Blood Testing And Cancer
In addition to serving as a general health “barometer,” blood work plays an important role in diagnosing certain types of cancer. For instance, leukemia, a cancer that affects the bodys blood-forming tissues, can sometimes be detected in a routine blood test. Specifically, the CBC test measures the levels of the various types of blood cells circulating in the bloodstream, including red blood cells, white blood cells and platelets. Although an abnormal result could point to leukemia, it is important to note that it could also indicate a benign inflammatory condition. Therefore, a physician will typically order follow-up testing to confirm or rule out a leukemia diagnosis.
Aside from leukemia, most cancers cannot be detected in routine blood work, such as a CBC test. However, specific blood tests are designed to identify tumor markers, which are chemicals and proteins that may be found in the blood in higher quantities than normal when cancer is present. One common example is theprostate-specific antigen test, which measures the level of PSA in the blood. An elevated level of PSAa protein produced by the prostate glandmay be a sign of prostate cancer.
Although blood work cannot currently be used on its own to conclusively diagnose cancer, it is often used in conjunction with other diagnostic tests, such as:
- A physical examination
- Imaging tests, such as X-rays, CT scans, MRIs, ultrasounds, bone scans and PET scans
What Are Some Measures I Can Take To Avoid Breast Cancer Or Minimize The Disease
Most experts agree that screening is the best way to catch breast cancer in its early stages. It doesnt prevent cancer but it can lead to quick detection and a better outcome. There is still some debate about when or whether to get screened for breast cancer, stemming from a study that showed more deaths from breast cancer occurred in younger women who didnt get regular mammograms. Arguments arose about false positives and over-treatment. In addition, different surveys can lead to different answers, so the best advice is to consult with your healthcare provider about your individual situation and relevant risk factors. An annual mammogram for women over 40 is still a good guide. The CA 27.29 is a blood test, a tumor marker, specific for screening for breast cancer. Other ways to boost your chances of not getting breast cancer and improve your overall health:
How Is Prostate Cancer Detected
There is no single test to detect prostate cancer. The two most common tests are the prostate specific antigen blood test and the digital rectal examination .
The PSA test measures the level of PSA in your blood. It does not specifically test for cancer. Virtually all PSA is produced by the prostate gland. The normal range depends on your age. A PSA above the typical range may indicate the possibility of prostate cancer. However, two-thirds of cases of elevated PSA are due to noncancerous conditions such as prostatitis and BPH.
A DRE is generally conducted by a urologist to feel the prostate. While DRE is no longer recommended as a routine test for men who do not have symptoms of prostate cancer, it may be used to check for any changes in the prostate before doing a biopsy.
If either of these tests suggest an abnormality, other tests are necessary to confirm a diagnosis of prostate cancer, usually a magnetic resonance imaging scan and transrectal ultrasound biopsy.
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Information Gained From Blood Tests For Cancer
Blood testing is one of the many tools that doctors use to diagnose and manage cancer. Blood tests provide information about:
- Overall health status
- Abnormal levels of chemicals and proteins in your blood that may indicate cancer
- High or low blood cell count
- Treatment options depending on the type and severity of cancer
- If cancer has come back
- Whether treatment is working or the disease is further developing
Although blood tests are useful in cancer diagnosis, other tests are necessary to confirm a diagnosis. Other tests to diagnose cancer include biopsies, x-rays, CT scans, MRIs, physical exams, mammograms, and pap smears.
Purpose Of Routine Blood Work
Routine blood work refers to blood tests ordered by your doctor as part of your yearly physical. They are used to screen for a range of health conditions, helping you make informed diet, lifestyle, and fitness choices. Routine blood work can also detect illness before symptoms arise. A routine complete blood count test is also commonly referred to as routine blood work.
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Is There A Blood Test For Colon Cancer
No blood test can detect colon cancer. However, your doctor may order blood tests to get a picture of your overall health, as well as use other screening methods to look for signs of colon cancer.
Your doctor may want to test your blood for a substance called carcinoembryonic antigen , which is produced by some colon cancer cells. Tracked over time, the level of CEA in the blood may help your doctor understand your treatment outlook and whether the cancer is responding to the treatment protocol. However, this test is not specific to colon cancer and may also be negative in other types of colon cancers.
It should be noted that research is being conducted in Taiwan for a blood test that can detect colon cancer. The test detects circulating tumor cells in the blood. According to the study, the blood test identified colon cancer in 87% of cases, ranging from stage I to stage IV cancer. The blood test was also able to detect 77% of precancerous lesions, indicating an early-stage disease.
While these early results appear promising, the sensitivity of the test is still not optimal. The number of patients in the study is also relatively small. Therefore, the test is not available in the U.S. yet.
