Biochemistry is the application of chemistry to the study of biological processes at the cellular and molecular levels. Biochemistry has become the foundation for understanding all biological processes. It provides explanations for the causes of many diseases and has found its place in the diagnosis and treatment of cancer.
Head and Neck oncology: Ferritin, lipid-associated sialic acid (LSA), carcinoembryonic
antigen (CEA)
and TPA (Tissue Polypeptide Specific Antigen) appears to be sensitive markers for the
prognosis of
head and neck cancers.
Paediatric Oncology & Haematology: NA
Tumour Markers: CEA and CA 19-9 are significantly increased in the patients with oesophageal cancer Liver enzymes: You may also have a blood test to check your liver function, because oesophageal cancer can spread to the liver.
Liver function tests may be performed to assess the function of your liver, to which
stomach cancer
can spread.
Tumour Markers: Markers CEA (carcinoembryonic antigen) and CA 19-9 (cancer antigen)
are
sometimes raised in stomach cancer as well as other cancers.
Liver Cancer: Blood tests are done to check for abnormalities in liver function,
these includes assay
of Alanine transaminase (ALT). ALT is an enzyme found in the liver that helps convert
proteins into
energy for the liver cells. When the liver is damaged, ALT is released into the
bloodstream and levels
increase.
Aspartate transaminase (AST). AST is an enzyme that helps metabolize amino acids. Like
ALT, AST is
normally present in blood at low levels. An increase in AST levels may indicate liver
damage, disease
or muscle damage.
Alkaline phosphatase (ALP): ALP is an enzyme found in the liver and bone and is
important for
breaking down proteins. Higher-than-normal levels of ALP may indicate liver damage or
disease,
such as a blocked bile duct or certain bone diseases.
Albumin and total protein: Albumin is one of several proteins made in the liver. Your
body needs
these proteins to fight infections and to perform other functions. Lower-than-normal
levels of
albumin and total protein may indicate liver damage or disease.
Bilirubin. Bilirubin is a substance produced during the normal breakdown of red blood
cells. Bilirubin
passes through the liver and is excreted in stool. Elevated levels of bilirubin
(jaundice) might indicate
liver damage or disease or certain types of anemia.
Gamma-glutamyl transferase (GGT): GGT is an enzyme in the blood. Higher-than-normal
levels may
indicate liver or bile duct damage.
Tumor Markers – Serum AFP: AFP stands for alpha-fetoprotein. It is a protein made in
the liver of a
developing baby. Healthy adults should have very low levels of AFP. High levels of AFP
can be a sign
of liver cancer and can help diagnose cancer when used with other tests. The test may
also be used
to help monitor the effectiveness of cancer treatment and to see if cancer has returned
after you've
finished treatment.
Urinalysis: This is a simple lab test to check for blood and other substances in a sample
of urine.
Urine cytology: For this test, a sample of urine is looked at with a microscope to see
if there are any
cancer or pre- cancer cells in it. Cytology is also done on any bladder washings taken
during a
cystoscopy (see below). Cytology can help find some cancers, but it isn't perfect.
Not finding cancer
on this test doesn’t always mean you are cancer free.
Urine culture: If you're having urinary symptoms, this test may be done to see if an
infection (rather
than cancer) is the cause. Urinary tract infections and bladder cancers can cause the
same
symptoms. For a urine culture, a sample of urine is put into a dish in the lab to allow
any bacteria
that are present to grow. It can take time for the bacteria to grow, so it may take a
few days to get
the results of this test.
Biochemistry: The blood test is used primarily to make sure your kidneys are functioning
normally.
Serum blood urea nitrogen and creatinine levels should be obtained for all patients in
whom bladder
cancer is suspected. If metastatic disease is suspected, a complete blood count and
complete
metabolic panel, including alkaline phosphatase level and assessment of liver function,
are
appropriate.
Glomerular filtration rate (eGFR): A reduced estimated glomerular filtration rate (eGFR)
was found to
be associated with a significantly increased risk for renal and urothelial cancer
Urine cytology: Renal cell cancer will have blood in their urine. If the patient has
transitional cell
carcinoma (in the renal pelvis, the ureter, or the bladder), sometimes a special test of
the urine
sample (called urine cytology) will show actual cancer cells in the urine.
Complete blood count (CBC): This is a test that measures the number of different cells
in the blood.
This test result is often abnormal in people with kidney cancer.
