top of page

Tumor Markers

Tumor markers are relatively inexpensive blood tests that can be used to identify and possibly quantify the tumor cells present, as well as be used for follow up to see if a treatment is effective or ineffective. It can be used in conjunction with other studies to follow tumor response, and also help identify recurrence.

Nagalase- an enzyme found in animals and bacteria that plays a role in regulating infectivity and immunosuppression. It can be used to assess tumor burden and aggressiveness, and to monitor response to treatment as well as tumor growth or recurrence. It can be used non-specifically for most solid and blood tumors. It is not usually effective for assessing superficial skin cancers, as most of these have not shed cancer cells into the blood stream unless they become more invasive. Nagalase can also be elevated in a viral disease.

 

AFP (alpha-fetoprotein)- hepatocellular (some primary liver cancers), non-seminomatous germ cell tumor (NSGCT), ovarian, gastric, and pancreato-biliary cancers

 

Bence-Jones Proteins or Monoclonal Immunoglobulins- Multiple Myeloma, Waldenstrom’s macroglobulinemia and chronic lymphocytic leukemia

 

Beta-2-microglobulin (B2M)- multiple myeloma, some lymphomas, chronic lymphocytic leukemia (CLL), and other inflammatory infections/ disorders such as HIV and CMV

 

BCR-ABL- chronic myeloid leukemia (CML), and BCR-ABL-positive acute lymphocytic leukemia (ALL)

 

Breast cancer gene expression tests (Oncotype DXÒ and MammaprintÒ)- breast cancer treatment monitoring and recurrence, may help avoid chemotherapy

 

BTA (Bladder Tumor Antigen)- bladder cancer, or kidney/ ureter cancers

 

CA 19-9- pancreatic ductal adenocarcinoma and biliary tree, gastric, liver, colorectal, lung and thyroid cancer

 

CA 15-3- breast cancer (usually later in the disease), lung, ovarian, endometrial, bladder and gastrointestinal cancers

 

CA-125- ovarian, endometrial/ uterine/ cervical, breast, gastric, colorectal, pancreas, liver and lung  cancers

 

CA 27.29- Breast (best for recurrence or metastasis), colon, gastric, liver, lung, pancreatic, ovarian and prostate cancers

 

Calcitonin- medullary thyroid cancer

 

CEA (Carcinoembryonic antigen)- colorectal, pancreatic, gastric, hepatobiliary, breast, lung, bladder, kidney, thyroid, head and neck, cervical, ovarian, liver, lymphoma and melanoma cancer.

 

Chromagranin A- carcinoid tumors, neuroblastoma, neuroendocrine tumors and small cell lung cancer

 

Cytokeratin Fragment 21-1 (blood test)- lung, urologic, gastrointestinal and gynecologic cancers

 

DCP (Des-gamma-carboxy prothrombin)- hepatocellular carcinoma

 

EGFR mutation- non-small cell lung cancer, possible head and neck cancer

 

Estrogen and Progesterone- breast cancer

 

Fibrin/ Fibrinogen- bladder cancer treatment response

 

Gastrin- G-cell hyperplasia, gastrin-producing tumor (gastrinoma)

 

hCG (human chorionic gonadotropin)- testicular and trophoblastic disease, germ cell tumor, choriocarcinoma and gestational trophoblastic neoplasia

 

HER2- breast, gastric and esophageal cancer

 

5-HIAA- carcinoid tumors

 

HPV (Human Papilloma Virus)- gynecologic, anal, penile and head and neck cancers

 

HVA (Homovanillic Acid)- neuroblastoma

 

JAK2 mutation- certain types of leukemia and myeloproliferative neoplasms

 

KRAS mutation- colon and non-small cell lung cancer

 

LDH- lymphoma, melanoma, acute leukemia, testicular and seminoma (germ cell tumors), nruoblastoma

 

Monoclonal immunoglobulins- multiple myeloma, Waldentrom’s macroglobulinemia

 

NSE- small cell lung cancer, neuroblastoma

 

NMP 22- bladder cancer

 

PAP (Prostatic Acid Phosphatase)- metastatic prostate cancer, myeloma, lung cancer and osteogenic sarcoma

 

PSA (Prostate Specific Antigen)- prostate

 

SCC-A- cervical cancer

 

SMRP (Soluble mesothelin-related peptides)- Mesothelioma

 

T-cell receptor gene rearrangement- T-cell lymphoma

 

Tg (Thyroglobulin)- thyroid cancer

 

Urine catecholamines: VMA (Vanillylmandelic Acid)- neuroblastoma, pheochromocytoma, ganglioneuroma, rhabdomyosarcoma, PNET

 

TUMOR MARKERS BY CANCER TYPE

 

BREAST CANCER: 

CA 27.29

CA 15.3

CEA

CA 19-9

 

PANCREATIC CANCER:

CA 19-9*

CEA

CA 125

*https://pmc.ncbi.nlm.nih.gov/articles/PMC4419808/

*https://pmc.ncbi.nlm.nih.gov/articles/PMC6987233/

 

COLORECTAL CANCER:

CEA

CA 125 *

CA 19-9

CA 242*

*superior per https://pubmed.ncbi.nlm.nih.gov/33935125/

 

GLIOBASTOMA CANCER:

No tumor markers currently available, especially if the blood-brain barrier is intact.

 

OTHER TESTS: 

Full body PET (positron emission tomography) scan- uses a radioactive tracer that is administered through an IV along with glucose.  As cancer cells love glucose, they will preferentially uptake the tracer. This can help identify tumors and metastatic disease. The PET scan will also give the FDG, which is how much radioactive tracer was taken up by the cells, indicating metabolic activity of the cells (higher in cancer cells). There are standard values for those areas of the body that typically have a higher FDG uptake because they normally have higher glucose needs (spleen, liver and brain). The Pet scan will also list the SUV (standard uptake value) a ratio that defines the activity of the FDG in a specific area on the PET scan. This also can be indicative of metabolic activity. In Houston, Texas, a PET scan will cost approximately $1400.

