|
Diagnosis
Choosing a Doctor
You will have many doctors involved in your care. Most times, your primary doctor will refer you to specialists
he/she recommends based on your insurance network. These doctors who focus on a specific area of cancer
treatment will examine you then offer their opinions. Sometimes this is done while you are in the hospital.
Radiologists, Oncologists, Pathologists, Radiation Oncologists, Surgeons, and your primary
doctor often will
meet at a tumor board conference. Here information about your cancer is presented, they exchange thoughts and
ideas, then a treatment plan is made based on what is best for you. Your oncologist will be the one to talk with
you
about your options and coordinate your treatment schedule. You should feel the most confident in this doctor.
If you like the idea that your doctors are already chosen for you, this is a good way to avoid having to
make more
decisions. If you like to pick your own doctors, don't be afraid to speak up. You have a right to be seen by any
doctor and get as many opinions as you want. Just be sure to check with your insurance company for a referral
ahead of time to find out if they will pay for you to see out-of-network doctors.
When choosing your own doctor(s), you need to decide what qualities you want in a doctor that make you
feel
comfortable and trust in him/her. Do you want a doctor who is knowledgeable, well-respected, caring, easy to
reach or talk to, local, spends time answering your questions without being rushed, explains things in a way you
understand, is willing to listen to your concerns, and/or has a good bedside manner? Think about how much
information you want or need to know. Is this doctor willing or able to give you the type of facts you need? Some
people only want to know the bare minimum and others want to know every detail in complete medical terms.
When you are first diagnosed with cancer, let the doctors know if you want them to talk about
your cancer with any
family members or friends. By law, doctors/nurses/medical personnel must keep your medical history and
treatments confidential. That means whatever happens to you stays between you and them unless you give
permission or request that others be told. Be clear about whom you want details shared with.
Meeting with the doctors to find out whether or not you have cancer or what treatment is available is a
traumatic
experience. Your mind floods with all ranges of feelings like fear, anger, and sadness. Your concentration
becomes poor because you have so much on your mind. Your memory will be even worse since most people
experience a state of fogginess. You will be lucky if you can accurately remember half the things discussed. It is
important to have a family member or friend to help you remember and be there for support.
Prepare a list of questions before your next appointment so you do not forget to ask them in all the confusion.
Check with your doctor ahead of time to see if he or she minds being tape recorded so that you can review the
information later. Another suggestion is to check off the questions you want to ask from this book, take it with you
to your appointment, then fill in the doctor's answers.
Common Questions to Ask
What is my diagnosis?
What is wrong with me?
Is it certain, without any doubt, that I have cancer?
How did I get this?
What treatments are available?
Are there other methods of treatment?
What treatment do you recommend?
Why do you recommend this?
What are the benefits/advantages of the various treatment options?
What are the risks/dangers?
What is the goal of treatment? (Circle one)
Cure: The goal of therapy is to eradicate the entire tumor.
Control: The goal of stopping tumor growth.
Palliation: The goal is to reduce symptoms when disease is beyond control. May still involve
surgery,
radiation therapy, or chemotherapy to control or prevent symptoms.
What are the side effects?
How should I expect to feel during treatment?
How will my life change?
Will I need to make changes in my work, family life, and recreation time?
What drug or drugs will I be taking?
How will the drugs be given?
What if I choose another or no treatment?
Where will I get my treatments?
How long will my treatment last?
How often will I need to be seen?
What types of tests will I need during and after treatment?
What if I miss a treatment?
What if I start treatment and later decide to stop?
What are my restrictions with each treatment?
May I drink alcoholic beverages?
Are there any special foods I should or should not eat?
Where can I get a second opinion?
Is the treatment worse than the illness?
How do you know treatment is working?
If I do not feel sick, does that mean the treatment is not working?
Will I still be able to have children after treatment is done?
What costs will I have?
Will my insurance cover this?
Who gets information about my condition?
What is the best time to call if I have a question?
If I don't feel sick, does that mean the treatment is not working?
What can I expect after treatment?
Can I still see my regular doctors for colds, eye exams, dental work?
When should I call the doctor?
Do I need any vaccination shots before starting treatment?
Can I still have pets?
Special Questions for Clinical Trials
Clinical Trials are discussed in detail in chapter 4 treatments. If you are offered the choice
to try a clinical trial,
you may want to ask a few different questions suggested below.
What is the purpose of the study?
Who has reviewed/approved the study?
