A new ad campaign in San Francisco intends to shock residents into getting their blood tested for Hepatitis B.  Hepatitis B is widespread in Asia and it is estimated that 1 in 10 residents of Asian descent are infected with the Hepatitis B virus. 

Overall about 1 in 1,000 people in the US are infected with Hepatitis B.  Fortunately Hepatitis B is easily identified with a Hepatitis B blood test.  In addition to being detectable through blood testing Hepatitis B can also be effectively treated and even prevented with a common vaccination.  If undetected Hepatitis B attacks the liver causing cancer and potentially death. 

The Hepatitis B virus is commonly spread through the exchange of bodily fluids, similar to other sexually transmitted diseases (STDs).  These types of disease have a stigma in certain communities where they often go undetected or untreated with debilitating consequences.  Periodic blood testing is an easy and convenient way to avoid serious health risks associated with STDs.  Blood tests can also be performed confidentially and anonymously to avoid embarrassment. 

 In Ads, Plea for Asians to Get Tests for Hepatitis

By JESSE McKINLEY

Published: May 2, 2010

SAN FRANCISCO — It is an image both shocking and strangely serene: 10 beauty queens, each with a broad smile, sparkling earrings and a beautiful gown. And written across the bottom of the photograph is a simple, stark question.

 “Which one,” it reads, “deserves to die?”

The image is part of a provocative advertising campaign by San Francisco Hep B Free, which aims to eradicate the disease with citywide vaccinations against hepatitis B. The campaign debuts here in print and on television this week and is aimed at jarring the city’s large Asian population into confronting the stubborn public health hazard of hepatitis B.

San Francisco health officials estimate that as many as 1 in 10 residents of Asian descent are infected with the virus here, a percentage that contributes to the nation’s highest rate of liver cancer, an unhappy distinction for a city that prides itself on its innovative universal health plan as well as its response to past epidemics like AIDS. In the general population, about 1 in 1,000 people are infected with hepatitis B, which attacks the liver.

A large part of the problem, according to leaders in the Chinese-American community, which is the largest Asian ethnicity here, is the stigma attached to the disease, which is endemic in much of Asia. The advertisements encourage people to get a “simple blood test” because “hepatitis B can be treated, even prevented.”

“We are not a confrontational group,” said Fiona Ma, a state assemblywoman from San Francisco, who is Chinese-American. “No one wants to talk about it. But we know that people care about their families and their friends. And maybe if they know it can affect them, then maybe they’ll talk about it.”

Ms. Ma knows of what she speaks; several years ago, she learned she had hepatitis B, which she apparently contracted from her mother. The virus that causes the disease can be spread through blood or other bodily fluids, said Dr. Edward A. Chow, vice president of the San Francisco Health Commission, who said that the disease often displays few symptoms in its carriers.

“It doesn’t manifest itself until it’s really too late,” said Dr. Chow, who said about 25 percent of patients, if untreated, develop serious ailments like liver failure.

The campaign’s confrontational approach has ruffled some feathers. Vicky M. Wong, the president and chief executive of DAE, the San Francisco firm that developed the ads, said that several of the beauty queen models walked out of the photo sessions because they were worried about its approach.

“There were so many debates as to whether ‘Are we going too far, is this right or not?’ ” said Ms. Wong, whose company specializes in campaigns geared to Asian audiences. “We got a lot of pushback. But there’s a lot of people who loved it.”

Ted Fang, a committee member for Hep B Free, said the high rate of infection among Asians here has been especially frustrating considering that a vaccine for the disease has existed for nearly 30 years.

“We have the medical tools, so long as doctors will test their patients and monitor them,” Mr. Fang said. “We can knock out this disease.”

Mr. Fang and others liken the city’s efforts to the battle against AIDS, which ravaged San Francisco and its gay community in the 1980s and 1990s and also inspired in-your-face tactics. The Hep B Free program began several years ago with a more gentle campaign — the tagline was “B A Hero” — but organizers said it had gone only so far.

“Saying ‘Life is beautiful; get tested,’ doesn’t work,” Ms. Wong said.

For the “Which one deserves to die?” campaign Ms. Wong enlisted volunteers from the Asian community to pose for photographs, depicting families, a basketball team, a group of doctors and office workers.

While the campaign is being published in several languages — including Chinese, Korean and Vietnamese — a target group is English-speaking doctors, outside the Asian community, who might not be aware of the prevalence of the disease.

“Within our ethnic groups, we are all aware of this, because we all have friends and families who have it,” Dr. Chow said. “But if you are a very busy practitioner who has a lot of different types of patients, you may not know to check at first.”

