Health Benefits of Chlorella

[Extracted from healingdaily.com]

Chlorella is a powerful detoxification aid for heavy metals and other pesticides. Numerous research projects in the U.S. and Europe indicate that chlorella can also aid the body in breaking down persistent hydrocarbon and metallic toxins such as mercury, cadmium and lead, DDT and PCB while strengthening the immune system response. In Japan, interest in chlorella has focused largely on its detoxifying properties - its ability to remove or neutralize poisonous substances from the body.

This detoxification of heavy metals and other chemical toxins in the blood will take 3 to 6 months to build up enough to begin this process depending on how much chlorella a person is taking. Chlorella is a food. As such, it is almost impossible to take too much chlorella. It is also this fibrous material which greatly augments healthy digestion and overall digestive track health.

How Does Chlorella Detoxify Your Body ?

Chlorella is comprised of a fibrous, indigestible outer shell (20%) and its inner nutrients (80%). It is the fibrous material which has been proven to actually bind with the heavy metals and pesticides - such as PCBs - which can accumulate in our bodies.

A clean bloodstream, with an abundance of red blood cells to carry oxygen, is necessary to a strong natural defense system. Chlorella's cleansing action on the bowel and other elimination channels, as well as its protection of the liver, helps keep the blood clean. Clean blood insures that metabolic wastes are efficiently carried away from the tissues.

Chlorella gets its name from the high amount of chlorophyl it possesses. Chlorella contains more chlorophyl per gram than any other plant. Chlorophyl is one of the greatest food substances for cleansing the bowel and other elimination systems, such as the liver and the blood.

Green algae are the highest sources of chlorophyl in the plant world. And of all the green algae studied so far, chlorella has the highest, often ranging from 3 to 5% pure natural chlorophyll.

Chlorella is a key detoxification tool

Hemoglobin is the protein in our red blood cells which binds with oxygen and gives blood its bright red color. Chlorophyll cells are nearly identical to hemoglobin, with one exception: Chlorophyll has a magnesium molecule at its center while hemoglobin has an iron molecule at the center of it.
This is important because magnesium is essential for the heart to function properly. Every time our heart beats, it is utilizing magnesium to do so.
Chlorophyll is effective against anemia and stimulates the production of red blood cells in the body. It also helps carry oxygen around the body and to the brain. This is why chlorella is often called a 'Brain Food'.

Several researchers have suggested the use of chlorophyll as a medical therapy for anemia.



Chlorella Will Improve Your Digestive System

Since chlorella has such a high chlorophyll content, people find chronic bad breath is often eliminated in just a few days on chlorella. Foul smelling stools are also greatly improved and chlorophyll has been attributed to relieving constipation.

Chlorella Shown To Be Helpful in Fighting Cancer

Interferon is one of our body's greatest natural defenses against cancer. One of the ways we fight cancer is to use agents to stimulate macrophage production and activity. Interferon is a natural secretion of the body which is thought to be a stimulator of macrophages and tumor necrosis factor.

Chlorella stimulates the activity of macrophages and T-cells by increasing interferon levels thus enhancing the immune system's ability to combat foreign invaders whether they are viruses, bacteria, chemicals or foreign proteins.

Chlorella Contains Natural Digestive and other Enzymes
Chlorella contains enzymes such as chlorophyllase and pepsin, which are two digestive enzymes. Enzymes perform a number of important functions in the body. Chlorella has many different types of enzymes that our bodies need.

It is essential that any chlorella you take is NOT freeze dried or pasteurized. If it is, then you have lost the crucial benefit of enzymes such as these.



Chlorella is Alkaline and Helps Balance Your Body's pH

It's important that we maintain a balance body pH of ideally about 7.2-7.4, which is about neutral. However, because of our poor diet of junk food, overcooked, processed foods, fast food, which include soft drinks which have a pH of 2.7, most of us are not balanced.

This is important because most diseases start, live and thrive in an acidic environment and do not live well in an alkaline environment. Cancer rates have risen steadily so that now fully 1/3 of all people in the U. S. will get cancer in their lifetime.

The rise of fast, junk and processed foods match those of rising cancer rates. 30 years ago, cancer in children was almost unheard of. Now they have entire hospital wards given over to children with cancer. Including whole foods like chlorella in your diet is one step you can take toward reducing your risks for cancer.

Chlorella Normalizes Blood Sugar and Blood Pressure

Studies have shown that chlorella tends to normalize blood sugar in cases of hypoglycemia. In hypoglycemia, blood sugar is too low. Proper levels of blood sugar are necessary for normal brain function, heart function and energy metabolism, all of which are crucial in sustaining good health and preventing disease.

High blood pressure is one of the major risk factors in heart attack and stroke, which account for more fatalities in the United States than any other disease. Laboratory experiments have shown that regular use of chlorella reduces high blood pressure and prevents strokes in rats.

What Time Of Day Or Night Should You Take Chlorella ?

Chlorella can be taken at any time of the day. It can be taken all at once but preferably it should be taken in small dosages throughout the day. Morning is also a good time to take chlorella, but never just before or after drinking coffee or soft drinks since caffeine is extremely detrimental to the digestive process.

Chlorella causes the bacteria in our stomachs, the Lactobacilli, to multiply at 4 times the rate of normal. This is why it is best to take with meals as chlorella helps provide very good digestion and more importantly, better assimilation of nutrients.

Can Everyone Tolerate Chlorella ?

Because of the fiber content in chlorella's cell wall and other nutritional factors, when some people begin to take chlorella for the first time they may go through cleansing reactions, sometimes referred to as a "healing crisis". This cleansing reaction comes in the form of intestinal activity such as gas, cramping, constipation or diarrhea.

This same type of cleansing reaction frequently occurs when people switch from a low-fiber, "junk-food" diet to a high fiber, natural food diet.

For this reason, some individuals may wish to start out with less than the suggested amount and gradually increase up to the recommended dose in 1-2 weeks. Very sensitive individuals may want to start with as little as 1/16 of a teaspoon per day (300 mg).

If you have not been eating many fresh raw vegetables in your diet, it is probably a good idea to start out with one 1/16 of a teaspoon with each meal and increase by 1/16 of a teaspoon every 2-3 days.

As long as you are not showing an allergic reaction (such as hives) or throwing up, you can safely continue the chlorella. In a couple of months, the reaction should decrease. And as it decreases, you can increase the dose.

Can You Take Too Much Chlorella ?

It is best to think of chlorella as a food because that is exactly what it is: one of the purest, most potent foods on earth. A person can not take too much chlorella because it is naturally detoxifying. Therefore, the fear of chlorella accumulating and becoming toxic to the body is not present.

However, there is a "comfort level" with every person where he or she knows how much Chlorella to take per day. In general, that level will be about 5-8 grams per day.

A person taking 15-20 grams of chlorella per day is not at all unheard of if someone is trying to combat a disease with the amazing medicinal properties of chlorella. It is a whole food, not a concentrate or extract, therefore you can NOT take too much of it because of its detoxifying abilities.

I spend a lot of time researching the best prices for supplements on the internet, and in my opinion the lowest prices for high quality chlorella can be found here.

Can Chlorella Be Given To Children ?

Absolutely. In fact, chlorella has been shown to promote rapid growth in children, as well as build in them superior immune systems. Children can take 1/2 to 1/4 the adult dose described above.

Infant Milk Poisoning (Due to Melamine)

[This is a nice simplified explanation of an on-going incident, about the presence of 'melamine' in infants' formula, as well as a range of other dairy products and food items. Thanks to a friend who sent it via email to me]

1. What really is poisoned milk ?
It is the milk powder that is mixed with "MELAMINE"



What is Melamine used for ? It is an industrial chemical, which is used in the production of melawares.



It is also used in home decoration, such as "US resistant board"





Don't anyone understand ! Melamine is used in industrial production ! It cannot be eaten !

2. Why is Melamine added in milk powder ?
The most important nutrient in milk is protein. And melamine has the same protein that contains "NITROGEN"



Adding Melamine in milk reduces milk content and it is cheaper than milk, so it lowers capitalization. It can give the businessmen more profit !