Who sponsors the study?
What does the study involve?
What kinds of tests are involved? (Find out what is done and how it is done.)
What is likely to happen in my case with, or without, this new research treatment? (What will the cancer
or
treatment do?)
What are other choices and their advantages and disadvantages? (Are there standard treatments
for my case and
how does the study compare with them?)
How could the study affect my daily life?
What side effects could I expect from the study? (There can also be side effects from
standard treatments and
from the illness itself.)
How long will the study last? (Will it require an extra time commitment on my part?)
Will I have to be hospitalized? If so, how often and for how long?
Will I have any costs?
If I am harmed from the research, what treatments will I qualify for and be entitled to?
What type of long-term follow up care is part of the study?
Diagnostic Tests
You may have already had certain tests done to find out if you have cancer or not. Most likely, you will
need more
tests to find out specific information about your cancer such as if it has spread, what size is it, and what treatments
will it respond to best. Doctors order these baseline tests as a starting place to compare future tests to. By doing
this, the doctor can measure how well the treatment is working and the status of your cancer.
If your doctor orders blood work or a test, look it up in the chart below to get an idea of what to expect.
Each lab
and X-ray department has their own way of doing their tests, so only use this as a guide and follow the instructions
they give you.
| Test & Purpose |
Procedure & Special Instructions |
| Angiogram:
Can view what the blood
vessels/tubes look like. |
A contrast is injected in a blood vessel in the groin area, then pictures are
taken. Takes one hour. Pressure is applied usually with sand bags over the
site. Bed rest for six hours after. |
| Barium Swallow:
(See Upper GI) Views
esophagus, stomach, and
part of intestines. Detects
tumors, polyps, ulcers and
motility disorders. |
Takes 30 minutes. Take laxatives if ordered. Notify MD if unable to have
bowel movement within two days. |
| Barium Enema:
Examines the intestines to
diagnose colorectal cancer
and inflammatory disease.
Detects polyps, diverticula,
and structural changes. |
The night before, a clear liquid diet is required. Laxatives and/or enemas may
be ordered. No food allowed after dinner and no liquids or food after
midnight. No oral medications. First, you lie on your back while a picture is
taken, then you lie on your left side while Barium Sulfate, a radiopaque
contrast, is inserted through a rectal tube in a form of an enema. May feel the
urge to have a bowel movement but you need to hold the enema in. Pictures
are taken. Takes 30 minutes to 1¼ hours. Drink lots of fluids. A laxative
may be ordered for up to two days after to prevent severe constipation from the
barium contrast. Feces/stools may be whitish color at first. Notify MD if
unable to have bowel movement within two days. |
| Biopsy:
Proof of malignancy.
Examining aspirated fluids,
scrapings, or washings
show malignant cells. |
Avoid aspirin one week prior. A biopsy is often the best way to tell if cancer is
present. While an abnormal area may be seen through scopes or on X-ray
films, a biopsy shows whether it is made of cancer cells. For some cancers, the
doctor uses a needle to withdraw fluid (aspirate) or remove small tissue
samples (needle biopsy). A surgical biopsy, done under local or general
anesthesia, removes the entire tumor or a piece of it. The sample of cells or
tissues removed is examined under a microscope. Takes 30 minutes to 2
hours. |
| Brain Scan:
Shows blood flow and
structure of brain. Reveals
tumors. |
A radio nuclide is injected intravenously. Thirty minutes later, pictures will be
taken while you are asked to lie still. Takes one hour total. |
| Bone Marrow Biopsy:
Diagnoses Oat Cell
Carcinoma, Leukemia, and
Hodgkin's Disease. |
Arrange for a ride home after the procedure in case the doctor wants to order a
sedative before the biopsy. A needle will be inserted and local anesthetic will
be used to numb the area. A sample from the chest (sternum) or hip (iliac
crests) will be withdrawn from a needle. You may feel a pressure sensation.
A small bandage or dressing will be applied. Takes 10 to 30 minutes. Apply
ice to area if sore. Ask the doctor if Tylenol can be taken for discomfort after.
Bed rest is recommended the rest of the day. Watch for signs of bleeding. A
small amount of dried blood is normal the first day. Anything more than that,
apply pressure over the site and call the doctor immediately. |
| Bone Scan:
Detects infection, bone
cancer and metastasis three
months before it will show
up on X-ray. |
Empty bladder before the scan. Two to three hours before, a contrast fluid will
be injected in a vein. Some places allow you to leave after the injection and
return in a few hours. You may be asked to drink four to six glasses of water
during that time. You will lie on a table while the scanner takes pictures.
