Cancer Tumor Markers
Cancer Tumor Markers
Jake Ames, M.D., H.M.D.
Puerto Vallarta, Mexico
Douglas M. Mitchell, Ph.D., D.Univ.
Melbourne, Australia
How does one diagnose cancer and what are tumor marker tests?
There are many ways to diagnose cancer, each with its strengths and weaknesses.
The gold standard test
I (JA) am a trained pathologist and have much experience diagnosing cancer. The gold standard test is to diagnose cancer by looking at biopsied tissue under a microscope.
Biopsies should and are always done after surgery. There is no reason not to get this accurate test.
Carrying out biopsies for diagnostic purposes is more controversial. Biopsies can certainly detect cancer, but there are problems:
• They may have false negatives. A prostate biopsy comprising multiple needle biopsies, for example, may not detect micro tumors if the needle doesn’t “hit” one
• The process of taking the biopsy may result in spreading the cancer into healthy tissues. One estimate is that this occurs with 5-25 % of biopsies.
• Biopsies may result in infection at the biopsied site.
• Biopsies may be used as an “excuse” to justify surgery, when less aggressive treatment is adequate.
Our personal preferences are to minimize the use of biopsies.
Diagnosis of new cancers
There are several classes of diagnostic tests:
Scans, including CAT, MRI, X-ray and PET scans. The first three detect “lumps” which may or may not be cancer. A PET scan detects areas of increased metabolic activity which often indicates the presence of cancer. It is the most useful but most expensive test. CAT and PET scans give the body a significant dose of radiation.
Tumor markers
Tumor markers are substances made in the body by both cancer cells and normal cells. They are at a higher concentration in cancerous cells. These markers are usually tested in blood, but some can be found in urine, stool, and tumor tissues. Most tumor markers are proteins. They are specific for one or more types of cancer.
Common Tumor Markers
Prostate cancer PSA (prostate-specific antigen), PAP (prostatic acid phosphatase), Mi-Prostate Score (MiPS) (urine), PCA3 and T2:ERG (urine)
Ovarian cancer CA 125 (cancer antigen 125)
Breast cancer CA 15-3 & CA 27-9
Colorectal, stomach, breast, lung, thyroid, pancreatic, ovarian cancers CEA (carcinoembryonic antigen) – mainly used for colorectal cancers
Colorectal cancer CEA (carcinoembryonic antigen), CA19-9
Liver, ovarian and testicular cancers (germ cell cancers of ovaries & testis) AFP (alpha-fetoprotein)
Squamous cell carcinoma of the oral cavity CEA (carcinoembryonic antigen, SCCA (squamous cell carcinoma antigen), IAP (immunosuppressive acidic protein)
Multiple myeloma, some lymphomas and leukemias B2M (beta 2-microglobulin)
Pancreatic, gallbladder, bile duct, bladder, colon, and stomach cancer CA 19-9 (more sensitive and specific for pancreatic cancer)
Choriocarcinoma, germ cell tumors beta hCG (beta-human chorionic gonadotropin)
Medullary thyroid cancer calcitonin
Thyroid cancer Tg (thyroglobulin)
Germ cell tumors, lymphoma, leukemia, melanoma, neuroblastoma LDH (lactate dehydrogenase)
Leukemia CBC (complete blood count), LSA (lipid bound sialic acid), FSA (free sialic acid), RI (Regan isoenzyme), LDH (lactate dehydrogenase)
Chronic lymphocytic leukemia, Waldenstrom’s macroglobulinemia lymphoma B2M (beta-2-microglobulin)
Bladder cancer, Kidney cancer, Ureter cancer BTA (bladder tumor antigen-urine test), CA-19-9 & TPA (tissue-polypeptide antigen), NMP-22 (urine)
Malignant melanoma LDH (lactate dehydrogenase), S100-beta, MIA (melanoma inhibitory activity)
Multiple myeloma Bence Jones proteins (urine), monoclonal immunoglobulins, B2M (beta-2-microglobulin)
Neuroendocrine tumors (carcinoid tumors, neuroblastoma, small cell lung cancer Chromogranin A
Lung, urological cancers, gastrointestinal, gynecological cancers Cytokeratin Fragment 21-1
Carcinoid tumors 5-HIAA (5-hydroxy-indol acetic acid-24 hour urine)
Small cell lung cancer, Neuroblastoma NSE (neuron specific-enolase), ProGRP (pro-gastrin-releasing peptide)
Lung cancer CEA (carcinoembryonic antigen-for adenacarcinoma), SCC (squamous cell carcinoma antigen-for squamous cell), NSE (neuron-specific enolase-for small cell carcinoma), CYFRA (cytokeratin 19 fragment-for squamous cell), ProGRP (pro-gastrin-releasing peptide-for small cell carcinoma).
