Sapna Syngal, MD, MPH
Dana-Farber Cancer Institute is launching a first-of-its-kind, integrated clinic to increase early detection of precancerous conditions and to prevent cancer from arising in individuals at increased risk for the disease. The new Centers for Early Detection and Interception at Dana-Farber bring together clinicians and researchers across many cancer types with a shared focus on precursor and hereditary conditions that can be early indicators of blood cancers and solid tumors. The Centers for Early Detection will focus on developing novel technologies and methods for earlier cancer detection, as well as innovative ways to proactively intervene before a cancer fully develops or progresses.
Many factors may influence an individual’s likelihood of developing cancer in their lifetime. Genetic conditions, such as Lynch or Li-Fraumeni Syndrome, greatly elevate the risk of a variety of cancers. Precursor conditions, such as smoldering myeloma, clonal hematopoiesis, or Barrett’s esophagus, all could represent early phases of diseases that may develop into cancers. Genetics and family history can significantly increase an individual’s risk of cancer. As many as 10% of Americans over 50 may have a precancerous condition that greatly increases their risk of the disease.
Irene Ghobrial, MD
For patients diagnosed with cancer precursor or inherited conditions, teams at the new Centers for Early Detection will define their risk of developing cancer and discuss with patients their personal risk of progression to active cancer and provide treatment options to prevent progression, using state-of-the-art technologies. Starting with an initial diagnostic evaluation, patients will receive a personalized plan for monitoring and interventions.
"The Centers for Early Detection and Interception represents a fundamental shift in how we think about and address cancer, from reactive to proactive," said Sapna Syngal, MD, MPH, Co-Director of the new Centers. "Most cancers are diagnosed when a patient already has symptoms, often when the cancer is already advanced, which can result in higher mortality. We are able to offer patients proven surveillance and prevention measures that can be implemented to stop cancer arising in individuals at increased risk or to find cancer in its earliest forms when the disease can be treated most effectively."
Patients at the Centers for Early Detection and Interception are cared for by a multidisciplinary team that harnesses Dana-Farber's leadership and expertise in screening, risk assessment, and prevention and interception. This includes hematologist-oncologists who specialize in specific precursor conditions, as well as specialists in genetic risk and prevention, genetic counseling, social support, and more.
Betsy O’Donnell, MD
Depending on the patient's risk factors for developing cancer, they may be seen by a combination of experts at the Centers for Early Detection and Interception specialty programs. Experts at the Center are also developing multiple modalities of early prevention including lifestyle modifications and interception methods, such as vaccines, immunotherapy, and early precision medicine, to stop cancer before it is symptomatic.
"When we detect cancer early, we have a far greater chance of successfully treating and curing that cancer," said Irene Ghobrial, MD, Co-Director of the new Center. "We want to transform cancer care and reach millions of at-risk people, changing their lives through improved screening, early detection, and intercepting disease before it develops or advances."
The Centers for Early Detection will also be home to a new clinic dedicated to multi-cancer early detection (MCED) tests. MCED tests are an emerging technology that can screen for numerous types of cancers, including breast, cervical, colorectal, and prostate cancers, from a simple blood test.
If an MCED test shows that cancer is present, patients will be referred to one of Dana-Farber's specialized treatment centers led by experts in their specific cancer type. And if cancer is not present, individuals will receive a custom follow-up plan, including ongoing screening and opportunities to participate in clinical trials.
"MCED tests can be an incredibly powerful tool in early detection of cancer but results from these screening tools require expert evaluation," said Betsy O’Donnell, MD, Director of Early Detection and Prevention of Malignant Conditions. "We're here to help patients better understand their test results and determine a plan for reducing their risk of progressing to cancer. We work with patients to conduct an initial diagnostic evaluation and develop personalized plans for monitoring and interventions as needed."
Patients accessing the Centers for Early Detection and Interception will also have the opportunity to participate in biobanking studies and clinical trials. Clinical studies and trials will include evaluation of new multi-cancer detection tests as well as immunoprevention studies, such as vaccines. Discoveries made through Centers for Early Detection and Interception will also be shared by Dana-Farber with medical colleagues around the world so that people everywhere can benefit from them.