Takes 30-60 minutes. |
| Bronchoscopy:
Shows inside the trachea,
nose, and bronchioles.
Detects tumors. |
Nothing to eat or drink six hours before. Remove wig, dentures, make-up, and
contact lenses. The back of the nose and throat is sprayed with a bitter tasting
numbing anesthetic. An intravenous sedative will be given, then a scope will
be inserted down your throat. You may feel like gagging, but the lungs have
no pain fibers so you will not be in pain. Takes 10 to 20 minutes.
Nothing to eat or drink until your gag reflex returns. This usually takes
approximately two to three hours. You may gargle after if your throat is sore.
Keep the head of the bed elevated until gag reflex is restored. |
| CT Scan:
Shows areas that may be
hidden by shadows of other
structures. Detects minor
differences between soft
tissue and bone densities in
any area of the body. |
You lie on a table then are moved into a large donut-shaped X-ray machine.
Pictures are taken as the scanner circles you. The computer analyzes them.
Takes 45 minutes to 1½ hours. |
| Chest X-ray (CXR):
Views lungs, bone, and
heart. Detects pneumonia
and tumors. |
Remove jewelry. Standing, you will be asked to take deep breaths, then hold
until the picture is taken. Takes two to four minutes. |
| Colonoscopy:
Views large intestine. |
A clear liquid diet may be ordered for two to four days and a laxative and/or
enema one to two days before. Stop using aspirin one week prior. You must
fast eight hours, then empty bladder and bowel prior exam. You will lie on
your left side after a sedative is given intravenously. A scope is inserted in the
rectum and along the bowel, Takes 30 to 90 minutes. |
| Colposcopy:
Views vagina and cervix. |
Empty bladder. You will lie on a table with your feet in stirrups. A speculum
is inserted and a PAP smear is done. If the doctor sees something suspicious,
he will use forceps to take a sample. Takes 10 to 15 minutes.
You may bleed for a few hours after. No tampons or sexual intercourse
allowed for two to seven days. |
| Cystogram/
Cytoscopy: Shows the
inside of the bladder,
prostate and urethra. |
You will lie on your back with your feet in stirrups spread apart. A scope with
numbing jelly is inserted, then an irrigation fluid fills the bladder.
Takes 15 minutes. |
| Endoscopy:
Views inside the GI tract,
respiratory system,
peritoneum, pleura,
diaphragm, mediastinum,
and reproductive system.
Detects lesions, strictures,
or foreign bodies in the
larynx. Aids in getting
samples to diagnose
laryngeal and other cancers. |
Nothing to eat or drink six to eight hours before the test.
A sedative will be given to help you relax, atropine to reduce secretions, and a
general or local anesthetic. Remove dentures, contact lenses, and jewelry prior
test. Empty bladder. An anesthetic spray numbs the throat. Intravenous
sedation is given, then small tube/scope is inserted into a body cavity or
opening. The scope can be rigid or flexible. Takes 30 min to one hour.
Avoid coughing and smoking the rest of the day. Spit out saliva instead of
swallowing it. Use throat lozenges to soothe a sore throat. |
| ERCP:
Views pancreas, liver, and
gallbladder. |
Nothing to eat or drink twelve hours before. Intravenous sedation and a
numbing throat spray are given. A scope is inserted. Takes 1 to 3 hours.
Nothing to eat or drink until the gag reflex returns usually in two to three
hours. |
| ER/PR Receptor Assay:
Estradiol and progesterone
levels will show if the
tumor will respond to
endocrine therapy. |
A sample of tissue is sent to a lab at the time of breast biopsy. See Biopsy.
Normal results are:
ER < 3 femtomoles/mg protein.
PR < 5 fem./mg. |
| Gallium Scan:
Detects presence and size of
tumors in brain, bone, liver,
lymph nodes and breast.
Used mostly for Hodgkin's
Disease and Non-Hodgkin's
Lymphoma. |
One to two days before the test, a radioactive fluid is injected in the vein.
Usually a laxative, enema, or suppository is taken at home the night before
and one to two hours before the test. You may eat a clear liquid supper.