Neuroblastoma HVA (homovanillic acid-24 hour urine)
Renal cell carcinoma NNMT (nicotinamide N methyltransferase), LCP1 (L-plastin), NM23A (non-metastatic cells1 protein)
There are more expensive genetic tests to diagnose and monitor cancer progression, but practically they may not be worth the cost. which I will explain later. The pathologist has an armatorum of diagnostic laboratory tests which help in diagnostics, but not following cancer progression.
Other markers
Checking for blood in stool is a very useful routine test for detecting bowel cancer.
There are other tests which should be in general use, but aren’t. For example, photodiagnosis is capable of detecting surface and near surface tumors with a sensitivity down to about a 1 mm tumor. The patient takes a sensitizer which selectively attaches to cancer cells. A strong red laser illuminates the relevant areas and a camera detects and displays fluorescent radiation from the sensitizer. I (DM) observed a melanoma patient whose scans detected about 15 tumors.
Photodiagnosis showed about 80 tumors. As treatment progressed, the small tumors disappeared, then the larger tumors.
Tests to monitor cancer progression
These are listed from most sensitive to least sensitive :
The CC cream test
I (JA) have been studying cancer since 1974 working as a pathology assistant at the University of California, San Francisco (UCSF) and Childrens Hospital in San Francisco, California. The CC cream is the number one test to follow cancer progression. At the same time, the CC cream is killing all anaerobic cells including fungi, anaerobic bacteria, and all cancer cell lines.
A 1 cm cancer tumor has about 1 billion cancer cells. The dead cancer cells, dead anaerobic bacteria, and dead fungi will appear on the skin as black dots, later forming scabs and multiple, coalescing black dots and ulcerations which we call by the Latin name, crud. If a patient is still presenting with this, they still have cancer. It is that simple.
See a talk about the CC cream on my (JA) cancer button at www.jakeamesmd.com.
If one has ruled out anaerobic bacteria and fungi, the CC cream has close to 100% sensitivity in telling the patient and physician that there is still cancer left in the body. It has 0% specificity. It will not tell what type of cancer the patient has. Although, one can presume if a woman is putting cream on her breasts and a man is using the cream downstairs, and they are reacting to the cream, they probably have breast and prostate cancer, respectively.
Circulating Tumor Cell Test
Next best is the circulating tumor cells (CTC) test. This measures the number of cancer cells per mL blood. High values are bad, low values are good. The test is carried out several different ways.
After apparently successful surgery, it is wise to monitor for cancer recurrence. The Maintrac test reputedly detects recurrences about 6 months earlier than scans and other tests. Very useful if the doctor has adequate follow up treatments.
Marker tests and scans
Fibrinogen, CRP-HS, CBC, Comprehensive Metabolic Panel and Urinalysis
The above tests can be regularly monitored as necessary. The main aims are to keep cancer markers low, fibrinogen below 300 mg/dl and the CRP-HS below 1 mg/L.
Wilhelm Reich, M.D.
Cancer is a systemic symptom, not a disease as was proven years ago by Wilhelm Reich, M.D. (The Cancer Biopathy by Wilhelm Reich, M.D.). The cancer cells and the cancer tumor are there to protect the body from T-bacilli (T, the German word for Todt-Death.) Unfortunately, this is a pathological protective mechanism. Cancer goes from stage 0 to stage 4. There are no stage 1, 2 or 3 cancers. Stage 1, 2 and 3 cancers are myths. Carcinoma in Situ (CIS), which some people call stage 0, is a group of abnormal cells that are only found in the place they were formed in the body. Cancer which shows the presence of T-bacilli at 4,000X using live, unstained blood under dark-field microscopic examination is represented by the amount of T-bacilli in the blood, saliva, urine or stool. Therefore, cancer is present before the formation of the first cancer cell (stage 0) or cancer tumor (stage 4).
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