Episode 45: Your Blood Shows Cancer Is Back 8 Months Before a Scan Does.

The technology exists. The blood draw is simple. So why won't most oncologists order it?Amy Delson has been treated for cancer four times. She's currently in active treatment. She's also a longtime breast cancer patient advocate — she reviews research grants for the Department of Defense, sits on lab teams asking researchers to do fewer biopsies on patients, and edits the informed-consent forms patients sign before clinical trials.She can't have mammograms anymore. So she fought to get a circulating tumor DNA test — ctDNA — through a researcher she works with, because her own community oncologist wouldn't order one. She talks about that fight in this episode, and about the bigger argument behind it: most oncologists are deciding for patients whether patients can handle the test results. Amy thinks that decision belongs to the patient.The science is moving fast. In 2025, the SERENA-6 trial — published in the New England Journal of Medicine — showed that switching therapy based on a ctDNA signal, before any scan showed progression, nearly doubled progression-free survival in HR-positive HER2-negative metastatic breast cancer. The "we don't have clinical utility yet" objection just got harder to hold.The test isn't perfect. It can detect DNA from cancer your immune system has already cleared. Amy is direct about that. The argument isn't that ctDNA is a crystal ball. The argument is that patients deserve to know what's available, what it can show, what it can't, and to decide for themselves.About Amy Delson Four-time cancer survivor. Breast cancer patient advocate. Reviews research grants for the Department of Defense. Works with I-SPY, the Translational Breast Cancer Research Consortium, and Komen.Recorded at RiseUp 2026.Subscribe for stories, science, and strategies from people kicking cancer's ass. New episodes weekly.Learn more about scalp cooling from episode sponsor - www.coldcap.comLearn more about UCSF RiseUp at https://riseup.ucsf.edu/ Listen to more episodes: Apple Spotify YouTubeWebsite