Below is Melamine. Doesn't it looks like milk. It doesn't have any smell, so cannot be detected.





3. When was it discovered ?

Year 2007 ! (US cats and dogs died suddenly. They found that pet food from China contains Melamine).



Starting 2008... In China, an abnormal increase in infant cases of kidney stones.



August 2008... China's Sanlu Milk Powder tested with Melamine



Sept 2008 ...New Zealand gov't ask China to check this problem
Sept 21 2008 ...Lots of food products in Taiwan tested with Melamine

4. What happens when Melamine is digested ?
Melamine remains inside the kidney. It forms into stones, blocking the tubes. Pain will be eminent and person cannot urinate. Kidney will then swell.



Although surgery can remove the stones, but it will cause irreversible kidney damage. It can lead to loss of kidney function and will require kidney dialysis, or lead to death because of uremia.

What is dialysis ? In fact, it should be called "blood washing". It is filtering all of the body's blood into the machine and then, go back to the body.



The whole process takes 4-5 hours and it is necessary to undergo dialysis once for every 3 days for the rest of your life.

Here is a dialysis center



Large dialysis center



A small hole is required in the arm, to insert the sub-dialysis catheter.



Why is it more serious in babies ? Because their kidney is very small and they drink a lot of milk powder.

Here is a baby undergoing dialysis.



China currenty has 13,000 infants hospitalized



It does not matter how much a human being took Melamine. The important point is "It cannot be EATEN !"


5. What are the foods to be avoided ?
Foods that contain dairy products should be avoided.



Remember : Foods with creamer, or milk should be avoided.

6. Which companies are affected ?
Here under, are the companies affected with Melamine :



7. What do we do next !!!
Avoid the above foods for at least six months.

If you have snack bar, restaurant, or coffee shops... stop selling dairy products for the meantime.

If you have infants at home, change to mother's milk, or find other substitutes.

Finally, share this information with friends so they will understand the risk of milk poisoning.

Breast Cancer (Are We Really Looking For a Cure, Or a Cash Cow ?)

[Extracted from Ezine Articles. Sonya Green is the webmaster and author of Reinventing Myself. Her writing reflects her passion for finding Joy in everyday life. Love, health and happiness are available to us. The article below is well-phrased by her]


It's breast cancer awareness month. Everywhere I turn I find someone or something trying to engage me in breast cancer awareness. I'm trying to focus on health and wellness but its difficult when the media keeps pushing fear, expectancy and urgency at me. Why not have a health, healing and happiness awareness month ? I try not to be too cynical and I do understand that so many people are wanting to inform and assist, but I do also see the negative influence of being stuck in defining myself as a cancer victim. I see it as a form of voodoo: you had cancer, your going to get cancer, cancer will kill you, let us save you, watch out for cancer; everyone is touched by cancer...What irritates me most about these foundations or campaigns is the obvious plea for donations in the name of research. Well excuse me, but after decades of research and billions of dollars, what I see is nothing much more than reinventing the wheel; better chemo drugs, better surgical techniques, better radiation equipment and countless reports and stats. No cure and not even any real understanding of the cause. The hard fact is that most of the money raised is spent on wages; scientists, surgeons, hospitals, technology, administration, advertising and pharmaceuticals. Cancer is definitely a big, big business. Most of the research is being done by people who have a great financial stake in treating cancer.

What would happen if we found out that cancer was caused by air pollution, food tampering and modifying, water contamination, vaccines, antibiotics, bacteria or parasite infestation ? What if it really is about stress overload or the effects of radiation or low levels of oxygen ? It has even been suggested that cancer might not be a disease at all but a response by the immune system or a symptom caused by the immune systems inability to cope with an overload of toxins. Its even been suggested that a tumour might be the only way that the immune system can hold back abnormal cells by isolating clumps. That sounds pretty radical but we do know that many people die from cancer after all tumours have been removed. What if cancer is just a natural way for the body to eat up poisons and other crap but becomes erratic or unbalanced at a point of toxic overload ?

We do know that meat and dairy products are very different now to what they once were. Both are extremely high in protein, vitamins and minerals and by all accounts should be superior sources of health giving nutrients. BUT animals are now pumped up with hormones and antibiotics and who knows what other chemicals. They do not usually graze on natural foods, most of them are penned and are so stressed by their living conditions, transportation and abattoir treatment that we can only concede that their flesh is flooded with stress hormones prior to slaughter.

Milk has changed so much since the days of the cow on the farm. Have you noticed that milk will now last for many weeks under refrigeration ? Why doesn't it go sour within a few days the way it used to? Without even going into the argument of additives or processing, lets just think about milk for what it really is. No animal other than humans continue to drink milk after they are weaned. Natural milk from a healthy mother (of its own species) is perfect food for a baby. Once the baby is able to eat solid food, milk is no longer provided or required. How do we justify ingesting the milk of another species ? Why do we, as adults, believe that we should continue breastfeeding from a cow ? My main concern about milk is that a woman's body, at a certain age, winds down the whole baby making system. Most breast cancers show up in post menopausal women; menopause being nature's way of closing down the baby making system. Could it be that the breasts themselves are rejecting the foreign milk supply ? Wouldn't is be likely that a lactating cow would be full of the very hormones that a menopausal woman's body is trying to diminish ?

So far, science does seem to agree that there is a link between hormones and inflammation as probable causes or influences in breast cancer. Well, considering that meat and dairy are both acid forming foods, which create inflammation, and again both are naturally and often artificially pumped up with hormones, doesn't it at least raise some questions ? It is also thought that cancer might be caused by bacteria or virus and it is now common knowledge that we are becoming resistant to a lot of antibiotics due to our over consumption, do we really need more coming through our food supply ? It does seem that most woman do tend to have a bacterial and or fungal imbalances a lot of the time.

Another area which has had very little attention is the possibility of parasite infestation. Most of us won't even consider the idea that we might be overrun with parasites and rarely consider them as a serious health issue. Many of us were treated for threadworm as kids but in modern times we tend to think that they are as insignificant as hair lice. Science seems to be tunnel visioned about viral and bacterial issues and seems to have little interest in parasites. It's an unsexy topic to be sure and very little research goes into it. We tend to think there are about four common worms and unless we have an itchy anus or little white threads showing in our poo then we assume we don't have a problem. Most treat themselves with a pill from the pharmacy but it is now thought that they only address a few of what might well be hundreds or more. They are not a third world country complaint - they are a human complaint and it has been estimated that as many as 85% of people will have a parasite problem. In countries where people are more aware of the problem they eat foods which prevent infestations whereas our diets actually encourage parasites; sugar being the main culprit. Many countries include things like garlic, tumeric, cabbage, chilli, pepetas, kelp, wasabi and cloves in their diets to address the parasite problem and interestingly these countries are also the ones with the lower breast cancer rates. It has always been thought that eating uncooked meat or touching animals are the main reasons for worms but in these days of global travel and eating out it is very likely that we are picking up parasites by breathing in eggs or touching things like money, handrails or shopping trolleys or pretty much anything that has been touched by unwashed hands.

So, what's the connection between parasites and breast cancer ? Well, there is some suggestion, or at least an interesting point of view, that parasites might cause cancer. One theory is that parasites might hide in joints and tissue and that the immune systems response leads to the abnormality of the cells. Another theory is that the parasites are giving off toxins which become carcinogenic. Another theory is that the parasites are robbing us of nutrients and weakening us to such a degree that the immune system becomes unable to preform effectively. It has also been suggested that many of our so called degenerative diseases such as arthritis might well be caused by the same principle. It's even been thought that a tumour might be a parasites hiding place - that is, parasites might actually create a safe hideout like a cocoon for their eggs.

I do not have the answers myself just a lot more questions. My take on all of this is that many of these things might prove to be correct and if that is so then very easily addressed. At worst, none of these alternatives will cause any harm and will at the very least help to cleanse and strengthen the body. Experimenting with our diet and lifestyle or attempting to rid the body of fungus and bacteria's will only create better health and well being. Detoxifying the body and taking antiparasitic herbs can only help and who knows might even be the simple answer we have been searching for.

