Today, the majority of cancers are diagnosed too late, when outcomes are poor. 71% of cancer deaths are caused by cancer not commonly screened for. We’re excited to share that we now offer a revolutionary multi-cancer early detection test for our patients.

It’s called the Galleri™ Multi-Cancer Early-Detection Test and it can detect more than 50 types of cancer by looking for signals in the blood that may be associated with cancer. If caught in its early stages, cancer treatment outcomes and survival rates may be improved.

A few benefits of the test:

• It detects many cancers that are not commonly screened for today, so you can get treated earlier.
• It can be incorporated into a routine visit through a simple blood draw.
• If a cancer signal is found, the results point to where in the body the cancer is coming from to help us guide your next steps.

Cost of the test: $949

• This amounts to about $18 per cancer being checked
• Interest-free payment plans available up to 6 months

The Galleri™ test is recommended for use in adults with an elevated risk for cancer, such as those aged 50 or older. It is intended to be used in addition to, and not replace, other cancer screening tests. To learn more about the test by watching this short explainer video. Please visit this page to review important safety information.

This test is done with a simple blood draw. Contact our office today and find out if the Galleri™ test may be right for you.

The news about COVID-19 has been mostly positive in the U.S. over recent months, and fortunately, the situation continues to look reassuring for individuals who are vaccinated. Unfortunately, the same cannot be said for those who are not vaccinated, largely because of the Delta variant.

The vaccines continue to work well against every variant, and the number of vaccinated Americans continues to rise. However, the U.S. still faces two problems. First, the pace of vaccinations has slowed down, and a considerable amount of Americans – close to one third – remain hesitant about getting the vaccine. These unvaccinated individuals will remain vulnerable to COVID outbreaks and to serious symptoms, or even death. Second, the Delta variant is spreading rapidly in the U.S. It now accounts for about 10 percent of cases, according to Dr. Scott Gottlieb, a former F.D.A. commissioner. The Delta variant is by far the most contagious variant of this virus and it is also more severe. In countries with more rapid, widespread testing, it has been found that patients are becoming sicker and their conditions are worsening much more quickly.  Together, these two factors help explain why new cases are no longer falling.

Experts are concerned that cases will eventually start to rise again as Delta becomes the dominant form of the virus. They are expecting to see surges this fall, including many hospitalizations and even deaths, in low-vaccine populations due to the combination of seasonality, the adverse effects of Delta, and the “back-to-normal” behavior.

There is one big piece of encouraging news: The vaccines continue to work extremely well against the variants, based on current evidence. The data suggests that fully vaccinated individuals remain protected from the variants. The vaccines vastly reduce the number of COVID cases of any kind and virtually eliminate death. This is demonstrated in Britain, where the Delta variant has spread widely and become dominant, and where the vaccination rate is high, there are still no signs of increase in deaths (Dr. Eric Tropol of the Scripps Research Translational Institute).

Nothing is more important than vaccination. COVID-19 vaccines are safe and effective. Studies show that the vaccines are effective at keeping individuals from getting COVID-19. Getting vaccinated will also help keep one from getting seriously ill even if they do get COVID-19. Vaccination is an important tool to bring everyone closer to enjoying the activities that have been missed. For more information regarding the COVID-19 vaccine, please visit the CDC website. For more information on where to get vaccinated, contact your local pharmacy or visit your local health department’s website. In Travis County, a mobile vaccine program has been implemented for homebound patients. Homebound patients seeking the COVID-19 vaccine can contact Austin Public Health to request a home visit. To do so, please call 3-1-1 or (512) 974-2000 and provide your name and return phone number. For key information regarding COVID-19, please refer to our website.

Following the Travis County Medical Society Town Hall Meeting, we would like to take this time to provide an update regarding the COVID-19 vaccine.

Two COVID-19 vaccines are expected to arrive in Texas around December 17-18, by two different manufacturers, Moderna and Pfizer/BioNTech. Both vaccines are similar in their active ingredient, messenger RNA, to allow the body to develop antibodies against the COVID-19 spike protein.