How Early Can This Blood Test Detect Cancer
Its estimated that detecting cancers before they reach stage IV may reduce cancer deaths. Unfortunately, at the moment, this test doesnt seem particularly good at picking up early stage cancer, and only correctly identified 16.8% of stage I cancers.
However, it successfully identified 77% of stage III cancers, which gives clinicians the opportunity to start treating people as soon as possible.
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What Are The General Warning Signs Of Cancer
While any persistent symptom warrants medical attention, watch for these signs and symptoms that could indicate a serious disease, including a malignancy:
- Unexplained weight loss with sudden loss of appetite that continues despite good nutrition.
- Persistent low-grade fever.
- White patches in the mouth.
- A lump or thickened area that can be felt through the skin.
Biomarker Challenge In Prostate Cancer
A PubMed Search on prostate cancer AND in English language yielded 3016 hits . The number of articles published on PCa biomarkers has increased steadily over the years. Despite this plethora of biomarkers reported to be promising, only one biomarker, is routinely used by urologists. Why are PCa biomarkers not living up to their promise? For one, there are remarkable analytical and regulatory barriers to the application of biomarkers in PCa care. These include but are not limited to the status of intellectual property protection, availability of standard reference materials for the assay, complexity of assay format, implementation of quality control to assure reproducibility and accuracy, sufficient market testing size to assess methods of commercialization, lack of clear guidelines for good manufacturing/laboratory practice and quality control requirements for all phases of biomarker development, cost and effort required to accumulate clinical data under appropriately designed and Institutional Review Board-approved prospective trials, and the interval required for resolution of patent issues, assay standardization, validation, testing, and regulatory approval.
Modification of the structured phase-approach to the systematic discovery, evaluation, and validation of biomarkers
How Are Researchers Trying To Improve The Psa Test
Scientists are investigating ways to improve the PSA test to give doctors the ability to better distinguish cancerous from benign conditions and slow-growing cancers from fast-growing, potentially lethal cancers. And other potential biomarkers of prostate cancer are being investigated. None of these tests has been proven to decrease the risk of death from prostate cancer. Some of the methods being studied include
Thompson IM, Pauler DK, Goodman PJ, et al. Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. New England Journal of Medicine 2004 350:22392246.
What Does A Complete Blood Count Measure
A CBC measures the amount of 3 types of cells in your blood:
White blood cell count. A white blood cell count, also called a leukocyte count, measures the total number of white blood cells in a sample of blood. These cells protect the body from infection by attacking invading bacteria, viruses, and other foreign materials in the body. Some white blood cells can also attack cancer cells.
White blood cell differential. A white blood cell differential measures the number of each type of white blood cell.There are 5 major types of white blood cells, andeach type plays a different role in protecting the body. Your doctor can learn valuable information about your health by measuring the levels of these cells:
Red blood cell count. Red blood cells carry oxygen throughout your body. A red blood cell count, also called an erythrocyte count, measures the number of red blood cells in a sample of blood. There are several ways to measure red blood cells. Two of the most common are:
Hematocrit , the percentage of your blood that is made up of red blood cells
Hemoglobin , the amount of the protein in red blood cells that carries oxygen
Platelet count. A platelet count measures the number of platelets in a sample of blood. Platelets help to stop bleeding by forming blood clots.
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How Are Blood Cancers Diagnosed
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If a person is suspected to have a type of blood cancer, there are several tests that will typically be run. Some of the tests can rule out other conditions that can also cause some of the general symptoms of blood cancer, and other tests are used to determine the specific type of blood cancer a person has. The subtype of cancer is important as it helps inform treatment recommendations.1
Blood Tests Have Come A Long Way
Historically, blood tests havent been the best way to detect cancer.
Even blood tests on people with blood cancers such as lymphoma and leukemia were ironically not the most effective way of determining whether a person has cancer.
But blood-testing technologies are now changing the way the disease is diagnosed and treated.
GRAILs technology is just the tip of the iceberg in terms of how genetics are revolutionizing cancer care.
In cancer biotech circles, the term blood test is out and the term liquid biopsy is in.
A liquid biopsy simply means an examination of cancer-related material from a blood sample.
Liquid biopsies havent yet replaced a tumor biopsy. But most people interviewed for this story agreed that liquid biopsies are showing great promise in facilitating individualized approaches to cancer treatment.
The Food and Drug Administration approved two blood tests earlier this year that can help guide treatment decisions for people with cancer.
The tests, Guardant360 CDx and FoundationOne Liquid CDx, are made by different companies and were approved separately.
Oncologists have historically based treatment decisions on features like the organ in which the cancer started growing, whether the cancer has spread, and whether the patient has other health conditions.