My main point is that we need to look outside the box that we keep looking into. Too many people are dying or at least suffering serious complications after chemo and radiation therapies. They keep saying that less people are dying of cancer but we are not hearing enough truth about the people who are dying from heart, liver and kidney diseases bought about by adverse reactions to such therapies. It is well documented that radiation can increase the risk of cancer! When the best we have on offer at the moment is the destruction of healthy cells, in an attempt to bring about a remission, then I do believe that we are not closer to a cure at all. I think we are creating other major health problems - like destroying cancer cells but dying from liver disease due to the toxicity of the drugs used.

Maybe modern medicine will come up with the answers, and all in all, I guess we can only be grateful for the time, effort and funding going into it. I'm just trying to raise questions about some of this funding going into practical help for the real sufferers; more money treating patients rather than servicing gala events and advertising. Let's put some funding into testing our food, air and water. Let's do some serious research on people who have survived cancer without medical interference. Let's be more honest about the real cause of death if it is caused by or influenced by medical intervention.

Let's be skeptical about the fact that too many diseases have drugs which don't cure but can be used ongoingly to stop the progression or alleviate the symptoms. Isn't it interesting that heart disease, high blood pressure, high cholesterol, diabetes, epilepsy and arthritis just to name a few, all have drug therapies that are taken on a daily and ongoing basis. What exactly has been actually cured in the last few decades ? Am I the only one who wonders if one very cheap drug cured a disease would it ever be released? Is a drug company ever going to sell a $5 cure when it can earn $50,000 over a lifetime of symptom suppression? If a research facility has invested millions of dollars into research, how will they recoup that money if they discover that a cure is something as simple as dechlorination the water or drinking green tea ?

At the very least I think it is up to us all to take our own health into consideration and not just blindly accept everything we are told. Everything is just a perception or an opinion until it becomes a truth for us. Lateral thinking might lead us through a few dead ends but if experimenting with alternatives helps to create stronger immune systems and "Does no harm" then surely they are worth exploring.

Deadly Breast Cancer !!!

Do not wait until it has reached these stages (see below).

Act early, or remove it ... even though your own doctor claimed that any such growth within your breast is 'non-malignant or non-cancerous'.

In actual fact, for any growth detected... they should be considered as 'cancerous'. There is no such thing as 'non-cancerous' and no one should leave it 'unattended' until a serious condition eventually evolved. It will be too late. A good doctor will ask you to remove it. If there is any doctor that asked you to leave it as it is, and until you 'detected' any high fever ...... you can ask him or her, to change their profession soon.

6 Breast Cancer Signs To Be Aware Of
Knowing the different breast cancer signs and symptoms can truly help save your life in the future. It is essential you understand everything that can be a signal for breast cancer so you can get treatment as soon as possible. Here are six breast cancer symptoms to be aware of.

1. Lump
Although most lumps found in breasts are not cancerous, this is the most common sign of breast cancer for both men and women. A lump or thickening in the breast is a clear indication that you should get a physical exam to make sure everything is ok. Often times the lump is painless, but it may be tender or sore from time to time.

2. Discharge from the nipple
You may experience a spontaneous clear or bloody discharge from your nipple. This is often times associated with a breast lump. While this does not mean you definitely have breast cancer, it is certainly a symptom you do not want to take lightly.

3. Change in size of your breast
This is where it becomes essential you are familiar and aware of your body. It can be difficult to notice a slight change in the size or contour of your breast, but this is a clear breast cancer sign to pay attention to. In some cases, the change in size may be much more obvious.

4. Indentation of your nipple
If you notice a retraction or indentation of your nipple, this is not something that typically occurs. You want to keep an eye on it and if it worsens, get into a doctor for a physical exam.

5. Indentation of skin over the breast
In addition to indentation of your nipple, you also want to keep an eye on the skin that is around the breast. A symptom of breast cancer is if you notice an indentation or flattening of the skin over your breast.

6. Redness of skin over the breast
The last sign you want to pay close attention to is any redness or pitting of the skin over the breast. Many times it looks almost like the skin of an orange in shape and texture.

There are a number of breast cancer signs you want to be aware of. If you feel you are experiencing one or several of the symptoms listed in this article, it is vital you get in to see a doctor immediately. The sooner you catch the cancer, the better chance you have of stopping it.

Knowledge about Jaundice !

[Extracted from Health-Cares.net]

What is jaundice ?

Jaundice is yellowing of the skin, sclera (eyes) and mucous membranes caused by increased levels of bilirubin in the system. Usually the concentration of bilirubin in the blood must exceed 2-3mg/dL for the coloration to be easily visible. Jaundice is not an illness, but a medical condition in which too much bilirubin – a compound produced by the breakdown of hemoglobin from red blood cells – is circulating in the blood. This excess of bilirubin causes the skin, eyes and the mucus membranes (inside of the mouth) to turn a yellowish color. This yellowish color is due to the bilirubin dissolving in the fat layer just below the skin.

The most important function of the liver is the processing of chemical waste products like cholesterol and excreting them into the intestines as bile. The liver is the premier chemical factory in the body--most incoming and outgoing chemicals pass through it. It is the first stop for all nutrients, toxins, and drugs absorbed by the digestive tract. The liver also collects chemicals from the blood for processing. Many of these outward-bound chemicals are excreted into the bile. One particular substance, bilirubin, is yellow. Bilirubin is a product of the breakdown of hemoglobin, which is the protein inside red blood cells. If bilirubin cannot leave the body, it accumulates and discolors other tissues. The normal total level of bilirubin in blood serum is between 0.2 mg/dL and 1.2 mg/dL. When it rises to 3 mg/dL or higher, the person's skin and the whites of the eyes become noticeably yellow.

Bile is formed in the liver. It then passes into the network of hepatic bile ducts, which join to form a single tube. A branch of this tube carries bile to the gallbladder, where it is stored, concentrated, and released on a signal from the stomach. Food entering the stomach is the signal that stimulates the gallbladder to release the bile. The tube, which is now called the common bile duct, continues to the intestines. Before the common bile duct reaches the intestines, it is joined by another duct from the pancreas. The bile and the pancreatic juice enter the intestine through a valve called the ampulla of Vater. After entering the intestine, the bile and pancreatic secretions together help in the process of digestion.

Jaundice is very common in a mild and transient form in newborn babies, and it is most often a harmless and easily remedied condition. It is caused by the baby having a higher blood count than needed and the blood cells are broken down. Severe cases are treated with special lights, called bililights, which break down the bilirubin.


What is bilirubin ?

When red blood cells are removed from the bloodstream, hemoglobin, the molecule in red cells that carries oxygen, is broken down into bilirubin. The hemoglobin is rapidly converted to bilirubin in the blood. The bilirubin is removed from the
blood by the liver, modified, and excreted into the bile. The bile flows into the intestine so that the bilirubin is eliminated in the stool. (It is bilirubin that gives stool its brown color.) Jaundice can occur whenever this normal process of destruction of red blood cells and elimination of bilirubin is interrupted. This occurs when there is abnormally increased destruction of red blood cells (hemolysis), liver disease that reduces the ability of the liver to remove and modify bilirubin, or obstruction to the flow of bile into the intestine.

Jaundice can be dangerous if the bilirubin reaches too high a level in the blood. The level at which it becomes dangerous will vary based on a child's age and if there are other medical conditions. A small sample of your baby's blood can be tested to measure the bilirubin level. Other tests may be needed to see if your baby has a special reason to make extra bilirubin that is causing the jaundice.


What causes jaundice ?

When red blood cells die, the heme in their hemoglobin is converted to bilirubin in the spleen. The bilirubin is processed by the liver, enters bile and is eventually excreted through feces. Once hemoglobin is in the red cells of the blood, it circulates for the life span of those cells. The hemoglobin that is released when the cells die is turned into bilirubin. If for any reason the RBCs die at a faster rate than usual, bilirubin can accumulate in the blood and cause jaundice.

