Chemotherapy has become synonymous with the word cancer.

“The best way I can explain it is, as if you have swallowed a hand grenade, and now it’s going to explode inside out. But then it doesn’t. Chemotherapy is simply just awful,” said Dr. Leela Ghaffari as she recounted her recent treatment journey.

It’s brutal, but often necessary. When used alongside other therapies, it has provided a growing number of cancer patients longer, recurrence-free survival.

“If you want to live, you don’t have a choice, right?” Ghaffari said. “You know, you don’t have a choice.”

Ghaffari was diagnosed with breast cancer for the second time last November. She went through 16 sessions of chemotherapy in order for doctors to shrink and then safely remove her clementine-sized tumor.

After she completed radiation sessions, her treatment would typically be considered done.

“They always ask, ‘What now? Are you sure? What can you do? What can you do to be sure?'” said Dr. Massimo Cristofanilli, director of breast medical oncology at NewYork-Presbyterian/Weill Cornell Medicine.

Cristofanilli said the lingering doubts are proof of the need for better monitoring tools for cancer patients, who, like Ghaffari, have just completed harrowing treatment journeys.

“In the past, there was no standard of monitoring this. Women have done the treatment, come for their clinical follow-up, and there is no imaging,” Cristofanilli said.

Traditionally, an imaging scan is ordered three months after the main treatment course ends. Now, due to work done in part by Cristofanilli, there’s a new way to monitor if a cancer returns, sooner.

It is called a liquid biopsy, performed from a simple blood draw. The sample is put in a machine that searches for traces of cancer cells. The latest technology can locate the DNA of those tumors. The more cells detected, the more advanced the disease.

“If a tumor is active somewhere in your body and it is shedding DNA, we can capture it,” said Dr. Nancy Chan, director of breast cancer clinical research at NYU Langone Health. There, doctors have been using liquid biopsies in clinical trials aimed at finding more targeted and less invasive treatments for patients.

“The test is available. We have to figure out what’s the best way to utilize it, to benefit breast cancer,” Chan said.

So far, studies show liquid biopsies can accurately identify lung cancers and recurrences of breast cancer.

“I can’t tell you how tragic it is, because you think that you’re done,” Ghaffari said. “And now all of the sudden you realize we are not done, you know, And it wouldn’t have been detected if I didn’t have the blood test.”

Which may be the silver lining of news of a cancer recurrence. A PET scan confirmed what the liquid biopsy detected: Ghaffari had a small, slow-growing tumor.

“I think it’s less than 1 centimeter. It’s very small. If we can catch it at that level, imagine how quickly they can intervene and stop it,” Ghaffari said.

With new targeted precision therapies, many with late stage cancers are surviving for years after treatment, and many early stage cancers are considered cured.

“Of course we do more frequent imaging for metastatic disease, but also, this blood test allows us to intervene even earlier than we used to do in the past,” Cristofanilli said. “So altogether, new drugs, ability to implement the right drug has definitely increased our ability to keep women not only alive but also functional, without having to do a very difficult, and of course toxic, treatment.”  

Now, Cristofanilli and his team are trying to answer the question: Can the liquid biopsy test be used to catch breast cancer cases earlier, the first time around? Weill Cornell is currently recruiting women with no history of breast cancer, to get liquid biopsies alongside their annual mammograms.

“Once we know and we can trust that it’s not a false positive, just a positive before the imaging, then we can design an intervention, so it’s very exciting for the future,” Cristofanilli said.

He said the hope is that the liquid biopsy will become for breast and other cancers what the A-1-C test is for diabetes.

“We can certainly say the majority of the cases would be stage one or even less, undetectable, that need to be prevented. So this is called cancer interception,” he said. 

“That’s really our goal. And also, more importantly, improve quality of life. So we are able to control the disease for longer. They’re able to stay on these drugs for longer without as much toxicity from standard chemotherapy,” Chan said.

For Ghaffari, early detection means no additional chemo. Still, the drugs targeting her new tumor come with their own uncomfortable side effects. She is working with Cristofanilli to adjust the dosing.

Ghaffari said she continues to fight through it all because she plans to go back to practicing dentistry, and hopes to celebrate her son’s upcoming marriage in style.

“I hope my body’s back to normal. My hair is back to normal. You know, it’s coming back,” Ghaffari said. “I want to have quality of life. And this type of test definitely is helpful so people can have quality of life, if they catch it early, you know, or in my case, adjusting the medication to make it livable.”

Spectrum News NY1 and News 12 are collaborating on a program for Breast Cancer Awareness Month that will air at 9 p.m. Monday, Oct. 30. The special will highlight cutting-edge research taking place in the Tri-State area as well as underscore the importance of breast cancer prevention and detection.