For Ms. Ma, the assemblywoman, who said she discovered she was positive for hepatitis B when she tried to donate blood, her goal was to bring the disease “above ground,” she said. And it is personal: while she is in good health, her mother, who is in her 70s, had part of her liver removed as a result of the disease.

She recovered, Ms. Ma said, but others she knew have not.

“It’s a silent killer,” she said.

A Cholesterol blood test should be performed semi annually as part of a personal wellness plan.  This schedule can be difficult for many individuals because of the requirement to fast prior to the blood test.  Specifically when having your blood tested for cholesterol the accepted procedure is to “fast” for nine to twelve hours prior to the test.  This means not to eat or drink anything (except water) during that period if you want the blood test results to be accurate.  Now research suggests that this may not be a steadfast requirement.   The new study followed children who had their total cholesterol, high density lipoproteins (HDL), low density lipoproteins (LDL) and triglycerides measured twice daily.  Researchers found that fasting had no significant impact on total cholesterol or HDL levels.   However, there was a nominal increase in LDL levels and a negative effect on the triglyceride levels in children who were fasting.  The findings were not conclusive but it does bring hope to those of us who don’t like to skip breakfast.

Fasting may not be necessary for children prior to cholesterol test–study

TheMedGuru.com:  May 4, 2010

According to a new study, the usual practice of fasting overnight before a cholesterol assessment so as not to affect the result may not be necessary in children.

According to a new study, the usual practice of fasting overnight before a cholesterol assessment so as not to affect the result may not be necessary in children.

Some recent studies in adults have established that elimination of fasting prior to lipid tests did not greatly alter the results.

Lead author of the study, Dr Asheley C. Skinner of the University of South Carolina, School of Medicine at Chapel Hill stated, “Cholesterol testing can be very difficult for families

When having to fast, this almost always means the child has to return on another morning for the test, which can be very problematic for busy families.”

Data analyzed

In a bid to assess whether lipid tests are reliable without fasting, the researchers analyzed data from the National Health and Nutrition Examination Survey 1999-2006 among kids and adolescents.

All the children were asked to have total cholesterol (TC), high density lipoproteins (HDL), low density lipoproteins (LDL) and triglycerides tests either in a morning or afternoon session.

The fasting status of the children was recorded. In addition, factors such as weight, age, race, ethnicity and sex were taken into account.

Findings of the study

The researchers noted that fasting had no significant effect on TC or HDL levels. Meanwhile, there was only a nominal increase on LDL levels in children who had fasted.

However, fasting did exhibit a negative effect on the triglyceride levels.

Skinner stated, “These results suggest it might be acceptable to simply test children immediately during whatever clinical visit prompted the recommendation to test.

“Because the American Academy of Pediatrics recommends cholesterol screening for a large group of children, these findings could reduce the burden of such screening.

The study has been presented at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

Cholesterol tests

A total cholesterol test is a rough measure of all the cholesterol and triglycerides in your blood.

Cholesterol is a waxy fat like substance found in all parts of the body. The body requires a small amount of cholesterol to work properly. Too much cholesterol can clog the arteries and lead to heart disease.

Some cholesterol is considered “good” and some is considered “bad.” Different blood tests are needed to individually measure each type of cholesterol.

The general procedure to get accurate results is not to eat or drink anything for nine to 12 hours before the test. Water is allowed but other beverages such as coffee, tea, or soda should be avoided. Drugs are also not allowed as that can affect the test.

by Neharika Sabharwal

In the midst of the medical community’s controversy regarding PSA blood testing a panel of prostate cancer experts brought together on Capitol Hill clearly concluded that a PSA blood test can save your life and is still the best tool for early detection of prostate cancer.  The statement of the panel reflected an understanding that men who are concerned about prostate cancer want to know if they have the disease or not and the PSA blood test is the best way to find out.  Overtreatment of prostate cancer is a macroeconomic concern – on an individual basis knowledge is still power.

Experts To Men: Controversy Aside, PSA Test Can Still Save Your Life

Article Date: 25 Apr 2010

A flurry of confusing research about the benefits of PSA testing has left many men and their physicians reticent to use a test that may be life-saving, says a panel of prostate cancer experts. The experts who gathered on Capitol Hill in Washington on Tuesday agreed that PSA testing, while not cancer-specific, is one of the best available tools for early detection of a cancer that kills 27,000 American men each year.

“Every man has the right to know if he has cancer,” said Jonathan W. Simons, MD, president and CEO of the Prostate Cancer Foundation. “And right now, the PSA test and an informed discussion with their doctor are the best tools men have for an early diagnosis.”

