From the Guidelines
Blood work for cancer typically involves a complete blood count (CBC), liver and renal function tests, alkaline phosphatase, calcium, and tumor markers such as CA 15-3, as recommended by the most recent guidelines 1.
Blood Tests for Cancer Diagnosis
The following blood tests are commonly used to detect, diagnose, and monitor cancer:
- Complete blood counts (CBC) to measure red and white blood cells and platelets
- Blood chemistry panels to assess organ function and detect abnormalities caused by cancer
- Tumor markers, such as PSA for prostate cancer, CA-125 for ovarian cancer, and CEA for colorectal cancer
- Circulating tumor cell tests to detect cancer cells in the bloodstream
- Circulating tumor DNA tests to identify genetic material from tumors
Specific Cancer Types and Blood Tests
Specific cancer types may require specialized blood tests, such as:
- Immunoglobulins for multiple myeloma
- Blood protein electrophoresis for certain blood cancers
Importance of Blood Tests in Cancer Diagnosis
Blood tests are an essential part of cancer diagnosis and monitoring, but they are typically used alongside imaging studies and biopsies for a complete diagnostic picture. The most recent guidelines recommend a thorough medical history and physical examination, along with laboratory and imaging studies, including chest X-ray, and, if lymphoblastic lymphoma (LL) is suspected, CT or PET/CT 1.
Limitations of Blood Tests
While blood tests can provide valuable information about cancer, they have limitations. For example, blood tests alone usually cannot definitively diagnose cancer, and some cancer types may not produce tumor markers or other detectable substances in the blood. Therefore, a combination of blood tests, imaging studies, and biopsies is often necessary for an accurate diagnosis and effective treatment plan.
From the Research
Blood Work for Cancer
- The blood work for cancer typically includes various tests such as complete blood count (CBC), liver function tests (LFTs), and tumor markers 2.
- Tumor markers are substances produced by cancer cells or in response to cancer, and they can be used to aid in cancer diagnosis, determine prognosis, and monitor therapy 2.
- Examples of tumor markers include carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), CA 125, and prostate-specific antigen (PSA) 2.
- A complete blood count (CBC) is a common blood test that evaluates the total numbers and characteristics of cell components in the blood, and it can be used to predict the risk of cancer, cardiovascular disease, and metabolic diseases 3.
- The utility of routine CBC, LFTs, and chest X-ray in the evaluation of patients with clinically node-negative breast cancer is low, and these tests are not recommended for routine screening 4, 5.
- The initial diagnostic workup for cancer of unknown primary (CUP) should include history and physical examination, full blood count, analysis of serum markers, a biopsy of the most accessible lesion, a CT scan of chest/abdomen/pelvis, and immunohistochemical testing 6.
Specific Blood Tests
- Fecal occult blood testing (FOBT) is used to screen for early colorectal cancer 2.
- Carcinoembryonic antigen (CEA) is used in the management of patients with colorectal cancer 2.
- Alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) are used in the management of patients with non-seminomatous germ cell tumors 2.
- CA 125 is used to monitor therapy in patients with ovarian cancer 2.
- Estrogen receptors are used to predict response to hormone therapy in breast cancer 2.
- Human epidermal growth factor receptor 2 (HER2) is used to identify women with breast cancer who are likely to respond to trastuzumab (Herceptin) 2.
- KRAS mutational status is used to identify patients with advanced colorectal cancer who are likely to benefit from treatment with anti-epidermal growth factor receptor antibodies 2.