Once hemoglobin is in the red cells of the blood, it circulates for the life span of those cells. The hemoglobin that is released when the cells die is turned into bilirubin. If for any reason the RBCs die at a faster rate than usual, bilirubin can accumulate in the blood and cause jaundice.

Pre-hepatic (or hemolytic) jaundice is caused by anything which causes an increased rate of haemolysis (breakdown of red blood cells). In tropical countries, malaria can cause jaundice in this manner. Certain genetic diseases, such as glucose 6-phosphate dehydrogenase deficiency can lead to increase red cell lysis and therefore hemolyic jaundice. Defects in bilirubin metabolism also present as jaundice.

Liver diseases of all kinds threaten the organ's ability to keep up with bilirubin processing. Starvation, circulating infections, certain medications, hepatitis, and cirrhosis can all cause hepatic jaundice, as can certain hereditary defects of liver chemistry, including Gilbert's syndrome and Crigler-Najjar syndrome. Hepatic causes include acute hepatitis, hepatotoxicity and alcoholic liver disease. Less common causes include primary biliary cirrhosis, Gilbert's syndrome and metastatic carcinoma. Jaundice commonly seen in the newborn baby is another example of hepatic jaundice.

Post-hepatic forms of jaundice include the jaundices caused by failure of soluble bilirubin to reach the intestines after it has left the liver. These disorders are called obstructive jaundices. The most common cause of obstructive jaundice is the presence of gallstones in the ducts of the biliary system. Other causes have to do with birth defects and infections that damage the bile ducts; drugs; infections; cancers; and physical injury. Some drugs--and pregnancy on rare occasions--simply cause the bile in the ducts to stop flowing. Post-hepatic (or obstructive) jaundice, also called cholestasis, is caused by an interruption to the drainage of bile in the biliary system. The most common causes are gallstones in the common bile duct and pancreatic cancer in the head of the pancreas. Other causes include strictures of the common bile duct, ductal carcinoma, pancreatitis and pancreatic pseudocysts. A rare cause of obstructive jaundice is Mirizzi's syndrome. The presence of pale stools suggests an obstructive or post-hepatic cause as normal feces get their colour from bile pigments.


What are the symptoms of jaundice ?

Jaundice is the yellow staining of the skin and sclerae (the whites of the eyes) by abnormally high blood levels of the bile pigment, bilirubin. The yellowing extends to other tissues and body fluids and also may turn the urine dark. Yellowing of only the skin also can be caused by eating too many carrots or drinking too much carrot juice. The urine is often dark because excess bilirubin is excreted through the kidneys. Other symptoms, such as itching and light-colored stools, may appear, depending on the underlying cause of the jaundice. For example, acute inflammation of the liver (acute hepatitis) may cause loss of appetite, nausea, vomiting, and fever. Blockage of bile may produce the symptoms of cholestasis.



What's newborn jaundice ?

Jaundice is very common in newborn babies due to the fact that the newborn liver is not able to cope with the normal breakdown of red blood cells. Normal newborn jaundice is the result of two conditions occurring at the same time--a pre-hepatic and a hepatic source of excess bilirubin. First of all, the baby at birth immediately begins converting hemoglobin from a fetal type to an adult type. The fetal type of hemoglobin was able to extract oxygen from the lower levels of oxygen in the mother's blood. At birth the infant can extract oxygen directly from his or her own lungs and does not need the fetal hemoglobin any more. So fetal hemoglobin is removed from the system and replaced with adult hemoglobin. The resulting bilirubin loads the system and places demands on the liver to clear it. But the liver is not quite ready for the task, so there is a period of a week or so when the liver has to catch up. During that time the baby is jaundiced.

In the newborn, jaundice first becomes visible on the face. As levels of bilirubin go up, the jaundice will move from head to toe. By the time an infant is jaundiced all over, bilirubin levels should be measured. Just looking at the baby is not an accurate test. Color can be influenced by many things, such as lighting or the color of the walls. Infants with higher levels of jaundice look more orange than yellow. The jaundice is more intense. Babies with higher bilirubin levels often are motionless and do not feed well.


What causes newborn baby jaundice ?

A baby born prematurely is more at risk for jaundice. Infection, not getting enough oxygen during birth, and some medicines may increase the baby's risk of jaundice. At birth, babies have a relatively immature liver function. Therefore, jaundice is
present to some degree in almost all newborns. Even the normal destruction of red blood cells by the liver in the newborn infant can cause jaundice. This form of jaundice usually appears between the 2nd and 5th days of life and clears by 2 weeks. It usually causes no problems.

Blood incompatibility ("ABO" incompatibility) is a common cause. It happens when the baby's major blood groups differ from the mother's. The most common group incompatibility is when the baby's blood type is "A", "B", or "AB" and the mother's blood type is "O". The mother can create antibodies to the baby's blood group. Damage to the baby's blood results in high levels of bilirubin in the blood. Bilirubin is harmless in low levels, but if the levels are very high, injury to the nervous system and brain occur. In most cases this problem is picked up shortly after birth with normal screening of babies who are born from group "O" mothers.

Breast feeding mothers often experience persisting jaundice or jaundice without blood group incompatibilities. There appears to be an association with breast feeding and exaggerated jaundice. There are certain chemicals produced in breast milk which seem to enhance normal jaundice. Breast-feeding jaundice is seen in 5-10% of newborns. It is similar to physiologic jaundice, but bilirubin levels tend to be slightly higher. This occurs when breast-fed babies do not take in enough breast milk and rarely requires treatment.

Sometimes a baby swallows blood during birth. This swallowed blood is broken down in the baby's intestines and absorbed into the bloodstream. Just as the excess blood from a blood clot will cause a rise in serum bilirubin, so will this.


What's the treatment for infant jaundice ?

Treatment is usually unnecessary. In all cases, it is important to keep the baby well-hydrated (breast milk and formula are preferable to glucose water) and encourage frequent bowel movements by feeding frequently. This is because broken down bilirubin is carried out of the body by the intestines in the stools (bilirubin is what gives stool their brown color).

Newborns are the only major category of patients in whom the jaundice itself requires attention. Because the insoluble bilirubin can get into the brain, the amount in the blood must not go over certain levels. If there is reason to suspect increased hemolysis in the newborn, the bilirubin level must be measured repeatedly during the first few days of life. If the level of bilirubin shortly after birth threatens to go too high, treatment must begin immediately. Exchanging most of the baby's blood was the only way to reduce the amount of bilirubin until a few decades ago. Then it was discovered that bright blue light will render the bilirubin harmless.

Sometimes artificial lights are used on infants whose levels are very high, or in premature infants. These lights work by helping to break down bilirubin in the skin. The infant is placed naked under artificial light in a protected isolette to maintain constant temperature. The eyes are protected from the light.

In the most severe cases of jaundice, an exchange transfusion is required. In this procedure, the baby's blood is replaced with fresh blood. Recently, promising studies have shown that treating severely jaundiced babies with intravenous immunoglobulin is very effective at reducing the bilirubin levels to safe ranges.

All about The Digestive System

[Extracted from MSN Health & Fitness]

What's the first step in the digestive process ? Believe it or not, it happens before you even taste your food. Just by smelling that homemade apple pie or thinking about how delicious that ripe tomato is going to be, you start salivating — and the digestive process begins, preparing for that first scrumptious bite.

Food is our fuel, and its nutrients give our bodies' cells the energy and substances they need to operate. But before food can do that, it must be digested into small pieces the body can absorb and use.

About the Digestive System
Almost all animals have a tube-type digestive system in which food enters the mouth, passes through a long tube, and exits as feces (poop) through the anus. The smooth muscle in the walls of the tube-shaped digestive organs rhythmically and efficiently moves the food through the system, where it is broken down into tiny absorbable atoms and molecules.

During the process of absorption, nutrients that come from the food (including carbohydrates, proteins, fats, vitamins, and minerals) pass through channels in the intestinal wall and into the bloodstream. The blood works to distribute these nutrients to the rest of the body. The waste parts of food that the body can't use are passed out of the body as feces.