During the scan, you lie on a table while pictures are taken. Lasts one to two
hours. After the test, drink lots of fluid to remove the radioactive materials. |
| IVP:
Detects size and shape of
kidneys and bladder. |
No food or liquid twelve hours before the exam. A laxative the night before
and an enema the morning of the test may be ordered. A contrast liquid is
injected in a vein a few minutes before the test, then pictures will be taken.
You may feel a warm sensation. Takes 45 minutes. Drink lots of fluids. |
| KUB (kidneys, ureters,
bladder): Detects disease,
obstruction, size, position,
and shape of kidneys and
bladder. |
No fasting needed. Lie flat while pictures are taken. Lasts one to two minutes. |
| Liver Biopsy:
Diagnoses tissue damage
and cancer. |
A local anesthetic is given by needle, then a piece of tissue is sampled by the
needle. Takes 15 to 30 minutes. Bed rest for rest of day. |
| Liver/Spleen Scan:
Evaluates the size, shape,
and position of the liver,
gallbladder, and spleen.
Detects obstruction
and metastasis. |
A radioactive fluid will be given by mouth or in a vein thirty minutes before.
You will lie on a table while the scanning machine takes pictures.
Takes approx. 1 to 1½ hours. |
| Lung Scan:
Reveals normal functioning
and structure of lungs.
Detects tumors. |
You will be asked to breathe through a closed ventilation system for four
minutes, then a small amount of radioactive gas will be added. You will need
to hold your breath at times. Takes 10 to 15 minutes unless a blood clot is
suspected, then may take 30 to 45 minutes. |
| Lumbar Puncture:
Detects leukemia and other
disorders. |
You will lie on your side while a needle will inject an anesthetic into your
spine to numb the area. The fluid will be withdrawn into a needle. Takes 15 to
30 minutes. Bed rest three hours, then limit activity rest of day. |
| Lymphangiogram:
Diagnosis and staging of
Hodgkin's and other
lymphomas, some pelvic
cancers, and prostate
cancer. |
No fasting needed. A blue dye will be injected by needle between the first three
toes after an anesthetic is given. Then 15 to 30 minutes later, pictures are
taken. Takes three hours and more pictures may be taken the next day. |
| Mammogram:
Detect breast tumors less
than one cm that cannot be
found with physical
examination. Views deeper
into tissue and is better able
to show the retro mammary
space. |
Do not use deodorants, powders or ointments the day of exam since they may
cloud the picture. Avoid coffee, tea, cola, chocolate five to seven days before
exam if breasts are sensitive. Pictures of the breast will be taken. Takes 15 to
30 minutes. |
| MRI:
Magnetic resonance
imaging views the body
similar to CT Scan without
exposing the patient to
radiation. Shows blood
flow, and diseased verses
healthy tissue. |
Notify the doctor if you have a pacemaker, any metal implants, any surgical
implants like a port or prosthetic knee. You lie on a table and are slid into a
tunnel. You hear a series of low tapping sounds and you must lie still for five
to ten minutes while pictures are taken and analyzed by the computer.
Images can be made clearer with the intravenous contrast agent DTPA.
Allergic reactions are rare. Takes 45 to 90 minutes. |
| MUGA Scan (cardiac
gaited pool scan): Detects
how the heart is operating. |
Thirty to sixty minutes before, a radioactive fluid will be injected in a vein.
Then you lie on a table while the scanner takes pictures for 15 to 30 minutes.
Takes 1 hour total. |
| Myelogram: |
No food or drink two to six hours prior. Same as a lumbar puncture, but an
intrathecal contrast is injected and X-rays are taken. The exam table may be
tilted to allow the dye to travel. Takes 30 to 60 minutes. Bed rest and increase
fluid intake. |
| Needle Aspiration/Biopsy:
Shows characteristics of
soft tissue and fluids. |
A local anesthetic is injected, then a sample of tissue is taken by needle.
Takes 30 to 60 minutes. |
| PAP Test: |
Lie on a table with feet in stirrups. A Speculum will be inserted in the vagina.
A Q-tip swab will be inserted to sample fluid and cells. Takes 5 to 10 min. |
| Sigmoidoscopy/
Rectal Exam: Detects
cancer and other diseases. |
Laxatives or enemas may be ordered the day before or one hour before the
exam. You will lay on your left side with your knees up to your chest while a
scope is inserted into the rectum. Takes 5 to 10 min. |
| Thyroid Scan:
Determines size and
function of the thyroid.