Key Assumptions for COVID-19 Vaccine:

• Limited doses may be available by mid December 2020, but supply will increase substantially in 2021
• Initial supply will either be approved as a licensed vaccine or authorized for use under an Emergency Use Authorization issued by the FDA
• Two doses, separated by 21 or 28 days, will be needed for immunity for most COVID-19 vaccines
• Risk of side effects are low and are similar to those of the influenza vaccine, such as local redness, swelling, soreness, and mild flu-like symptoms

The COVID-19 vaccine timeline will follow 4 phases based on the activities allowed by availability of supplies:

• Phase 1 (November-December 2020)
  • Limited doses
  • Priority groups based on CDC guidance when sufficient vaccine is made available: critical infrastructure workers, individuals who are at high risk for severe COVID disease, individuals who are at high risk for acquiring or transmitting COVID, people with limited access to vaccines (see below for CDC Critical Populations for COVID-19)

• Phase 2 (January-July 2021)
  • Number of doses available increases (~660M nationwide)
  • Our practice will likely fall in this phase, and we can expect to have the vaccines available in our office sometime in early 2021
• Phase 3 and Phase 4
  • Likely excess supply
  • Outreach to hard-to-reach populations
  • Plan for potential seasonal vaccine

We will email our patients when our practice is able to administer the COVID-19 vaccine. Please visit our blog and check your emails regularly for ongoing updates regarding the COVID-19 vaccine.

As the number of COVID-19 cases continues to rise in the U.S., the number of serology (antibody) tests aimed at identifying those with prior exposure to COVID-19 have made their way into the market. These tests are regulated by the U.S. Food and Drug Administration (FDA), which requires all commercially marketed serological tests to apply for and receive an Emergency Use Authorization (EUA) in order to market these tests to the public. The FDA also provides recommended performance standards that these tests should meet. As of June 17, approximately 18 commercial serological tests have been granted EUAs, while over 120 tests are currently on the market.

Serology tests have several limitations that make correct interpretation of the results critical. There is still so much unknown about immune status for the novel virus. Limitations to be aware of include:

• False positive results: Serological testing for disease with a low prevalence in the population (such as the case in the U.S. and Travis county) present inherent challenges with interpretation of positive results. Even high performing tests with high sensitivity and specificity will return false positive results when disease prevalence is low, as is currently the case with COVID-19. Let’s take for example, a community of 100 individuals with a disease prevalence of 5%. If a test with a specificity of 95% was used in this population, it would be expected to return 5% false positives, so 5 out of the population of 100. 5 true positives would also be expected, as the disease prevalence is 5%. Overall, this test would return 10 positive results. However, only half of those results would be accurate, which shows the inherent limitation of these tests in low disease prevalence states. Once the disease prevalence is higher, the concern about false positives becomes somewhat mitigated, however, this is not the current reality with COVID-19.
• Cross-reactivity: Cross-reactivity occurs when a test for antibodies for SARS-CoV-2 identifies not only antibodies for this virus, but also for other coronaviruses, such as those that cause the common cold. For tests where cross-reactivity is possible, antibodies for other coronaviruses may result in a positive result even when the patient was not infected with COVID-19.
• Immune status: Given that COVID-19 is a novel virus, there is much that we don’t know about what, if any, immunity it may confer to those exposed and recovered from the infection. According to the FDA and the CDC, there is currently no available evidence showing immunity to COVID-19 after infection. While individuals typically develop some type of immune response after exposure to most viruses, it is not yet clear when an immune response develops after COVID-19 infection, how strong this immune response may be, and how long the immune response may last.

Recommendations from the Centers for Disease Control and Prevention (CDC) and the American Medical Association (AMA):

• Serology tests should not be used as the sole basis of diagnosis of COVID-19 infection.
• Use of serology tests should currently be limited to population-level seroprevalence study, evaluation of recovered individuals for convalescent plasma donations, and in other situations where they are used as part of a well-defined testing plan and in concert with other clinical information by physicians well-versed in interpretation of serology test results.
• Serology tests should not be offered to individuals as a method of determining immune status. Individuals receiving positive test results may falsely assume it is safe to discontinue physical distancing. The AMA and CDC recommend all individuals to continue to abide by physical distancing recommendations, and face covering and shelter in place requirements.
• Serology tests should not currently be used as the basis for any “immune certificates.”
• Serology tests should not be used to inform decisions to return to work, or to otherwise inform physical distancing decisions. Doing so may put individuals, their household and their community at risk.
• Serology tests should not be used to make decisions about grouping persons residing in or being admitted to congregate settings, such as school, dormitories, or correctional facilities.

Currently, the prevalence in Travis County is less than 1%. Because of this low prevalence, the serology antibody test will yield a high percentage of false positives. At this time, we are not recommending routine serology testing. These tests may play an important role in determining the overall prevalence of COVID-19 in the U.S. population, and may also be important in determining the prevalence of asymptomatic infections. While these tests will undoubtedly play an important role in population-level studies going forward, they are not without limitation and we must be well-versed in these limitations in our current environment and have a strong understanding of both the test and the potential results.