Every morsel of food we eat has to be broken down into nutrients that can be absorbed by the body, which is why it takes hours to fully digest food. In humans, protein must be broken down into amino acids, starches into simple sugars, and fats into fatty acids and glycerol. The water in our food and drink is also absorbed into the bloodstream to provide the body with the fluid it needs.

How Digestion Works
The digestive system is made up of the alimentary canal (also called the digestive tract) and the other abdominal organs that play a part in digestion, such as the liver and pancreas. The alimentary canal is the long tube of organs — including the esophagus, stomach, and intestines — that runs from the mouth to the anus. An adult's digestive tract is about 30 feet (about 9 meters) long.

Digestion begins in the mouth, well before food reaches the stomach. When we see, smell, taste, or even imagine a tasty meal, our salivary glands, which are located under the tongue and near the lower jaw, begin producing saliva. This flow of saliva is set in motion by a brain reflex that's triggered when we sense food or think about eating. In response to this sensory stimulation, the brain sends impulses through the nerves that control the salivary glands, telling them to prepare for a meal.

As the teeth tear and chop the food, saliva moistens it for easy swallowing. A digestive enzyme called amylase, which is found in saliva, starts to break down some of the carbohydrates (starches and sugars) in the food even before it leaves the mouth.

Swallowing, which is accomplished by muscle movements in the tongue and mouth, moves the food into the throat, or pharynx. The pharynx, a passageway for food and air, is about 5 inches (12.7 centimeters) long. A flexible flap of tissue called the epiglottis reflexively closes over the windpipe when we swallow to prevent choking.

From the throat, food travels down a muscular tube in the chest called the esophagus. Waves of muscle contractions called peristalsis force food down through the esophagus to the stomach. A person normally isn't aware of the movements of the esophagus, stomach, and intestine that take place as food passes through the digestive tract.

At the end of the esophagus, a muscular ring or valve called a sphincter allows food to enter the stomach and then squeezes shut to keep food or fluid from flowing back up into the esophagus. The stomach muscles churn and mix the food with acids and enzymes, breaking it into much smaller, digestible pieces. An acidic environment is needed for the digestion that takes place in the stomach. Glands in the stomach lining produce about 3 quarts (2.8 liters) of these digestive juices each day.

Most substances in the food we eat need further digestion and must travel into the intestine before being absorbed. When it's empty, an adult's stomach has a volume of one fifth of a cup (1.6 fluid ounces), but it can expand to hold more than 8 cups (64 fluid ounces) of food after a large meal.

By the time food is ready to leave the stomach, it has been processed into a thick liquid called chyme. A walnut-sized muscular valve at the outlet of the stomach called the pylorus keeps chyme in the stomach until it reaches the right consistency to pass into the small intestine. Chyme is then squirted down into the small intestine, where digestion of food continues so the body can absorb the nutrients into the bloodstream.

The small intestine is made up of three parts :

a) the duodenum, the C-shaped first part
b) the jejunum, the coiled midsection
c) the ileum, the final section that leads into the large intestine

The inner wall of the small intestine is covered with millions of microscopic, finger-like projections called villi. The villi are the vehicles through which nutrients can be absorbed into the body.

The liver (located under the rib cage in the right upper part of the abdomen), the gallbladder (hidden just below the liver), and the pancreas (beneath the stomach) are not part of the alimentary canal, but these organs are essential to digestion.

The liver produces bile, which helps the body absorb fat. Bile is stored in the gallbladder until it is needed. The pancreas produces enzymes that help digest proteins, fats, and carbohydrates. It also makes a substance that neutralizes stomach acid. These enzymes and bile travel through special channels (called ducts) directly into the small intestine, where they help to break down food. The liver also plays a major role in the handling and processing of nutrients, which are carried to the liver in the blood from the small intestine.

From the small intestine, undigested food (and some water) travels to the large intestine through a muscular ring or valve that prevents food from returning to the small intestine. By the time food reaches the large intestine, the work of absorbing nutrients is nearly finished. The large intestine's main function is to remove water from the undigested matter and form solid waste that can be excreted. The large intestine is made up of these three parts :

The cecum is a pouch at the beginning of the large intestine that joins the small intestine to the large intestine. This transition area expands in diameter, allowing food to travel from the small intestine to the large. The appendix, a small, hollow, finger-like pouch, hangs at the end of the cecum. Doctors believe the appendix is left over from a previous time in human evolution. It no longer appears to be useful to the digestive process.

The colon extends from the cecum up the right side of the abdomen, across the upper abdomen, and then down the left side of the abdomen, finally connecting to the rectum. The colon has three parts: the ascending colon; the transverse colon, which absorb fluids and salts; and the descending colon, which holds the resulting waste. Bacteria in the colon help to digest the remaining food products.

The rectum is where feces are stored until they leave the digestive system through the anus as a bowel movement.
Digestive System Problems

Nearly everyone has a digestive problem at one time or another. Some conditions, such as indigestion or mild diarrhea, are common; they result in mild discomfort and get better on their own or are easy to treat. Others, such as inflammatory bowel disease, can be long lasting or troublesome. A doctor who specializes in the digestive system is called a GI specialist or gastroenterologist.

Problems With the Esophagus
Problems affecting the esophagus may be congenital (present at birth) or noncongenital (developed after birth). Examples include:

Congenital conditions [Tracheoesophageal fistula] is a connection between the esophagus and the trachea (windpipe) where there shouldn't be one. In babies with esophageal atresia, the esophagus comes to a dead end instead of connecting to the stomach. Both conditions are usually detected soon after a baby is born — sometimes even before — and require surgery to repair.

Noncongenital conditions [Esophagitis] (inflammation of the esophagus) can be caused by infection, certain medications, or gastroesophageal reflux disease (GERD). With GERD, the esophageal sphincter (the valve that connects the esophagus with the stomach) doesn't work well and allows the acidic contents of the stomach to move backward up into the esophagus. GERD often can be corrected through lifestyle changes, such as dietary adjustments. Sometimes, though, it requires treatment with medication.

Problems With the Stomach and Intestines
Almost everyone has experienced diarrhea or constipation. With diarrhea, muscle contractions move the contents of the intestines along too quickly and there isn't enough time for water to be absorbed before the feces are pushed out of the body. Constipation is the opposite: The contents of the large intestines do not move along fast enough and waste materials stay in the large intestine so long that too much water is removed and the feces become hard.

Other common stomach and intestinal disorders include :

Gastrointestinal infections can be caused by viruses, by bacteria (such as Salmonella, Shigella, Campylobacter, or E. coli), or by intestinal parasites (such as amebiasis and giardiasis). Abdominal pain or cramps, diarrhea, and sometimes vomiting are the common symptoms of gastrointestinal infections. These usually go away on their own without medicines or other treatment.

Appendicitis, an inflammation of the appendix, most often affects kids and teens between 11 and 20 years old, and requires surgery to correct. The classic symptoms of appendicitis are abdominal pain, fever, loss of appetite, and vomiting.

Gastritis and Peptic Ulcers arise when a bacterium, Helicobacter pylori, or the chronic use of drugs or certain medications weakens the protective mucous coating of the stomach and duodenum, allowing acid to get through to the sensitive lining beneath. This can irritate and inflame the lining of the stomach (gastritis) or cause peptic ulcers, which are sores or holes in the lining of the stomach or the duodenum that cause pain or bleeding. Medications usually successfully treat these conditions.

Inflammatory bowel disease (IBD) is chronic inflammation of the intestines that affects older kids, teens, and adults. There are two major types: ulcerative colitis, which usually affects just the rectum and the large intestine; and Crohn's disease, which can affect the whole gastrointestinal tract from the mouth to the anus as well as other parts of the body. They are treated with medications and, if necessary, intravenous (IV) feedings to provide nutrition. In some cases, surgery may be necessary to remove inflamed or damaged areas of the intestine.

Celiac disease is a disorder in which the digestive system is damaged by the response of the immune system to a protein called gluten, which is found in wheat, rye, and barley and a wide range of foods, from breakfast cereal to pizza crust. People with celiac disease have difficulty digesting the nutrients from their food and may experience diarrhea, abdominal pain, bloating, exhaustion, and depression when they eat foods with gluten. Symptoms can be managed by following a gluten-free diet. Celiac disease runs in families and can become active after some sort of stress, such as surgery or a viral infection. A doctor can diagnose celiac disease with a blood test and by taking a biopsy of the small intestine.

