treatment response and detect relapse or recurrence in cancer patients. Unlike traditional biopsies that require tissue samples, liquid biopsy offers a less invasive alternative for surveillance. The ease of monitoring is particularly beneficial for cancer patients who are frequently undergoing lab tests for other reasons. Dr. Escobar details the conditional nature of liquid biopsy’s current use, emphasizing its role in patient monitoring rather than initial cancer diagnosis.

2. Challenges and limitations: Despite its advantages, liquid biopsy is not without its challenges. Dr. Escobar mentions the necessity of comparing ctDNA with DNA from a previous biopsy. Additionally, certain conditions, such as a previous bone marrow transplant, may limit ctDNA effectiveness. Another significant challenge is the potential for emotional impact on patients due to "watchful worrying," knowing that while their markers may be rising, visible signs of cancer may not immediately appear on scans.

3. Potential and future of liquid biopsy: Dr. Escobar discusses the hopeful future of cfDNA technology, particularly for the early detection of ovarian and pancreatic cancers, which currently lack effective screening methods. Advancements in identifying specific ctDNA signatures for various cancers could revolutionize early detection and management, reducing the necessity for more invasive procedures. However, she underscores that while promising, the science has yet to fully catch up to the technology, and ongoing research is crucial.