Conflicting major studies from 2009 about the value of PSA screening in men created many questions about whether the test leads to unnecessary intervention. Experts agree that prostate cancer is often overtreated, leading to an estimated $3 billion in unnecessary health care expenditures each year.

Yet, the panel agreed on Tuesday that men with a higher risk of prostate cancer-such as health profile, race or family history-should talk to their physicians about a baseline screening at age 40. Generally speaking, all men should partner with their doctor to create a proactive prostate health plan that is right for them based on their lifestyle and family history.

“This underscores the acute need for better diagnostics in prostate cancer,” continued Simons. “Fortunately, we are on the cusp of many promising advances that will tell us not only whether cancer is present, but also help us distinguish between the mostly benign slow-growing cancers and the fast-moving deadly cancers.”

These experimental blood and urine tests that examine genetic markers will help physicians hone in on the more aggressive cancers and ensure that treatment is used on those who actually need it. The federal government is currently funding critical pieces of research, primarily through the Department of Defense Congressionally Directed Medical Research Program (CDMRP) for prostate cancer, that have led to important advances in the state of the science.

“We need to make sure that policymakers understand the imperative to maintain this level of research,” says Ward “Trip” Casscells, MD, Retired Assistant Secretary of Defense, and Professor of Medicine and Public Health at the University of Texas Health Science Center. “Without that investment, we will continue to throw money away each year on overtreatment.”

The experts on the panel concluded that there is still much work to be done in advancing the diagnostics and treatments for prostate cancer. Prostate cancer is the most common non-skin cancer in America, affecting 1 in 6 men. In 2009, more than 192,000 men were diagnosed with prostate cancer, and more than 27,000 men died from the disease. One new case occurs every 2.7 minutes and a man dies from prostate cancer every 19 minutes. It is estimated that there are more than 2 million American men currently living with prostate cancer.

The panel was moderated by Dr. Trip Casscells and included experts from the Prostate Cancer Foundation, the AUA Foundation, Johns Hopkins University Medical Center, the Louis Warschaw Prostate Cancer Center at Cedars Sinai Medical Center, UCLA and the Black Barbershop Health Outreach Program. Richard Steele, a prostate cancer survivor and on-air radio host for Chicago Public Radio, also participated. A video archive of the discussion can be found at http://www.pcf.org.

Source

Prostate Cancer Foundation

A report given at the American Association for Cancer Research annual meeting on Saturday by John Hopkins University researchers found that a new and improved PSA blood test increased the accuracy of filtering aggressive prostate cancer tumors to 70%.  This new PSA blood test measures three different types of PSA and is a marked improvement over the current PSA test which while proven to identify prostate cancer does not differentiate between aggressive and less aggressive forms of the disease.  There is currently a heated controversy in the medical community regarding the widespread use of PSA blood testing leading to unnecessary treatment of nonaggressive tumors.

New PSA test may predict prostate cancer’s aggressiveness

By Ed Edelson, HealthDay

An updated version of the standard prostate cancer test can help improve predictions about which men might not require immediate treatment, researchers report.

The basic test measures blood levels of prostate-specific androgen (PSA), a protein produced by prostate gland cells. But the standard PSA test cannot distinguish between cancers that grow so slowly they can safely be left alone and aggressive life-threatening tumors that call for surgery or radiation therapy.

The new test measures blood levels of three different types of PSA. Combined with annual biopsies, or tissue samples, it was about 70% accurate in singling out the aggressive tumors in a small study, John Hopkins University researchers were to report Sunday at the American Association for Cancer Research annual meeting, in Washington, D.C.

“What we have shown is that using the Prostate Health Index and tissue DNA measurement is informative in separating out patients whose cancers are likely to progress vs. those that are not likely to progress,” said study leader Robert W. Veltri, an associate professor of urology and oncology at Hopkins.

Prostate Health Index is the name given to the test by Beckman Coulter Inc., which plans to market it.

The study included 71 men originally diagnosed as having small, low-grade and low-stage prostate cancer, the kind whose ultimate aggressiveness is often in doubt.

Currently, identifying the dangerous tumors in that group is no better than “a coin-flip,” Veltri said, and, as a result, many men and their doctors choose treatment that might be unnecessary and can cause impotence and other major problems.

Men in the trial had periodic blood tests that measured three different forms of PSA, including pro-PSA, a molecule in which two of the amino acids that make up the protein have been clipped off. It is the pro-PSA level that is most valuable as a predictor, Veltri said, but it is only one part of the study.