Prenuvo- a whole body scan that assesses your neck, chest abdomen, pelvis and legs. It can assess for solid tumors, metabolic disorders such as fatty liver, spinal degeneration, non-cancerous conditions such as cysts, hematomas or abscesses, auto-immune disorders or brain aneurysms. The cost is $2499.

Liquid Blood Biopsies

A liquid biopsy is a blood test that will assess for either:

Circulating tumor cells (CTCs)- a cancer cell from the tumor that is in the bloodstream

Circulating tumor DNA (ctDNA)- a DNA fragment with the genetic code from the tumor cell

Circulating cancer stem cells (cCSC) small subpopulation of cells within tumors with capabilities of self-renewal, differentiation, and tumorigenicity

 

Available Liquid Biopsy Cancer Tests as described on the respective websites:

 

Signatera- a highly sensitive and personalized MRD assay using ctDNA (circulating tumor DNA) and is custom designed for each patient to help identify relapse earlier than standard of care tools. This requires a one time analysis of both blood and a tissue sample. The test is then built specifically for your tumor, which can then be used to test your blood in future blood draws. This can be followed to monitor for relapse or recurrence, as well as to monitor the tumor response to treatment. Some tests are covered by Medicare- colon, breast and bladder, but not for lung.

 

­Galleri- scans a blood sample for a cancer-specific signal found on cell-free DNA (cfDNA), and can localize the origin of the cancer signal with “High accuracy”. This signal is shared by 50+ cancer types. Further diagnostic testing is then needed to confirm cancer.

 

Cell Search- detects CTCs to predict the likely outcome for those with metastatic breast, prostate or colon cancer.

 

cobas EGFR Mutation Test v2- detects ctDNA looking for a mutation error on the EGFR gene that is common in non-small cell lung cancer.

 

Guardant360 CDx- detects ctDNA; also used to detect common genetic errors and to help choose the most effective treatments.

 

­FoundationOne Liquid CDx - a blood test that analyzes a patient’s genetic profile to help choose effective treatments.

 

​

Playbook for Cancer

You have a mass or tumor.

  1. You need a biopsy because you need to know the tissue of origin. Depending on the type of cancer, you may be able to perform a Signatera test to identify the tumor cells for future monitoring and surveillance.

  2. PET scan- a specialized 3D image of the entire body with the injection of a small amount of radioactive glucose through an arm IV. Cancer and tumor cells love glucose, so any areas or masses in the body with an increased uptake of glucose will light up on the scan. Eat a low carbohydrate diet for 24 hours before the scan, and do not eat or drink anything except water for 6 hours before the scan, which takes 30-60 minutes.  Drink plenty of fluids afterwards. We have found that oftentimes there are tumor cells already in other areas of the body when a tumor mass is first found.  This makes a difference in the classification of the disease state and the plan for treatment.

  3. Cancer loves sugar- a low carbohydrate diet will help limit the fuel available for the cancer. Continuous glucose monitors are available either by a prescription from your physician, or on the internet. A good place to start is to keep the blood sugars under 100 mg/dL. A stricter diet has been found to be unsustainable, and even with the addition of a glutamine blocker, has not always been shown to impact the disease progression.

  4. Obtain baseline tumor markers for your particular cancer, if available.  The above table contains a potential list of tumor markers that may be available for you. These can be drawn every 4-6 weeks during treatment to assess the response of your cancer to the treatment, as well as be used to help identify recurrence once treatment is completed.

  5. Additions to your chosen cancer therapy that have no side effects, nor will they interfere with other therapies. You can discuss with your physician.  These are described in more detail on other pages on the HRF website:

  • Molecular hydrogen- non-toxic biologically inactive gas with anti-inflammatory and anti-oxidant, inhibits tumor growth, protects DNA and mitochondria, scavenges toxic reactive oxygen species (ROS) and inhibits ROS-dependent signaling pathways for cancer cells. Research indicates that cancer is a metabolic disease of the mitochondria, so mitochondrial repair has to be at the forefront for fighting and eradicating cancer. 

  • Deuterium depleted water (DDW)- deuterium is also known as “heavy hydrogen” and is found in the air and the liquids and foods we ingest. A high deuterium level in the body has been shown to cause chronic fatigue, metabolic problems and premature aging. DDW inhibits the proliferation and migratory ability of numerous tumor cells, accelerates apoptosis, autophagy and senescence in tumor cells.  The benefits seen with hyperbaric oxygen therapy (HBOT) may be due to a reduction of the deuterium level, but this needs to be further studied.  HBOT is expensive as it needs to administered 3 times per week until the cancer is gone, which can take greater than 6 months at approximately $1,000/ week.

​

  6.  High intensity focused ultrasound: HIFU (or Histotripsy)causes selective tissue necrosis in a well-defined volume either through   heating or cavitation, without requiring a surgical incision. The  treatment is only FDA approved for liver tumors, although it has been studied for over 10 years, particularly for tumors in the breast, uterus, liver, kidney, pancreas, bone and brain.

        https://academic.oup.com/bjr/article-abstract/76/909/590/7470691

​

       

​

The information provided on this website is for educational and research purposes only, and does not substitute for professional medical advice. You should consult your physician or health care professional to determine if any of the information is right for your unique needs.

©2024 by Hippocrates Research Foundation. Proudly created with Wix.com

bottom of page