Natera Empower Hereditary Cancer Test

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testing765
Posts: 324
Joined: Tue Aug 19, 2014 9:41 am

Natera Empower Hereditary Cancer Test

Postby testing765 » Sun Nov 28, 2021 3:43 pm

Hi. I recently had a surveillance follow up colonoscopy, after having colon cancer in 2014. The gastroenterologist recommended the Natera Empower Hereditary Cancer Test. https://www.natera.com/oncology/empower ... ncer-test/ As I understand, this test does not involve the original tumor cells, it does require a current blood sample. Has anyone had this genetic test? Did you obtain any useful information from this test? Did you insurance cover the cost of this test? Thank you for sharing your experience.
male-age 44 at diagnosis
8/14-clnscopy
8/14-CT scan,no mets
9/14-left colectomy,CEA 2.2 before surgery
pT2pN2bpM0
3 cm tumor in dscnding colon
7/23 pos LNs
low grade MSI stable
10/14-start folfox
1/15-CT & PET scan and sigmdoscopy- no mets
3/15-finish folfox
9/15- clnscopy- 3 polyps removed
10/15- CT scan, NED
10/16- CT scan, NED, CEA 1.6
10/17- clnscopy- 4 polyps removed, CT scan NED, CEA 1.8
10/14 1.9; 4/15 2.8; 5/15 2.4; 9/15 2.8; 12/15 3.1; 1/16 3.0; 4/16 2.5; 7/16 2.5; 10/16 1.6; 1/17 1.9

User avatar
beach sunrise
Posts: 1034
Joined: Thu Mar 05, 2020 7:14 pm

Re: Natera Empower Hereditary Cancer Test

Postby beach sunrise » Sun Nov 28, 2021 4:40 pm

Must be a different natera test than I had done.
The one I had Natera Signatera Residual Disease Test (MRD) included tumor sample plus bloodwork.
Insurance covered it. Out of pocket cost without insurance for the one I was tested on is $948.00 I think.
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

User avatar
JJH
Posts: 408
Joined: Mon Apr 24, 2017 7:26 am

Re: Natera Empower Hereditary Cancer Test

Postby JJH » Mon Nov 29, 2021 11:29 am

testing765 wrote:Hi. I recently had a surveillance follow up colonoscopy, after having colon cancer in 2014. The gastroenterologist recommended the Natera Empower™ Heriditary Cancer Test. https://www.natera.com/oncology/empower ... ncer-test/ As I understand, this test does not involve the original tumor cells, it does require a current blood sample. Has anyone had this genetic test? Did you obtain any useful information from this test? Did you insurance cover the cost of this test? Thank you for sharing your experience.

1. Has anyone had this genetic test?

I have not had this genetic test, but I have had experience browsing this company's website a few years ago, and at the time I was disappointed because the website had quite a lot of marketing/sales documents, but I could not find any useful technical information about how their tests were actually validated. Now, after several years, I notice that their website has improved somewhat, with a number of links to various other documents, brochures, manuals, white papers, etc.

In the company's current website, there are a few links especially relevant to their Empower™ product:


2. Did you obtain any useful information from this test?

The Empower™ Gene Table by Panel document above may be of interest to you because it identifies the 53 oncogenes that are used in the mutation testing, and what illnesses they could be linked to.

In my layman's opinion, the two genes that might be of interest to you are the BRCA genes and the APC gene. The BRCA gene is usually linked to breast cancer, however it also linked to prostate cancer, but at a lower level of risk. The APC (Adenomatous Polyposis Coli) gene might be of interest to you because of your past surveillance colonoscopies that have found multiple polyps, suggesting that you might have a mild risk for polyposis.

I think it would also be important for you to ask the gastroenterologist exactly why he is suggesting that the Empower™ test might be relevant for you. What are his reasons, specifically? And what reason would he give that would be acceptable to the Insurance company?

It should also be mentioned that one of the risks of doing a test like this is that it may find a number of minor mutations that neither you nor the doctor can make much sense out of, and that may just serve to heighten your anxiety knowing that you have these unknown risk factors.

3. Did your insurance cover the cost of this test?

Apparently, for some patients the cost of the test is covered by Insurance, but in other cases the patient is confronted with a large unexpected bill at the end, much higher that what the company had estimated at the beginning.