Detects tumors. |
Stop iodine intake one week prior. Avoid all thyroid medications, weight
control medications, multivitamins, oral contraceptives, cough medications,
and foods with iodine. A radioactive fluid will be swallowed or given
intravenously. The area will be scanned twenty-four hours later while you lie
on your back. Takes 20 minutes. |
| Ultrasound:
Views deep structures.
Differentiates between cyst
and solid mass. It is most
useful for tumors larger
than two cm in diameter in
the peritoneum, pelvis, and
retroperitoneum. |
Uses a microphone-like device that sends sound waves that bounce off internal
organs. The sound echoes made by the sound waves are converted into a
picture by computer. Takes 30 to 60 minutes. |
| Upper GI:
Detects size and function of
the stomach. |
No food or liquid after midnight. Sometimes, medication may be taken with a
sip of water. Ask your doctor. You lie on a table while a picture is taken.
Then, you may be asked to drink a contrast liquid that will help the X-ray pick
up more detailed information. Takes 45 minutes. Drink lots of fluids. A
laxative may be ordered to prevent severe constipation from the barium
contrast. Feces/stools may appear whitish at first as the barium is eliminated. |
Labs:
| Name |
Normal Results |
Implications |
| 17 Ketosteroids |
24 hour urine
Male: 8-22 mg./d
Female: 6-15 mg./d |
Increased in adrenal tumors, testicular tumors,
interstitial cell tumors, androgenic ovarian tumors. |
| Acid Phosphatase |
Serum Total
Males: 2.5-11.7 u/L
Females: 0.3-9.2 u/L
Tartrate: Inhibited
Fraction
Males: 0.2-3.5 u/L
Females: 0-0.8 u/L |
Elevated in prostatic cancer in 5% with the tumor
confined to prostate glands, 20% with regional
extension of tumor and 80% with bone metastasises.
Elevated some primary bone malignancies and
multiple myelomas.
Special Instructions: Temporary rise after a
transurethral resection of prostate or biopsy.
Alcohol, arsenicals, fluorides, heparin, oxalates, and
phosphates may interfere with test results. |
| Adrenocorticotropic
Hormone (ACTH) |
Plasma
Highest in the morning
Lowest at bedtime |
Increased in ectopic ACTH-producing tumors (lung,
adrenal carcinoma, adenoma). |
| Androstendione |
Serum
Male: 107 ± 25 ng/dl
Female: 151 ± 38 ng/dl |
Increased in ectopic ACTH-producing tumors,
ovarian tumors. |
| Antidiuretic Hormone
(ADH) |
Plasma
1-5 pg./ml |
Elevated in brain tumors and in systemic
malignancies with ectopic ADH production. |
| Alkaline Phosphatase |
Serum Adult:
4-13 u/100 ml
(King-Armstrong),
1.5-4.5 u/100 ml
(Bodawsky), 0.8-2.3
u/100 ml (Bessey-Lowry) |
Elevated in metastatic cancer to bone and liver,
osteogenic sarcoma, myeloma, and Hodgkin's
lymphoma with bone involvement.
Special Instructions: May be elevated in healing
fractures, renal disease, and liver disease. |
| Alpha Fetoprotein (AFP) |
Serum <30 ng/ml |
Elevated in 70% of liver (hepatocellular) cancers, in
choriocarcinoma, teratoma, embryonal cell tumors of
testis and ovary, some pancreatic, stomach, colon, and
lung tumors. Not in pure seminomas without
teratomatous component. |
| Amylase |
Serum
Adult: 56-190 IU/L |
Elevated in some lung and ovarian tumors. |
| Beta-Microglobulin |
2.0-2.5 ug/ml. |
Elevated in solid tumors, lymphoma, leukemia, and
multiple myeloma. |
| Bilirubin |
0.3-1.3 mg./dl. |
Special Instructions: Many medications may alter the
test results. |
| BUN (blood, urea,
nitrogen)
|
10-15 mg./100 ml. |
Special Instructions: Many medications may alter the
test results. |
| Calcitonin |
Fasting serum or plasma
Male: <100 pq/ml
Female: <25 pq/ml |
Elevated in medullary carcinomas of the thyroid,
some lung and breast tumors, carcinoids, colon
cancer, and GI malignancies.
