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Chapter 13

Malignancy Disorders

QuestionAnswer
Tumor markers are by broad definition biochemical analytes that are useful in detecting cancer, tumor growth prediction, or progression of the illness.
These markers can help the physician monitor the recurrences or spread of the malignancy.They can also serve as a marker of total removal of a tumor by surgical methods.
Serial markers can help the oncologist assess the effectiveness of the treatment that they are rendering.
Hyperalbuminema leads to dehydration
Increased alpha 2 globulin due to alpha 2 macroglobulin: nephrotic syndrome with peripheral edema, membranous glomerulonephritis, hyperlipidemia
Decreased alpha 2 globulin due to haptoglobin: hemolytic anemia with spherocytes in PB
a minimum of 10 ml of urine for electrophoresis.
Most urine samples require concentration to obtain this minimum amount and for optimal concentration
Electrophoresis on urine is the preferred technique for identification of Bence Jones proteins in patients with suspected multiple myeloma.
Bence-Jones protein should always be done in conjunction with serum, so the results can be compared directly.
Laboratories can perform testing that detects specific DNA. This can be used to detect viruses or genes in our DNA.
The main testing done by the labs involves polymerase chain reaction (PCR) testing, and Fluorescent in situ hybridization (FISH) testing methodologies.
Fish is used to detect specific sequences of DNA
PCR is used to multiply the amount of DNA present and then identify it.
50% of all men over the age of 70 have prostate cancer
Prostatic acid phosphatase was originally used as a prostate cancer marker, this test is hard to run and perform accurately.
Prostatic acid phosphatase has now been almost completely replaced by prostatic specific antigen (PSA) this comes in total and free forms, can help tell the difference between cancer and benign prostatic hyperplasia (BPH)
If the PSA value doubles within a 12 month period it indicates that further testing is required typically a biopsy.
Pancreatic cancer is the fourth most common cause of cancer death in the U.S.
Pancreatic cancer is hard to detect early and since it is not usually detected until the latter stages, chemo and radiation therapy rarely help.
What two enzymes can be used to detect problems with the Pancreas ? Amylase and Lipase
CA 19-5 and CA 19-9 have the most relevance to use with pancreatic cancer.
CA 125 Is a carbohydrate marker associated with ovarian and endometrial carcinomas.
CA 125 is also elevated in patients with bladder cancer, pericarditis, cirrhosis, endometriosis, pregnancy or ovarian cysts.
CA 15-3 is a carbohydrate marker that if elevated can serve as a guideline for treatment efficacy of breast cancer.
A lump biopsy may also be tested for the presence or absence of a HER2/neu to see if the tumor would respond to Herceptin (transuzumab) therapy.
The HER2/neu test is done using FISH technology and is performed on tissue.
The CA 15-3 marker can be performed on serum or plasma.
Fecal Occult blood testing can be used to screen for colorectal cancer but the utility of this testing is in question. The testing has frequent problems and the effectiveness is debatable.
The mental capacity of the target audience for colorectal cancer is a direct problem, and the directions given to them by physicians is greatly varied.
Created by: Mgoodall