BIOCHEMICAL ASPECTS OF CANCER AND TUMOR MARKERS

1. By
Dr KHALED ALGARIRI
CAMS- QASSIM UNIVERSITY
May 2023

2. Cancer is a disease in which some of the body’s cells
grow uncontrollably and spread to other parts of the
body.
Cancer can start almost anywhere in the human body,
which is made up of trillions of cells.
Normally, human cells grow and multiply (through a
process called cell division) to form new cells as the
body needs them. When cells grow old or become
damaged, they die, and new cells take their place.
Introduction
WHAT IS CANCER??

3. Introduction
Sometimes this orderly process breaks down, and abnormal or
damaged cells grow and multiply when they shouldn’t. These cells
may form tumors, which are lumps of tissue. Tumors can be
cancerous or not cancerous (benign).

4. Malignant tumors & Benign tumors
Cancerous tumors spread into, or invade, nearby tissues and can travel
to distant places in the body to form new tumors (a process
called metastasis). Cancerous tumors may also be
called malignant tumors. Many cancers form solid tumors, but cancers
of the blood, such as leukemias, generally do not.
Benign tumors do not spread into, or invade, nearby tissues. When
removed, benign tumors usually don’t grow back, whereas cancerous
tumors sometimes do. Benign tumors can sometimes be quite large,
however. Some can cause serious symptoms or be life threatening, such
as benign tumors in the brain

8. Tumor Markers
Tumor markers are substances that are released by cancer cells or
produced by the body in reaction to a malignant tumor or benign condition.
By measuring these biomarkers in blood, urine, stool, cerebrospinal fluid,
peritoneal fluid (abdominal fluid), or pleural fluid.
Most tumor markers are proteins, but DNA changes such as mutations and
other alterations may also be used as biomarkers or tumor markers. A
biomarker can be found circulating in bodily fluids or in a tumor tissue .

9. Tumor Markers

12. Purpose of Tumors Markers Tests
1-To monitor progress of a cancer: The most common use of tumor markers
is to follow a known cancer. In this setting, a decrease in the level of a tumor marker may
be a sign that a tumor is decreasing in size (in other words, that the treatment is
working) whereas an increase in the level could mean a tumor is progressing.
2-To monitor for cancer recurrence: With some cancers, an increase in a
particular tumor marker may indicate a recurrence of the cancer after
surgery.
3-To help diagnose cancer: Tumor markers are not used alone to diagnose
cancer but may provide clues as part of the workup.

13. 4-To screen for cancer: An example of a tumor marker used for screening
is the Prostate Specific Antigen(PSA) test for prostate cancer. PSA can be
used as both a screening test and to monitor a cancer. In some cases, a
tumor marker may be used to to screen people who have a high risk of
developing a particular cancer but not the general population.
5-To help stage a tumor: In some cases, tumor markers may be helpful in
determining the stage of a cancer, which is important in choosing the best
treatment options.
6-To help diagnose metastases: If a particular tumor marker level is very
high, it may suggest that a tumor is not only growing, but has spread
(metastasized) to other regions of the body.

14. 7-To estimate prognosis: In some cases, higher levels of a particular
tumor marker may indicate a poorer prognosis.
8-To predict complications of cancer: A 2018 study found that high
tumor markers (CEA, CA 19-9, and CA 125) in people with colon,
pancreatic, and ovarian cancers were associated with a high risk of
blood clots (deep vein thrombosis), a complication that already affects
roughly 20% of people with cancer at some time.

16. Some tumor marker tests that use body fluids (mainly blood or
urine) have a limited role in screening for certain types of cancer.
The tests are mostly used to screen people who:
•Have a high risk for the type of cancer that's linked to the tumor
marker being measured
•Have symptoms that could be from that type of cancer.

17. Common Tumor Markers
1-Alpha-Fetoprotein (AFP): Used to test for recurrence, help diagnose, or
monitor treatment with liver cancer or germ cell tumors of the ovaries or
testicles. False positives may occur with cirrhosis and hepatitis.
2-Beta human chorionic gonadotropin (Beta hCG): Used to
monitor choriocarcinoma and germ cell tumors. It’s also often
tested to confirm pregnancy. It may be elevated in both seminoma
and non-seminoma testicular cancers.
3-Calcitonin: Hormone that is used to monitor medullary thyroid
cancer.
4-Carcinoembryonic antigen (CEA): May be used to look for
recurrence, spread, or progression of colorectal cancer. It is also used
with some other cancers.

18. 5- CA-125: May be used to monitor progress with ovarian cancer. While it
has sometimes been used to screen for the disease, there are many false
positives.
6-Alk.phosphatase:The alkaline phosphatase marker is raised in the
following ways:metastatic tumors of bone or liver, prostatic cancer with
bone metastasism breast cancer metastasis ,Leukemia, and GIT tumors.
7- B2M (Beta 2-microglobulin): Tumor marker for multiple myeloma,
some lymphomas, and leukemias. It use to see if cancer treatment is
working and predict chances for recovery
Common Tumord Markers

19. What noncancerous conditions cause tumor markers to
rise?
Many noncancerous conditions can cause high tumor marker results.
Some of the most notable include:
1. Anemia.
2. Thyroid disease.
3. Ovarian cysts (benign).
4. Kidney disease.
5. Kidney stone

20. What does it mean when your tumor markers are
high?
High tumor marker results could suggest the presence of cancer.
It may also suggest that cancer has progressed or spread
(metastasized). But this test alone isn’t enough to diagnose
cancer. If you have high test results, the doctor will explain what
the numbers mean. They may also run additional tests.

21. What does it mean when tumor markers go down?
If tumor markers go down, it could mean treatment is working.
Tumor markers can go up and down over time, even over the
course of your treatment. For this reason, it can be difficult to
measure them consistently. That’s why doctor uses tumor marker
tests in combination with other diagnostic tests.

22. THANK YOU