Biochemistry tests: High levels of liver enzymes are sometimes found. High blood
calcium levels may
be found which might lead to more imaging tests. Blood chemistry tests also measure
kidney
function, which is especially important if certain imaging tests or if surgery is
planned.
Tumour Makers cancer antigen 15-3 (CA 15-3), cancer antigen 27.29 (CA 27.29), and carcinoembryonic antigen (CEA) -- have been used to help monitor metastatic breast cancer (advanced disease),
Tumour markers: Carcinoembryonic antigen (CEAs) represents a heterogeneous group of
glycoproteins, with common antigenic determinants. CEA is produced by the secretary
cells of the
normal adult gastrointestinal tract and clearance is accomplished primarily in the
liver. The highest
concentrations of the marker are found in patients with liver metastases from carcinoma
of the
colon. CEA assays are useful in lung cancer clinical management.
Chromogranin A: is a protein released from neuroendocrine cells that has been
demonstrated in
serum of patients with lung cancer.
Adrenocorticotropic hormone: small cell carcinoma of the lung (SCLC), which originated
from
neuroendocrine tissue, can develop into paraneoplastic endocrine syndromes, such as
Cushing
syndrome, because of an inappropriate secretion of ectopic adrenocorticotropic hormone
(ACTH).
Insulin-like growth factor 1 (IGF1): high levels of circulating insulin-like growth
factor 1 (IGF1), the
main ligand for IGF1R, increases the risk of developing lung malignancy in the future.
Neuron specific enolase (NSE): high serum levels of NSE were noticed in the patients with neuroblastomas and malignant gliomas, etc.
Tumour Markers – Carcino Embryonic Antigen (CEA): The most common tumor marker for
colorectal
cancer is carcinoembryonic antigen (CEA). Blood tests for this tumor marker can
sometimes suggest
someone might have colorectal cancer, but they can't be used alone to screen for or
diagnose cancer
High levels of CEA may indicate that a cancer has spread to other parts of the body. In
addition,
other medical conditions can cause CEA to increase. A CEA test is most often used to
monitor
colorectal cancer for people who are already receiving treatment. It is not useful as a
screening test.
Testicular Cancer:There are three important tumor markers for testicular cancer:
Alpha-fetoprotein: AFP is a protein secreted by the fetal yolk sac, liver and
gastrointestinal tract and
appears in high levels in the blood of the fetus. AFP can be secreted by NSGCT that
contain
embryonal carcinoma, yolk sac tumor or teratoma. By definition, seminoma or
choriocarcinoma do
not secrete AFP. Therefore, any patient with an elevated AFP must have a non
seminomatous
component of testis cancer.
Human Chorionic Gonadotropin (HCG): HCG is a glycoprotein produced by the placenta to
maintain
the corpus luteum during pregnancy. HCG can be elevated in a number of other
malignancies,
including cancers of the liver, lung, pancreas and stomach. In germ cell tumors of the
testis, including
both seminomas and NSGCT, cancerous cells can transform into syncytiotrophoblasts (a
normal
component of the placenta) and secrete HCG. Levels greater than 5,000 IU are usually
indicative of
NSGCT, and in NSGCT, higher levels of HCG are associated with a worse prognosis.
However, HCG-
producing seminoma (approximately 15 percent of seminomas) has the same prognosis as
seminoma that does not produce HCG.
Lactate Dehydrogenase (LDH): LDH is a cellular enzyme found in every tissue in the body.
Highest
concentrations of LDH in normal tissue are found in muscle (including skeletal, cardiac
and smooth
muscle), liver and brain. LDH is less specific for testis cancer than HCG or AFP.
However, elevated
LDH levels are correlated to high tumor burden in seminoma and recurrence in NSGCT.
Prostate-specific antigen (PSA) test: A blood sample is drawn from a vein in your arm and analyzed for PSA, a substance that's naturally produced by your prostate gland. A higher-than-normal level of PSA may indicate prostate infection, inflammation, enlargement or cancer.
Blood test: A routine assessment of renal function tests, electrolytes and liver
function tests will be
suggested by the clinician to help in the treatment, assessment and follow up.
Skin Cancer: Doctors often test blood for levels of a substance called lactate
dehydrogenase (LDH)
before treatment. If the melanoma has spread to distant parts of the body, a high LDH
level is used
for staging and effectiveness of treatment.
Bone Cancer: People with osteosarcoma or Ewing sarcoma may have higher alkaline
phosphatase
and lactate dehydrogenase levels in the blood. However, it is important to note that
high levels do
not always mean cancer.
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