Irritable bowel syndrome (IBS), a common intestinal disorder, affects the colon and may cause recurrent abdominal cramps, bloating, constipation, and diarrhea. There is no cure, but IBS symptoms may be treated by changing eating habits, reducing stress, and making lifestyle changes. A doctor may also prescribe medications to relieve diarrhea or constipation. No one test is used to diagnose IBS, but a doctor may identify it based on symptoms, medical history, and a physical exam.

Problems With the Pancreas, Liver, and Gallbladder
Conditions affecting the pancreas, liver, and gallbladder often affect the ability of these organs to produce enzymes and other substances that aid in digestion. Examples include :

Cystic fibrosis is a chronic, inherited illness where the production of abnormally thick mucus blocks the ducts or passageways in the pancreas and prevents its digestive juices from entering the intestines, making it difficult to properly digest proteins and fats. This causes important nutrients to pass out of the body unused. To help manage their digestive problems, people with cystic fibrosis can take digestive enzymes and nutritional supplements.

Hepatitis, a condition with many different causes, is when the liver becomes inflamed and may lose its ability to function. Viral hepatitis, such as hepatitis A, B, or C, is highly contagious. Mild cases of hepatitis A can be treated at home; however, serious cases involving liver damage may require hospitalization.

The gallbladder can develop gallstones and become inflamed — a condition called cholecystitis. Although gallbladder conditions are uncommon in kids and teens, they can occur in those who have sickle cell anemia or are being treated with certain long-term medications.
Keeping Digestion on Track

The kinds and amounts of food a person eats and how the digestive system processes that food play key roles in maintaining good health. Eating a healthy diet is the best way to prevent common digestive problems.

Reviewed by: Stephen E. Shaffer, MD
Date reviewed: January 2007

What are Tumour Markers ?

[Extracted from American Cancer Society]

Tumor markers are substances that can be found in the body when cancer is present. They are usually found in the blood or urine. They can be products of the cancer cells themselves or of the body in response to cancer or other conditions. Most tumor markers are proteins.

There are many different tumor markers. Some are seen only in a single type of cancer, while others can be found in many types of cancer.

To test for a tumor marker, the doctor sends a sample of the patient's blood or urine to a lab. The marker is usually found by combining the blood or urine with manmade antibodies designed to react with that specific protein.

For many reasons, tumor markers by themselves are usually not enough to diagnose or rule out cancer. Most tumor markers can be made by normal cells as well as by cancer cells. Sometimes, non-cancerous diseases can also cause levels of certain tumor markers to be higher than normal. And not every person with cancer may have higher levels of a tumor marker.

For these reasons, only a handful of tumor markers are commonly used by most doctors. When a doctor looks at the level of a certain tumor marker, he or she will consider it along with the results of the patient's history and physical exam and other lab tests or imaging tests.

In recent years, doctors have begun to develop newer types of tumor markers. With advances in technology, levels of certain genetic materials (DNA or RNA) can now be measured. And while it has been hard to identify single substances that provide useful information, doctors are now beginning to look at patterns of genes or proteins in the blood. These new fields of genomics and proteomics, respectively, are discussed further in the section "What's New in Tumor Marker Research?"

How Are Tumor Markers Used ?

Screening and Early Detection of Cancer
Screening refers to looking for cancer in people who have no symptoms of the disease. Early detection is finding cancer at an early stage, when it is less likely to have spread and is more likely to respond well to treatment. Although tumor markers were first developed to test for cancer in people without symptoms, very few markers have been shown to be helpful in this way.

The most widely accepted tumor marker is the prostate-specific antigen (PSA) blood test, which is used (along with the digital rectal exam) to screen for prostate cancer. But because it's not always clear what the test results mean, not all doctors agree that PSA screening is appropriate for all men. Newer versions of the PSA test may prove to be more accurate.

Most other tumor markers have not been shown to detect cancer much earlier than they would have been found otherwise.

Diagnosing Cancer
Tumor markers are usually not used to diagnose cancer. In most cases, cancer can only be diagnosed by a biopsy (removal of tumor cells so they can be looked at under a microscope). Still, markers can help determine if a cancer is likely. They can also help diagnose the source of widespread cancer in a patient when the origin of the cancer is unknown. An example is a woman who has cancer throughout the pelvis and abdomen. The presence of a high level of the tumor marker CA 125 will strongly suggest ovarian cancer, even if surgery can't identify the source. This can be important because treatment can then be tailored to this type of cancer.

Determining the Prognosis (Outlook) for Certain Cancers
Some types of cancer grow and spread faster than other types. But even within a cancer type (such as breast cancer), some cancers will grow and spread more quickly or may be more or less responsive to certain treatments. Some newer tumor markers help show how aggressive a person's cancer is likely to be, or even how well it might respond to certain drugs.

Determining the Effectiveness of Cancer Treatment
One of the most important uses for tumor markers is to monitor patients being treated for cancer, especially advanced cancer. If a tumor marker is available for a specific type of cancer, it is much easier to measure it to see if the treatment is working rather than repeating chest x-rays, CT scans, bone scans, or other tests. It also tends to be less expensive.

If the tumor marker level in the blood goes down, it is almost always a sign that the treatment is having an effect. On the other hand, if the marker level goes up, then the treatment probably should be changed. (One exception is if the cancer is very sensitive to a certain chemotherapy treatment. In this case, the chemotherapy can cause many cancer cells to die and release large amounts of the marker into the blood, which will cause the level of the tumor marker to rise for a short time.)

Detecting Recurrent Cancer
Markers are also used to look for cancer that may come back (recur) after initial treatment. Some tumor markers may be useful once treatment is complete and there is no evidence of cancer remaining. These include PSA (for prostate cancer), human chorionic gonadotropin (HCG) (for gestational trophoblastic tumors and germ cell cancers of the ovaries and testicles), and perhaps CA 125 (for epithelial ovarian cancer).

Some women who have been treated for breast cancer have yearly blood tests for levels of the tumor marker CA 15-3. This can sometimes detect cancer recurrence before the woman has symptoms or evidence of cancer on imaging tests. Many doctors question the test's value, though, because no one has shown a long-term advantage in finding recurrent breast cancer early. And usually the cancer causes symptoms or can be found by the doctor around the same time that the CA 15-3 level rises. The same is true for carcinoembryonic antigen (CEA), a tumor marker used to monitor colorectal cancer.

Because of this, some doctors and medical groups do not recommend using these tumor markers after treatment aimed at curing these cancers. They are more likely to be used to monitor more advanced cancer, especially when treatment may not be expected to result in a cure, as mentioned above.

History of Tumor Markers
The first modern tumor marker used to detect cancer was human chorionic gonadotropin (HCG), the substance doctors look for in pregnancy tests. Women whose pregnancy has ended but whose uterus continues to be enlarged are tested for the presence of HCG. A high level of HCG in the blood may indicate the presence of a cancer of the placenta called gestational trophoblastic disease (GTD). This cancer continues to produce HCG. Some testicular and ovarian cancers resemble GTD because they start in reproductive cells called germ cells. These cancers also make HCG, so this marker is used to help diagnose them and monitor their response to therapy.

The hope in the search for tumor markers was that all cancers could someday be detected by a single blood test. Both GTD and germ cell tumors of the ovaries and testicles are too rare to look for these cancers by testing everyone. But other cancers, such as colon, breast, and lung are much more common. A simple blood test that could detect these cancers in their earliest stages could prevent the deaths of millions of people. And so, many scientists began working toward this goal.

The first success in developing a blood test for a common cancer was in 1965, when carcinoembryonic antigen (CEA) was found in the blood of some patients with colon cancer. By the end of the 1970s several other blood tests had been developed for different cancers. The new markers were often given numeric labels. There was CA 19-9 for colorectal and pancreatic cancer, CA15-3 for breast cancer, and CA 125 for ovarian cancer. Many others were also found, but because they did not show an advantage over the already discovered markers, they were not studied any further.