Now they often use genetic changes in the tumor, according to the .
Certain targeted therapies and immunotherapies work best against tumors that have specific genetic changes.
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Multicancer Early Detection Tests
Multicancer early detection tests are tests that measure biological signals in body fluids that may be shed by cancer cells. These signals are also known as biomarkers or tumor markers. Depending on which signals the MCED test measures, it may detect several different types of cancer. Whether MCED tests are effective for cancer screening in people without symptoms is unknown and needs to be assessed through randomized clinical trials.
No MCED tests have been approved by the US Food and Drug Administration. However, a health care provider may be able to order an MCED test for a patient.
For more information, see Tumor Markers and Questions and AnswersCancer Screening with Multi-Cancer Early Detection Tests.
Testing The Liquid Biopsy Test
Figuring out how liquid biopsies might fit into the diagnostic process is something that researchers on the DETECT study hoped to find out.
According to the studys results, 96 of the 10,000 enrolled women received diagnoses of cancer during the trial. Of those, 26 were identified by the blood test, 24 by standard screening methodsand 46 after they developed symptoms.
Of the patients diagnosed by the blood test, 14 had hard-to-find cancers in organs such as ovaries, kidneys or the lymphatic system. Nine of these tumors had not yet spread beyond their original sites.
One of the things we wanted to see with this trial was if we were competing with the standard of care, or if the test is additive and synergistic, Papadopoulos says. We detected 26 cancers with our blood tests within the population that we tested. And then detected with the standard of care. So the blood test doubled the screen-detected cancers, which was a very good result.
According to Buchanan, the goal of the trial was primarily to assess the tests feasibility and safety. Researchers wanted to know how well it worked, but also if it could be used to minimize negative outcomes like false positives that would lead people to have additional medical tests.
Thats why the GRAIL test can tell the clinician not only if the patient likely has a tumor but also what type of cancer it is likely to be. In a clinical trial of the test, researchers detected more than 50 cancer types with 93% accuracy.
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How Should Mced Tests Be Used
Figuring out how MCED tests should be implemented in the clinic will take many years.
Researchers and clinicians are just beginning to address questions on who should be tested, at what age, and how past medical and family history should be taken into account. Setting guidelines for how doctors will further evaluate positive MCED results is just as important.
Previously, guidelines recommended that all men ages 55 to 69 regularly get blood tests to determine their levels of PSA, a protein produced by cancerous and noncancerous prostate tissue. But now the recommendation is more nuanced, with screening suggested on an individual basis that takes into account personal preferences.
Another concern is that further testing to confirm positive MCED results will be costly and a burden to the medical system, particularly if a full-body scan is required. The out-of-pocket cost for an MRI, for example, can run up to thousands of dollars.
And patients who get a positive MCED result but are unable to confirm the presence of cancer after extensive imaging and other follow-up tests may develop lifelong anxiety about a potentially missed diagnosis and continue to take expensive tests in fruitless search for a tumor.
What Are Survival Rates For Early/late Diagnosis
According to the American Cancer Society , the 5-year relative survival rate is very different depending on how early the cancer is detected.
- If non-small cell lung cancer is diagnosed before spreading outside the lungs, the 5-year relative survival rate is 64 percent.
- When non-small cell lung cancer has spread to nearby structures or lymph nodes at the diagnosis, the 5-year relative survival rate is 37 percent.
- If non-small cell lung cancer has spread to other parts of the body before its diagnosed, the 5-year relative survival rate is 8 percent.
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Clinical Breast Exams And Regular Breast Self
Routine examination of the breasts by health care providers or by women themselves has not been shown to reduce deaths from breast cancer. However, if a woman or her health care provider notices a lump or other unusual change in the breast, it is important to get it checked out.
Further Tests For Prostate Cancer
If results of the PSA test or the DRE are abnormal, a urologist will likely recommend a biopsy, where small samples of tissue are removed from the prostate and examined.
If cancer is diagnosed, other tests may be used to check the progression of the cancer, including:
- magnetic resonance imaging scan of the prostate â often done before a biopsy
- bone scanâ to check whether or not cancer cells have spread to the bones
- computed tomography scan â a specialised x-ray
- pelvic lymph node dissection â a nearby lymph node is removed and examined to check whether or not cancer cells have entered the lymphatic system .
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Tests To Rule Out Other Conditions
Some of the symptoms that are common to blood cancer are also commonly caused by other conditions. In some cases, additional blood tests may be used, such as:
- Testing for viral infections , or cytomegalovirus )
- Lactate dehydrogenase to potentially help evaluate cancer, as well as response to cancer treatment3,4