The new PSA test is given twice a year, along with a digital rectal exam to determine the size of the tumor, and a yearly biopsy. The regimen found unfavorable indications for 39 of the cancers — meaning progression of cancer grade or tumor size — and favorable for the 32 others, Veltri said. “When you combine the DNA reading and the serum Prostate Health Index, it is accurate in about 7 out of 10 cases,” he said.

But it was a small study, and “it will take another year or two to get enough cases to nail down the predictive index,” Veltri said.

The Hopkins group is trying to identify other biomarkers that would improve the program’s predictive value, he said. One hope is that the now-annual biopsies could be done every other year, Veltri said.

The study results have caused “excitement,” he said. “Through active surveillance, we can identify a set of prostate cancer patients with low-grade tumors that may be able to have intervention deferred or delayed,” Veltri said.

The Hopkins work was described as “outstanding” by Dr. William J. Catalona, director of the prostate cancer program at Northwestern Memorial Hospital’s Robert H. Lurie Comprehensive Cancer Center, who pioneered the use of the standard PSA test and helped develop the new version of the test.

The test is awaiting approval by the U.S. Food and Drug Administration and already is approved for use in Europe, Catalona said. In a study of 2,000 men in the Chicago area, “we found it to be more accurate than the tests now available, and it also seems to identify the more aggressive prostate cancers,” he said.

Another report at the same meeting described use of a microchip to detect tumor cells in the blood of people with prostate cancer. The presence of circulating cells can indicate spread of the cancer to other parts of the body, but they are so rare that they are invisible to current technology.

The new circulating tumor cell (CTC) chip identified such cells in nearly half of 20 people with early-stage prostate cancer and in two-thirds of people with advanced cancer, providing important prognostic information, researchers at Massachusetts General Hospital reported.

A neurological study has found that increase levels of CRP are associated with thinking problems in executives.  This study measured skills such as decision making, planning and memory.  The finding suggested that participants with the highest CRP levels took longer to complete the tests.   

The CRP blood tests is typically used to measure inflammation in the blood and is also known as an indicator of heart attack risk.  This new research suggests ties to other functions including neurological health.  We believe that monitoring CRP levels through periodic blood testing is going to prove more and more valuable as more research such as this is released.

 Blood Gives Clues to ‘Executive Thinking’ Problems

High levels of C-reactive protein may affect decision-making and self-control

 MONDAY, March 29 (HealthDay News) — High blood levels of C-reactive protein (CRP) are associated with problems in executive thinking skills, such as planning, decision-making and self-control, says a German study.

CRP is considered an indicator of inflammation.

For the study, 447 older people underwent brain scans and were given tests of verbal memory, word fluency and executive function. Overall, the average time to complete the test of executive function was 85 seconds. But participants with the highest levels of CRP took an average of seven seconds longer to complete the test than those with the lowest CRP levels.

The researchers also found that those with the highest CRP levels had brain changes equivalent to 12 more years of aging than those with the lowest CRP levels.

There was no link between CRP levels and other cognitive functions, such as memory and language.

The study is in the March 30 issue of Neurology.

“The use of aspirin and (cholesterol-lowering) statin drugs, as well as physical activity and controlling weight, can help lower CRP levels in the body, but our analyses did not consider whether therapy would be effective or not,” Dr. Heike Wersching of the University of Munster, an author of the study, said in a news release from the American Academy of Neurology.

More information

The American Association for Clinical Chemistry has more about C-reactive protein.

– Robert Preidt

SOURCE: American Academy of Neurology, news release, March 29, 2010

Copyright © 2010 HealthDay. All rights reserved.

New findings were released at the 101st Annual Meeting of the American Association for Cancer Research suggesting a link between C-Reactive Protein (CRP) levels and colon cancer.  These findings support a hypothesis that chronic inflammation increases the risk of cancer.  A CRP blood test is typically used as a measure inflammation making it an indicator of infection in the body.  Research also clearly indicates that high CRP levels are correlated with a higher risk of heart attack and cardiac disease.  This new research suggests that high CRP levels may be a risk marker for cancer and a CRP blood test should also be considered when screening for colon cancer.

Blood test for inflammation could also show risk for colon cancer

Tuesday, April 20, 2010

Washington, April 20 (ANI): Scientists say that a blood test used to determine the level of inflammation in the body may offer some help in assessing colon cancer risk.

Gong Yang and colleagues show that levels of C-reactive protein (CRP), a protein produced by the liver in response to inflammation, are increased in women with colon cancer.

Blood tests for CRP are typically used as a non-specific marker for infection and inflammatory conditions. A more sensitive CRP test (hs-CRP) can help determine heart disease risk.