Unfortunately, none of these tumor markers, including CEA, met the original goal of reliably finding cancer at an early stage. There were a few reasons for this:

a) Almost everyone has a small amount of these markers in their blood, and it is very hard to spot early cancers by using these tests.

b) The levels of these markers tend to get higher than normal only when there is a large amount of cancer present.

c) Some people with cancer never have higher levels of these markers.

d) Even when levels of these markers are high, they are often not specific enough. For example, the level of the tumor marker CA 125 can be high in women with gynecologic conditions other than ovarian cancer.

Because of this, these markers are used mainly in patients who have already been diagnosed with cancer to monitor their response to treatment or detect the return of cancer after treatment.

The only tumor marker widely used in screening is the prostate-specific antigen (PSA) test. It was discovered around the same time as the others, but it's been in widespread use for screening since the early 1990s because it has certain advantages. First, it is made only by prostate cells, so a rise in PSA is fairly specific to a prostate problem. Also, the PSA level usually rises even in early cancers, so most prostate cancers can be found at an early stage, when they are most likely to be curable. The test is not perfect, however. Some men may have an elevated PSA because of other prostate conditions or a prostate cancer that would never need treatment, and some men with prostate cancer may not have an elevated PSA. Because of this, doctors and medical organizations do not agree about whether all men should be tested.

Many other tumor markers have been found in recent years and are now under study. Some of these are different from traditional markers, which were proteins found in the blood.

Specific Tumor Markers
This section focuses on the most commonly used tumor markers.

There are many other markers being made by commercial testing labs that are not commonly used. They are sometimes advertised as being better than the commonly used markers but then often fall out of use when they show no advantage over the others. There are also other markers that are used by researchers. These are often not available to doctors or hospital labs. If research does show that they are useful, they are then made available to doctors and their patients. This list is limited to those tumor markers available to most doctors and for which there is reliable scientific information showing that they are useful.

The cancers described in these brief summaries are those for which the marker is usually used. These marker levels may be increased in other kinds of cancer as well, which is why they are not used to diagnose which type of cancer a person has.

As with other kinds of lab tests, different labs may consider slightly different marker levels to be normal or abnormal. This can depend on a number of factors, including a person's age and gender, which test kit the lab uses, and how the test is performed. The values listed below are average values, but most labs will list their own "reference ranges" along with any test results you receive. If you are being tested for a tumor marker, be sure to ask your doctor about what your results mean.

Alpha-Feto Protein (AFP)
AFP is most useful in following the response to treatment for liver cancer (hepatocellular carcinoma). Normal levels of AFP are usually less than 20 nanograms per milliliter (ng/mL). A nanogram is one-billionth of a gram. AFP levels are higher than normal in about 2 out of 3 patients with liver cancer. The level increases with the size of the tumor. In most patients with liver cancer, the level is more than 500 ng/mL. In very small tumors the levels may be less than 20 ng/mL. AFP is also elevated in acute and chronic hepatitis, but is seldom above 100 ng/mL in these diseases.

AFP is also higher in certain testicular cancers (embryonal cell and endodermal sinus types) and is used for follow-up of these cancers. Elevated AFP levels are also seen in a certain rare types of ovarian and testicular cancer called yolk sac tumor or mixed germ cell cancer.

Beta-2-Microglobulin (B2M)
B2M blood levels are elevated in multiple myeloma, chronic lymphocytic leukemia (CLL), and some lymphomas. Levels may also be higher in some non-cancerous conditions, such as kidney disease. Normal levels are usually below 2.5 micrograms per milliliter (ug/mL). A microgram is one-millionth of a gram. B2M is useful in helping to determine prognosis (long-term outlook for survival) in some of these cancers. Patients with higher levels of B2M usually have a poorer prognosis.

Bladder Tumor Antigen (BTA)
BTA is found in the urine of many patients with bladder cancer. It may be present in some non-cancerous conditions too. The results of the test are reported as either positive (BTA is present) or negative (BTA is not present). It is being used along with NMP22 (see below) to test patients for recurrent cancer. This test is not widely used but is still being studied. It is not certain whether it is as sensitive as cystoscopy (looking directly into the bladder through a thin, lighted tube). Most experts still recommend cystoscopy for diagnosis and follow-up of bladder cancer.

CA 15-3
CA 15-3 is used mainly to monitor patients with breast cancer. Elevated blood levels are found in less than 10% of patients with early disease and in about 70% of patients with advanced disease. Levels usually drop following effective treatment, although they may spike in the first few weeks after treatment is started, a result of dying cancer cells spilling their contents into the bloodstream.

The normal level is usually less than 25 U/mL (units/milliliter), depending on the lab. But levels as high as 100 U/mL can sometimes be seen in women who do not have cancer. Levels of this marker can also be higher in other cancers and in some non-cancerous conditions such as benign breast conditions and hepatitis.

CA 27.29
CA 27.29 is another marker used to follow patients with breast cancer during or after treatment. This test measures the same marker as the CA 15-3 test, but in a different way. Although it is a newer test than CA 15-3, it does not appear to be any better in detecting either early or advanced disease. It may be less likely to be positive in people without cancer. The normal level is usually less than 38 to 40 U/mL (units/milliliter), depending on the testing lab. This marker can also be elevated in other cancers and in some non-cancerous conditions, and it may not be elevated in some women with breast cancer.

CA 125
CA 125 is the standard tumor marker used to follow women during or after treatment for epithelial ovarian cancer (the most common type of ovarian cancer). Normal blood levels are usually less than 30 to 35 U/mL (units/milliliter). More than 90% of patients have higher levels of CA 125 when the cancer is advanced.

Levels are also elevated in about half of women whose disease is still confined to the ovary. Because of this, CA 125 is being studied as a screening test. The problem with using it as a screening test is that it would still miss many early cancers, and conditions other than ovarian cancer can cause an elevated CA 125 level. For example, it is also often higher in women with uterine fibroids or endometriosis (having uterine cells in abnormal locations), in men and women with lung cancer, and in people who have had cancer in the past. Because ovarian cancer is a relatively rare disease, an increased CA 125 level is more likely to be caused by something other than ovarian cancer.

CA 72-4
CA 72-4 is a newer test being studied in ovarian and pancreatic cancer and cancers starting in the digestive tract, especially stomach cancer. There is no evidence that it is better than current tumor markers, but it may be valuable when used along with other tests. Studies of this marker are still in progress.

CA 19-9
Although the CA 19-9 test was first developed to detect colorectal cancer, it is more sensitive to pancreatic cancer. It will not usually detect very early disease, which is why it is not used as a screening test. But it is now considered the best tumor marker for following patients with cancer of the pancreas.

Normal blood levels of CA 19-9 are below 37 U/mL (units/milliliter). A high CA 19-9 level in a newly diagnosed patient usually means the disease is advanced.

CA 19-9 can also be used to monitor colorectal cancer, but because it is less sensitive than the CEA test, most medical groups recommend CEA testing when following this disease.

CA 19-9 can also be elevated in other forms of digestive tract cancer, especially cancers of the stomach and bile ducts, and in some non-cancerous conditions such as pancreatitis (inflammation of the pancreas).

Calcitonin
Calcitonin is a hormone produced by certain cells (called parafollicular C cells) in the thyroid gland. It normally helps regulate blood calcium levels. In cancer of the parafollicular C cells, called medullary thyroid carcinoma (MTC), blood levels of this hormone are elevated.

This is one of the rare tumor markers that can be used to help detect early cancer. Because MTC is often inherited, blood calcitonin can be measured to detect the cancer in its very earliest stages in family members who are at risk. Other cancers, particularly lung cancers, can also cause calcitonin levels to be elevated, but measurement of its level in the blood is not usually used to follow these cancers.

Carcino Embryonic Antigen (CEA)
CEA is the preferred tumor marker for following patients with colorectal cancer during or after treatment, but it is not useful as a screening or diagnostic test. The normal range of blood levels varies from lab to lab, but levels higher than 5 nanograms per milliliter (ng/mL) are generally considered abnormal. The higher the CEA level at the time colorectal cancer is detected, the more likely it is that the cancer is advanced.