Special Instructions: Many drugs including antacids,
estrogens, iron, potassium, diuretics, aspirin, insulin,
heparin, and laxatives may interfere with test results. |
| Calcium |
Fasting Serum
Adult: 8.4-10.2 mg/dl |
Elevated in 9% of malignancies with bone
involvement (mainly breast, lung, and kidney). Also
in multiple myeloma, lymphomas, leukemias,
squamous cell carcinoma of the lung, cancer of the
kidney, esophagus, pancreas, liver, parathyroid
tumors and bladder. |
| CA 15-3 |
Less than 31 U/ml. |
Elevated in breast, lung, ovary, and pancreatic
cancers. |
| CA 19-9 |
Less than 33 U/ml. |
Elevated in pancreatic, lung, colorectal and gastric
cancers. |
| CA 125 |
Less than 35 |
Elevated in ovarian cancer and some breast tumors. |
| Carcinoembryonic
Antigen (CEA) |
Plasma
Nonsmokers: 0-5 ng/ml
Smokers: 0-10 ng/ml
|
Elevated in 70% of colon cancers. Also seen in lung,
pancreas, stomach, breast, head and neck, and
prostate malignancies. Elevated in 20% of heavy
smokers. |
| Cholesterol |
Serum, Plasma Fasting
twelve hours.
Adults: 140-310 mg/dl |
Decreased in 16% of malignancies with bone
involvement. Elevated in some prostatic, liver, and
pancreatic malignancies. |
| Chorionic Gonadatropin
(beta subunit) (P-HCG) |
Serum or Plasma
Males and nonpregnant
females: <5.0 IU/L |
Elevated in a hydatidiform mole, choriocarcinoma,
testicular teratoma, ectopic HCG production by some
cancers of the pituitary gland, stomach, pancreas,
lung, colon, and liver. |
| Complete Blood Count
(CBC):
Leukocyte Count (White
Blood Cell Count, WBC)
Differential Count
Neutrophils
Segmented
Bands
Lymphocytes
Monocytes
Eosinophils
Basophils
Platelet Count
Hematocrit (Hct)
Hemoglobin (Hgb) |
Whole Blood
Adult Male: 3,900-10,600/MM3 (10.6)
Adult Female: 3,500-11,000/MM3 (3.5-11.0)
% of total WBC
56%
3%
34%
4%
2.5%
0.5%
Adults: 150,000-400,000/mm 3
Adult Males: 40-54%
Adult Females: 37-47%
Adult Males: 13.5-17.5
gm/dl
Adult Females: 12.0-16.0
gm/dl |
Elevated in hematologic malignancies,
myeloproliferative disorders.
Elevated in a wide range of myeloproliferative
disorders. May be elevated in wide spread
malignancies.
Elevated in lymphocytic leukemias. May be elevated
in Hodgkin's disease and malignancies.
Elevated in monocytic leukemia.
May be elevated in chronic myelogenous leukemia,
Hodgkin's disease, metastatic malignancies.
May be elevated in chronic myelogenous leukemia,
Hodgkin's disease.
Elevated myeloproliferative disorders. May be
elevated in advanced malignancies. May be decreased
in leukemias, tumors metastatic to bone marrow.
Low in anemia associated with many malignant
processes, leukemias. High in polycythemia.
Elevated in anemia associated with many malignant
processes, leukemias. |
| Electrophoresis:
Immunoglobulin A
Approximately 15% of
(IgA)
Immunoglobulin D
About 1% of (IgD)
Immunoglobulin E About
1% of (IgE)
Immunoglobulin G
Accounts for 75% of total
(IgG)
Immunoglobulin M
(IgM) |
Serum
Adult: 60-330 mg/100 ml
Adult: 0-15 mg/dl
Adult: .01-.04 mg/100 ml
Adult: 550-1900 mg/dl
Adults: 45-145 mg/dl |
Slight polyclonal increase in some malignancies of
breast, and monoclonal. Elevated in IgA myeloma.
Slight monoclonal increase in IgD myeloma.
Slight monoclonal increase in IgE myeloma. Slight
increase in certain advanced stage neoplasms.
Slight monoclonal increase in IgG myeloma.
Approximately 10% of immunoglobulins. First
antibody to respond to bacteria and bacteria toxins. |
Estrogens, Total
Estrogen (Estradiol)
Receptor Assay |
Serum
Adult Male: 40-115 ng/L
Adult Female: 61-350
ng/L
0.5-1.0 grams of tissue
Negative: <3.0 fmol/mg
protein
Borderline: 3-10 fmol/mg
protein
Positive: >10 fmol/mg
protein |
Elevated in estrogen-producing ovarian tumors, some
testicular tumors and adrenal cortical tumors.