Previous studies suggested an association between elevated CRP levels and colon cancer, which fits with the hypothesis that chronic inflammation increases cancer risk. But due to small population sizes and mixed results of the studies, the relationship between CRP and colon cancer risk remains controversial.

“Although cancer-induced inflammation has been proposed to explain the relationship between elevated CRP levels and cancer risk, this hypothesis has not been well evaluated in previous studies,” said Yang.

“This study, the largest study thus far on circulating CRP and colorectal cancer risk, allows us to test this hypothesis in a more definitive manner,” Yang added.

The researchers measured CRP levels in blood samples from women participating in the Shanghai Women’s Health Study, a large population-based prospective study of nearly 75,000 Chinese women.

In an analysis of 209 cases of colon cancer and 279 healthy controls, the researchers found that women with CRP levels in the highest quartile (the upper 25 percent) had a 2.5-times greater risk of colon cancer compared with women in the lowest quartile. To examine if there is a causal relationship between blood CRP levels and colorectal cancer risk, they stratified the samples by the time intervals between blood sample collection and disease diagnosis.

They found that the increased risk was primarily seen in women with high blood CRP levels measured within the three years prior to diagnosis. As the interval between the blood draw and cancer diagnosis increased, the association between CRP levels and risk faded.

Because the increased risk associated was greatest in the first years after CRP measurement, Yang believes that high CRP levels may arise largely from the patient’s inflammatory response to cancer.

Therefore, high CRP may be more of a “risk marker” rather than a “risk factor”.

The findings were presented at the 101st Annual Meeting of the American Association for Cancer Research (AACR). (ANI)

A new tumor marker blood test for breast cancer is moving into a testing phase in the UK.  This blood test has the potential of diagnosing breast cancer before there are any visible signs of the disease.  The blood test would be very beneficial for younger women for whom mammograms are less effective.  Currently the CA 27.29 is the best blood test for breast cancer.  The level of CA 27.29 antigen in the blood increases as breast cancer progresses.  However, the CA 27.29 blood test is not highly sensitive or specific, meaning that it can result in false positives.

Simple blood test may help detect breast cancer

TheMedGuru.com: April 5, 2010

In what can be termed as a major breakthrough for an early diagnosis of breast cancer, a less invasive method may be on its way.

According to researchers, a simple blood test may detect breast cancer at the earliest stages, which will bring us a step closer to cure the killer disease that afflicts thousands of women each year.

The simple test would not only be a means to detect the disease when it’s still curable but the procedure would bypass unnecessary biopsies and all the anxiety and risks.

Dr James Mackay an oncologist and researcher at University College London who is helping to launch the test in the UK for private patients stated, “This test will be particularly useful for younger women who are at risk of developing breast cancer. They tend to have denser breast which mammograms cannot easily penetrate.

“What we are suggesting is that they have a mammogram and combine it with this test so that there is a greater chance of detection.”

The potential of the blood test

The general technique for breast cancer involves x –rays which detect the tumor only once it is enlarged and well on its way to spreading beyond the breast.

Additionally, there is a strong possibility of the tumors being missed altogether in a quarter of the cases especially younger women.

The new blood test, a brainchild of Diagenic ASA a Norwegian company, can pinpoint cancer long before the traditional scans currently in operation.

According to experts, a tumor the size of a small seed can be detected even before a woman has developed any symptom.

The process identifies elevated levels of chemical “markers” for cancer which are then picked up as blood flows through a tumor.

However, the scientists advise that a combination of the traditional mammography with the latest test would enhance the odds of tumor detection.

“We believe this technology has huge potential. There are many women, especially women below 50, for whom mammography can miss 20 to 30 per cent of their cancers.” remarked Dr Erik Christensen, the chief executive, DiaGenic.

Moreover, women found to have cancer by the test can then be given an MRI scan so that the tumor can be picked out, biopsied and then removed if the necessity arises.

Initial trials show promise

In the small trails conducted, it has shown promise in 75 per cent of the cases. Also it has saved one woman from losing both her breasts.

Dr Mackay said, “The lady was sent to us by a surgeon because she had several lumps in each breast and he was convinced they were cancerous. We ran a blood test that showed they were benign and she has been saved from horrendous surgery.”

The test is currently available at a private Harley Street clinic for £499 and doctors are optimistic that it shall be available for the general public on the Health Service within the next five years.

Need for more research

Researchers concede that despite the technology exhibiting a lot of potential, there is need for bigger trials before establishing the benefits of the test and recommending it for women at high risk.

Professor Kefah Mokbel, a consultant breast surgeon at London’s St George’s Hospital, said, “We need more trials before this can be taken on by the NHS but it is an interesting development.