Before you sign up for a potentially expensive test like this, I think it would be a good idea for you to read the complaints about the company that have been submitted to the Better Business Bureau -- especially the complaints that rate the company with a "1"or "2" rating. Their billing practices may give you more anxiety than what you are willing to put up with.

https://www.bbb.org/us/ca/san-carlos/profile/laboratory-research/natera-1116-537368
"The darkest hour is just before the dawn" - Thomas Fuller (1650)
●●●

testing765
Posts: 324
Joined: Tue Aug 19, 2014 9:41 am

Re: Natera Empower Hereditary Cancer Test

Postby testing765 » Mon Nov 29, 2021 1:12 pm

Hi JJH. Thank you for all of the useful information. I have been making calls to the prescribing doctor's office, to my insurance company, and to in-network labs today. Natera claims that the cost of the test is capped at $250, but I would prefer to go through an in-network lab because my insurance company says that genetic testng is covered 100 percent at in-network labs. I do remember being tested for Lynch Syndrome in 2014 or 2015 and I was negative for that. Hopefully I can get this genetic testing covered by insurance and that it will provide me with useful information.
male-age 44 at diagnosis
8/14-clnscopy
8/14-CT scan,no mets
9/14-left colectomy,CEA 2.2 before surgery
pT2pN2bpM0
3 cm tumor in dscnding colon
7/23 pos LNs
low grade MSI stable
10/14-start folfox
1/15-CT & PET scan and sigmdoscopy- no mets
3/15-finish folfox
9/15- clnscopy- 3 polyps removed
10/15- CT scan, NED
10/16- CT scan, NED, CEA 1.6
10/17- clnscopy- 4 polyps removed, CT scan NED, CEA 1.8
10/14 1.9; 4/15 2.8; 5/15 2.4; 9/15 2.8; 12/15 3.1; 1/16 3.0; 4/16 2.5; 7/16 2.5; 10/16 1.6; 1/17 1.9

Rock_Robster
Posts: 1027
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: Natera Empower Hereditary Cancer Test

Postby Rock_Robster » Mon Nov 29, 2021 10:01 pm

I had a similar test done through a public laboratory here in Australia; they ran a standard colorectal genetic panel which I believe looked at some-90+ markers. I had no known mutations or other biomarkers of concern for hereditary risk. My wife had the same thing done for colorectal and breast panels, again all normal.

The main issue with these seems to be that they can test for these genetic abnormalities, but there isn’t yet a lot of research to say what a particular change might mean (except as JJH points out for things like BRCA and APC, which can have clear clinical and screening implications). The geneticist I saw said that a potentially pathological finding could trigger increased colorectal cancer screening for family members (and pre-implantation genetic testing if we decided to have a baby via IVF), but the reality is with a stage IV diagnosis at 36, any close family is likely to be subject to increased screening anyway (particularly children). We mainly wanted to know for reproductive testing purposes, so if you weren’t planning on having any (more) kids, I’m not exactly sure what you would do with the results (although that still doesn’t mean it’s bad to have, particularly if the testing isn’t too expensive/invasive).
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19>30>140>70
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resection
NED 2 years
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
10/22 PALN SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial
12/23 Modified FOLFIRI+Bev
3/24 VAXINIA (CF33 + hNIS) trial

testing765
Posts: 324
Joined: Tue Aug 19, 2014 9:41 am

Re: Natera Empower Hereditary Cancer Test

Postby testing765 » Mon Nov 29, 2021 10:10 pm

Hi Rock Robster. Thank you for sharing your experience. Yes, it sounds like there are limitations on these types of genetic tests. So I will have to weigh the cost of the test against the useful information that I might gain from the test.
male-age 44 at diagnosis
8/14-clnscopy
8/14-CT scan,no mets
9/14-left colectomy,CEA 2.2 before surgery
pT2pN2bpM0
3 cm tumor in dscnding colon
7/23 pos LNs
low grade MSI stable
10/14-start folfox
1/15-CT & PET scan and sigmdoscopy- no mets
3/15-finish folfox
9/15- clnscopy- 3 polyps removed
10/15- CT scan, NED
10/16- CT scan, NED, CEA 1.6
10/17- clnscopy- 4 polyps removed, CT scan NED, CEA 1.8
10/14 1.9; 4/15 2.8; 5/15 2.4; 9/15 2.8; 12/15 3.1; 1/16 3.0; 4/16 2.5; 7/16 2.5; 10/16 1.6; 1/17 1.9


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