Determines if breast cancer will respond to hormone
therapy. |
| Ferritin |
Serum
Male: 15-200 mg/dl
Female: 12-150 mg/dl |
Elevated in acute myeloblastic and lymphoblastic
leukemias, some Hodgkin's lymphomas, and breast
cancers. |
| Glucagon |
Plasma 50-200 pg./ml. |
Decreased in some pancreatic neoplasms. |
| Glucose |
Serum
Adult: 70-105 mg/dl |
Elevated in pheochromocytoma, glucogonama;
pancreatic malignancies. May be elevated in presence
of islet cell tumors, carcinoma of the adrenal gland,
and stomach, and fibrosarcoma. |
| Haptoglobin (Hp) |
Serum
Adult: 30-160/100 ml |
May be elevated in cancer, particularly with
metastasis, and in lymphomas. |
| Human Chorionic
Gonadotropin (HCG) |
Serum or plasma
Males and nonpregnant
females: <5.0 IU/L |
Elevated in seminomas and some female reproductive
organ cancers. |
| Lactic Dehydrogenase
(LDH) |
Serum
Ranges are highly
method-dependent
Men: 63-155 units
Women: 62-131 units |
Elevated in extensive carcinomatosis, leukemia, and
malignant processes (about 50% of cancer patients
have alterations in LDH patterns). |
| Leucine |
Serum 14-4 U/L |
Elevated in 60% of patients with pancreatic
carcinoma with liver metastasis. |
| Lysozyme |
Serum 4.0-13.0 mg/L |
Elevated in acute monocytic or myelomonocytic
leukemia and chronic myeloid leukemia. |
| Neuron Specific Enolase
(NSE) |
|
Elevated in neuroendocrine, neuroblastoma, and
SCLC (small cell lung cancer). |
| Pancreatic Oncofetal
Antigen (POA) |
Serum
|
Positive in large percentage of pancreas tumors. |
| Placental Alkaline
Phosphatase (PLAP) |
Serum (Regan
Isoenzyme) |
Elevated in seminoma and ovarian tumors.
|
| Progesterone Receptor
Assay |
1 Gram of tissue
Normal: <5 fmol/mg
protein
Positive: >10 fmol/mg
protein |
May be useful in predicting tumors likely to respond
to endocrine manipulation. |
| Progesterone |
Serum
Male: 0.12-0.3 ng/ml
Nonpregnant Female:
0-30 ng/ml |
Elevated in some ovarian tumors, molar pregnancy. |
| Prostatic Acid
Phosphatase (PAP) |
less than 2 ng/ml. |
Elevated in prostatic cancer. |
| Prostatic Specific
Antigen (PSA) |
0-4.0 ng/ml. |
Elevated in prostate cancer. |
| Serum Glutamic Pyruvic
Transaminase (SGPT) |
Serum
Adult: 5-35 U/ml |
Elevated in some liver carcinomas.
Special Instructions: Many drugs including aspirin,
antibiotics, and pain medication may interfere will
test results. |
| Serum Gamma Glutamyl
Transpeptidase (SGGT) |
Serum
Males: 6-37 mU/ml
Females: 4-24 mU/ml |
Elevated in some cases of renal cell carcinoma and
liver metastasis.
Special Instructions: Many drugs including aspirin,
antibiotics, and pain medication may interfere will
test results. |
| Serum Glutamic
Oxaloacetic
Transaminase (SGOT) |
Serum
Adult: 5-40 U/ml |
Elevated in about 50% of patients with liver
metastasis or infiltration. |
| Squamous Cell
Carcinoma (SCC) |
2 ng/ml. |
Elevated in cervical, head and neck, lung, and anal
cancer. |
| Testosterone |
Serum
Adult Male: 572 ± 135
Nonpregnant Females:
37 ± 10 ng/dl |
Elevated some adrenocortical tumors, gonadotropin-producing extra gonadal tumors. |
| Tissue Polypeptide
Antigen (TPA) |
95 U/L. |
Elevated in bladder, breast, colorectal, and lung
cancer. |
| Uric Acid |
Serum
Male: 4.2-8 mg/dl
Female: 3.2-7.3 mg/dl |
Elevated in some disseminated malignancies.
Decreased in some neoplasms including Hodgkin's
lymphoma, multiple myeloma, and bronchogenic
carcinoma. |
|