“The results so far are interesting and it would be an extremely useful advance which could be combined with a mammogram to find tumors at an early stage.”

by Neharika Sabharwal

The following article describes that it is common for Malaysians to request tumor marker blood tests as part of their yearly medical checkup.  These blood tests are rarely done by physicians in the US as part of a preventative regimen and mainly utilized to guide treatments or if there are already signs of cancer or a family history of the disease.   Tumor marker blood tests screen for certain products that specific types of cancer produce and release into the blood.  The Carcinoembryonic antigen (CEA), Alpha feto-protein (AFP), CA 19.9, and Prostate specific antigen (PSA) blood tests are described.  The article accurately states that the tests are not 100% sensitive and potentially positive results should be interpreted by a doctor. 

Marked for Cancer

To detect the presence of cancer, tests can be carried out to track for tumour markers

Sun2Surf by Earn Gan

Most Malaysians who go for yearly medical checkups request for tests to detect tumour markers. A string of blood tests are carried out to detect different types of cancer. These tests basically check for tumour markers – substances that can be found in the body when cancer is present.

Cancer/tumour markers can be found in the blood or urine. They are the products of cancer itself or a product of our body in response to certain cancer or condition.

Some of these are marker specific for one particular cancer; some are markers for many types of cancer. There are many types of markers and they are generally used to diagnose cancer, to determine the prognosis and to detect recurrent cancer.

Common cancer marker

» Carcinoembryonic antigen (CEA)

This marker is sometimes detected in patients with colon cancer. However, for healthy people, CEA should not be used to screen for colon cancer, as this test cannot tell for sure whether or not someone has colon cancer.

This marker can be appear normal in person with colon cancer and can be high in conditions other than cancer. The main usage of CEA is to monitor the response of patients with confirmed colon cancer towards treatment and to detect early recurrence of cancer after surgery or treatment. This marker can be high in some non-cancerous conditions such as colitis (inflammation of colon), non-cancerous tumour of intestine, certain liver disease, and chronic lung disease. Smoking can also increase CEA level.

» Alpha feto-protein (AFP)

This marker is present in most liver cancer patients but again, not all. In patients with liver tumour, high AFP above a certain level means liver cancer. A high level of AFP is also present in people with inflammation of liver, certain testicular tumour or a rarer form of ovarian tumour.

» CA 19.9

This is a marker for cancer of the gastrointestinal tract, particularly cancer of the pancreas. In the early stage of pancreatic cancer, the level can be normal. It can be high in patients with colon cancer, stomach cancer, liver cancer and bile duct cancer. It can also be elevated in certain non-cancerous conditions such as thyroid disease, pancreatitis (inflammation of pancreas), colitis and certain female reproductive organ diseases such as endometriosis.

» Prostate specific antigen (PSA)

It is one of the more sensitive tumour markers. It is a protein produced by prostate and is elevated in patients with prostate cancer. However, it can also be elevated in men with benign prostate hypertrophy and infection or inflammation of the prostate. It is higher in the elderly and temporarily elevated after ejaculation. Many doctors do not recommend using it as a general screening test even though it is quite sensitive. It is mainly used to monitor the progress or prognosis of prostate cancer after treatment.

» Limitations

Most of these markers are not 100% sensitive. The reading can be normal even if a person has that particular tumour. Please be aware that this kind of phenomenon is not only seen in early cancer, it also happens in very advanced cancer.

These markers are not specific. The level can be high but not related to any cancerous tumours at all.

Some markers are not specific for one type of cancer. Further tests and investigations are needed to figure out what type of cancer a person is having.

Please do not have a false sense of security when the reading is normal. Some people think normal cancer marker levels mean no cancer, which is not true. As mentioned above, the markers are not sensitive in screening for cancer among the population.

If you want to screen for cancer, you should go to your doctor and have a proper examination and investigations done for that particular organ system. For example: mammogram for breast cancer; ultrasound for liver, pancreas, reproductive organ and prostate cancer; endoscopy for stomach and colon cancer.

If you have a mildly elevated marker and all the investigations are normal, you should consult your doctor for further evaluation. If you have a very high marker level, do not panic. Go to your doctor and get all investigations done as soon as possible.

Do not rely on cancer marker screening to prevent cancer. If you have strong family history of cancers, or symptoms that worry you, seek appropriate medical advice from your doctors.

New study recommends annual Hemoglobin A1c blood test for type 2 diabetes starting as early as age 30 and to be performed as vigilantly as cholesterol and blood pressure testing.

Call for Earlier Diabetes Screenings – Researchers Find Testing as Soon as Age 30 May Reduce Heart Attacks, Diabetes-Related Complications, Death

CBS News: March 30, 2010

(CBS)  Nearly 18 million Americans are currently diagnosed with diabetes, according to the American Diabetes Association. However, an additional 5.7 million Americans have Type 2 diabetes — but don’t even know it.

On “The Early Show,” CBS News Medical Correspondent Dr. Jennifer Ashton said screenings are traditionally recommended to begin for low-risk patients at age 45 and repeated every three years after. Low-risk, Ashton explained, means you are not overweight, obese or have a family history.

But a new study in in The Lancet medical journal, may change things. The research, based on a sample of the U.S. population, says earlier screening for Type 2 diabetes, starting between 30 to 45 years, can reduce heart attacks, diabetes-related complications and even death. Researchers recommend that people have their screenings done along with cholesterol and blood pressure tests.

Ashton explained there are currently three tests available for diabetes. The two older tests, Fasting Plasma Glucose Test and Oral Glucose Tolerance Test for Diabetes, both require overnight fasting. A “newer” test called the A1C test is a simple blood test and does not require fasting and can diagnose a stage before Type 2 diabetes called pre-diabetes. The A1C provides an average of your blood sugar control for up to three months. She added the A1C test is also used for home to monitor levels.

“These are all tests that can help catch the disease before it becomes too late and the harm is done to your body,” she said.

Another concern is diabetes among children. Type 2 diabetes is generally associated with older patients. But Ashton said, because of high childhood obesity rates, Type 2 diabetes rates have increased in children.

Ashton said if your child’s body mass index is over the 85th percentile, your child could be at high risk for Type 2 diabetes. Parents, Ashton said, should keep their child’s pediatrician up to speed on family history of diabetes (first or second-degree relative).

Ashton said, “Type 2 diabetes develops gradually, so some children may not show any symptoms or signs of diabetes — but if your child is overweight and has symptoms like increased thirst and frequent urination, blurred vision, fatigue, or patches of darkened skin (which may be a sign of insulin resistance) or slow-healing sores or frequent infections, see your pediatrician about any of the screening tests.”

Ashton pointed out a Centers for Disease Control and Prevention (CDC) recommendation that children should be tested starting from age 10 or the onset of puberty.

“Type 2 diabetes for children under 10 is rare,” Ashton said, citing the CDC. “Like adults, high-risk children need to be tested every three years.”

Screening tests can also look for pre-diabetes, which affects 57 million Americans — more than double the number of people who have diabetes.

Ashton said knowing you’re pre-diabetic can stop trouble in its tracks.

“Pre-diabetes is when your blood glucose levels are higher than normal but not yet high enough to be diabetes — research shows that this is a crucial point of diabetes prevention or future disease management,” she said. “You can delay and even prevent Type 2 diabetes by up to 58 percent through earlier intervention like exercising more and losing weight. Just 30 minutes a day of moderate exercise and reducing your body weight by five to 10 percent can reduce your risks.”

Early screening is also important because people with Type 2 diabetes might not have symptoms at all, Ashton said.

“Diabetes usually occurs gradually and the earlier you know, the earlier you can start to manage this disease,” she said. “Type 2 diabetes is frequently not diagnosed until complications appear. That’s why it’s important to get screened early — and also important to know your risk factors.”

Risk factors include:

• Family history

• Overweight

• High blood pressure

• Race/ethnicity (African-American, Hispanic/Latino, Asian American or Native American)

• History of gestational diabetes

The FDA has approved a blood test to aid in the evaluation of ovarian cancer.  This blood test would be used prior to a patient’ surgery to help determine if a ovarian mass is malignant.  This test called to OVA1 is combination of five established blood tests known as tumor markers: Cancer Antigen 125 (CA 125 II), Transthyretin (TT or prealbumin), Apolipoprotein A-1 (Apo A-1), Beta2-Microglobulin (Beta2M), and Transferrin (Tfr).   The results of these blood tests are combined in an equation to produce a single numerical score.

OVA1 Blood Test Now Available to Aid Pre-surgical Evaluation of Women for Ovarian Cancer

FDA-cleared test helps direct women to the most appropriate surgeon, promoting better outcomes

PRNewswire:  March 9, 2010

OVA1™, the first blood test cleared by the U.S. Food and Drug Administration (FDA) for aiding in the pre-surgical evaluation of a woman’s ovarian mass for cancer, is now available nationally through Quest Diagnostics, Inc. (NYSE: DGX), the world’s leading cancer diagnostics provider. With the availability of OVA1, physicians can assess, prior to a planned surgery, the likelihood that a woman’s ovarian mass is malignant in order to direct her to the most appropriate surgeon, promoting more favorable treatment outcomes. Vermillion, Inc. (OTC: VRML.PK), a molecular diagnostics company, developed the test in cooperation with Quest Diagnostics.

OVA1 is the first FDA-cleared protein-based in vitro diagnostic multi-variate index assays (IVDMIA), a new class of state-of-the-art software-based diagnostics. The test combines the results of five well-established protein biomarkers to produce a single numerical result to help a physician classify the likelihood that a woman’s mass is cancerous or benign.

“The availability of a new test that can help gynecologists and other physicians determine the likelihood a woman’s mass is benign or malignant is a significant development in the battle against this devastating disease,” said Karen Orloff Kaplan, MSW, MPH, Sc.D., chief executive officer of the Ovarian Cancer National Alliance, a leading patient advocacy group. “It is a big step towards helping each woman get the most appropriate care for her unique situation.”

Ovarian cancer is the leading cause of death from gynecologic cancers in the United States and the fifth-leading cause of cancer deaths in women.(1) Ovarian masses affect an estimated one million women and lead to as many 300,000 ovarian mass surgeries in the United States each year, according to an analysis by third parties on behalf of Quest Diagnostics.

Clinical practice guidelines recommend that women with ovarian cancer be under the care of a gynecologic oncologist. Yet, pre-surgical evaluations of ovarian masses, which include clinical evaluation and radiological tests such as CT scans and ultrasound, may provide inconclusive evidence of cancer. An estimated one third of initial surgeries for ovarian cancer are performed by gynecologic oncologists.(2)

“Studies show that surgery performed by a gynecologic oncologist to remove a cancerous ovarian mass is associated with more favorable outcomes,” explained Fred Ueland, M.D., associate professor gynecologic oncology at the University of Kentucky’s Markey Cancer Center and principal investigator of the prospective, multi-center OVA1 clinical trial evaluated by the FDA. “Based on my clinical experience, I believe OVA1 will not only help identify more women with ovarian cancer for referral to a gynecologic oncologist and improve cancer treatment outcomes, but it also will give other women greater confidence that their ovarian tumor is benign.”

In a prospective clinical study, OVA1, when combined with pre-surgical clinical and radiological assessments and used by non-gynecologic oncologists, detected 92 percent of malignant ovarian masses compared to 72 percent without OVA1. In addition, 14 of 20 woman who participated in the study whose cancer was missed by pre-surgical clinical and radiological assessments would have been identified as having malignant ovarian masses had OVA1 results also been evaluated prior to their surgeries.

“Too often, a gynecologist will operate on a patient for an ovarian mass only to find an invasive malignancy requiring the skill of a specialist to remove,” said Jon R. Cohen, M.D., senior vice president and chief medical officer, Quest Diagnostics, and a surgeon. “When this happens, the physician may need to prolong or terminate and reschedule the operation unless a gynecologic oncologist is readily available. OVA1 may help gynecologists and other physicians direct more women with cancer to a gynecologic oncologist for their first and hopefully only surgery.”

Approximately 21,600 new cases of ovarian cancer will be diagnosed in the United States in 2009, and approximately 14,600 women will die of the disease.(3)

The FDA announced it had cleared OVA1 in September 2009, and Quest Diagnostics is the only national laboratory services provider to offer it broadly in the United States. For more information, physicians and patients should refer to www.QuestDiagnostics.com or www.QuestDiagnostics.com/womenscancers. Physicians may also refer to www.Vermillion.com.

About OVA1

OVA1 is the first protein-based in vitro diagnostic multi-variate index assays (IVDMIA), a new class of state of the art software-based diagnostics, cleared by the FDA. The test utilizes five well-established biomarkers — Transthyretin (TT or prealbumin), Apolipoprotein A-1 (Apo A-1), Beta2-Microglobulin (Beta2M), Transferrin (Tfr) and Cancer Antigen 125 (CA 125 II) — and proprietary software to determine the likelihood of malignancy in women with ovarian mass for whom surgery is planned.

OVA1 is indicated for women who meet the following criteria: over age 18, ovarian adnexal mass present for which surgery is planned, and not yet referred to an oncologist. It is an aid to further assess the likelihood that malignancy is present when the physician’s independent clinical and radiological evaluation does not indicate malignancy. The test should not be used without an independent clinical/radiological evaluation and is not intended to be a screening test or to determine whether a patient should proceed to surgery. Incorrect use of the OVA1 Test carries the risk of unnecessary testing, surgery, and/or delayed diagnosis.