Many doctors use this marker to follow other cancers, such as lung cancer and breast cancer. CEA levels are also elevated in many other cancers such as those of the thyroid, pancreas, liver, stomach, ovary, and bladder. They are elevated in some non-cancerous diseases and in otherwise healthy smokers, too.

Chromogranin A (CgA)
Chromogranin A is made by neuroendocrine tumors, which include carcinoid tumors, neuroblastoma, and small cell lung cancer. The blood level of CgA is often elevated in people with these diseases. It is probably the most sensitive tumor marker for carcinoid tumors, being abnormal in 1 out of 3 people with localized disease and 2 out of 3 of those with metastatic cancer. Levels can also be elevated in some advanced forms of prostate cancer that have neuroendocrine features. The range of normal blood levels varies between testing centers, but is generally less than 76 nanograms per milliliter (ng/mL) in men and less than 51 ng/mL in women.

Estrogen Receptors/Progesterone Receptors
Breast tumor samples--not blood samples--from women and men with breast cancer are commonly tested for these markers. Breast cancers that contain estrogen receptors are often referred to as "ER-positive," while those with progesterone receptors are "PR-positive." About 7 out of 10 breast cancers test positive for at least one of these markers. These cancers tend to have a better prognosis than cancers without these receptors and are much more likely to respond to hormonal therapy such as tamoxifen or aromatase inhibitors.

HER2 (also known as HER2/neu, erbB-2, or EGFR2)
HER2 is a marker that is elevated in some breast cancer cells. Higher than normal levels are also found in some other cancers. The HER2 level is usually found by testing a sample of the cancer tissue itself, not the blood. About 1 in 5 people with breast cancer test positive for HER2. Its main use is as a predictor of prognosis (outlook for survival). Those whose cancers are positive for this marker don't respond as well to chemotherapy, and in the past were thought to have a less favorable outlook. But this may be changing, as these cancers are more likely to respond to newer treatments such as trastuzumab (Herceptin®) and lapatinib (Tykerb®), which work against the HER2 receptor on breast cancer cells.

Human Chorionic Gonadotropin (HCG)
HCG (also known as beta-HCG) blood levels are elevated in patients with some types of testicular and ovarian cancers (germ cell tumors) and in gestational trophoblastic disease, mainly choriocarcinoma. They are also higher in some men with certain cancers in the middle of their chest (mediastinum) that start in the same cells as testicular cancer (mediastinal germ cell neoplasms). Levels of HCG can be used to help diagnose these conditions and can be followed over time to monitor how well treatment is working. They can also be used to look for cancer recurrence once treatment has ended.

An elevated blood level of this marker will also raise suspicions of cancer in certain situations. For example, in a woman who continues to have a large uterus after pregnancy has ended, a high blood level of this marker is a possible sign of a cancer. This is also true of men with an enlarged testicle or with a mass in their chest. The definition of a normal level is hard to determine because there are different methods of testing for this marker and each has its own normal value.

Immunoglobulins
Immunoglobulins are not really tumor markers but antibodies, which are blood proteins normally made by immune system cells to help fight germs. There are many types of immunoglobulins, including IgA, IgG, IgD, and IgM. Bone marrow cancers such as multiple myeloma and Waldenstrom macroglobulinemia often result in too many immunoglobulins in the blood (and in the urine). A high level of immunoglobulins may indicate the presence of one of these diseases.

There are normally many different immunoglobulins in the blood, with each one differing very slightly from the others. A classic sign in patients with myeloma or macroglobulinemia is a very high level of one specific (monoclonal) immunoglobulin. This can be seen on a test called protein electrophoresis, which separates the globulins by electrical current. With myeloma or macroglobulinemia, the globulins (also called monoclonal proteins or M proteins) stick together and form a monoclonal "spike" (often called the M spike) on the readout of the test. The level of the spike is important, because older people may show low levels of a spike without having myeloma or macroglobulinemia. The diagnosis, however, must be confirmed by a biopsy of the bone marrow.

Immunoglobulin levels can also be followed over time to help determine how well treatment is working.

Lipid Associated Sialic Acid in Plasma (LASA-P)
LASA-P has been studied as a marker for ovarian cancer as well as some other cancers. Generally it has not proven valuable, however, and it has been replaced by more specific marker tests. It is not specific for any particular cancer or even for cancer in general, as it can also be elevated in some non-cancerous conditions. It is sometimes used along with other tumor markers to follow response to treatment.

Neuron-Specific Enolase (NSE)
NSE, like chromogranin A, is a marker for neuroendocrine tumors such as small cell lung cancer, neuroblastoma, and carcinoid tumors. It is not used as a screening test. It is most useful in the follow-up of patients with small cell lung cancer or neuroblastoma (while chromogranin A seems to be a better marker for carcinoid tumors). Elevated levels of NSE may also be found in some non-neuroendocrine cancers. Abnormal levels are usually higher than 9 micrograms per milliliter (ug/mL).

NMP22
NMP22 is a protein found in the nucleus (control center) of cells. Levels of NMP22 are often elevated (more than 10 U/mL or units/milliliter) in the urine of people with bladder cancer. So far it hasn't been found to be sensitive enough to be used as a screening tool. It is most often used to look for cancer recurrence after treatment. This is a less invasive form of monitoring than cystoscopy (looking into the bladder with a thin, lighted tube), but it's not clear whether it is as accurate, so it is not as widely used. NMP22 levels can also be higher than normal due to non-cancerous conditions or recent treatment with chemotherapy.

Prostate-Specific Antigen (PSA)
PSA is a tumor marker for prostate cancer. It is the only marker used to screen for a common type of cancer (although some medical groups do not recommend its use). It is a protein made by cells of the prostate gland in men, which is responsible for making some of the liquid in semen. The level of PSA in the blood can be elevated in prostate cancer, but PSA levels can be affected by other factors, too. Men with benign prostatic hyperplasia (BPH), a non-cancerous growth of the prostate, often have higher levels. The PSA level also tends to be higher in older men and those with larger prostates, and it can be elevated for a day or two after ejaculation.

When the PSA test is used for screening, it should be done along with a digital rectal exam. For this test the doctor inserts a gloved, lubricated finger into the rectum to feel the prostate gland for any abnormalities.

PSA is measured in nanograms per milliliter (ng/mL). Most doctors feel that a blood PSA level below 4 ng/mL means cancer is unlikely, while levels greater than 10 ng/mL mean cancer is likely. The area between 4 and 10 is a gray zone. Doctors often recommend a prostate biopsy (getting samples of prostate tissue to look for cancer) for men with a level above 4 ng/mL.

But there is some controversy surrounding these cutoff points. Some men with prostate cancer do not have an elevated PSA level, while some others with a borderline or elevated level will not have cancer. Some doctors are now recommending following the PSA level over time (PSA velocity) because an increase from one year to the next may mean prostate cancer is more likely. Doctors are also looking at the PSA level in other ways to see if it might be more useful.

A helpful test when a PSA value is between 4 ng/mL and 10 ng/mL is to measure the free PSA (or percent-free PSA). PSA in the blood exists in 2 forms – some is bound to a protein and some is free. As the amount of free PSA goes up, the less likely it is that there is prostate cancer. When the free PSA makes up more than 25% of the total PSA, prostate cancer is unlikely. If the free PSA is below 10%, the chance of prostate cancer is much higher.

The PSA test is very valuable in the follow-up of patients with prostate cancer. For patients who have been treated with surgery meant to cure the disease, the PSA should fall to an undetectable level. Those treated with radiation therapy should also have a significant drop in PSA after treatment. A rise in the PSA level may be a sign the cancer is coming back. The PSA can also be used to follow the response to treatment for more advanced disease. For more information about the PSA test, see our Prostate Cancer document.

Prostatic Acid Phosphatase (PAP)
PAP (not to be confused with the Pap test for women) is another test for prostate cancer. It was used before the PSA test was developed but is rarely used now because the PSA test is much more sensitive.

Prostate-Specific Membrane Antigen (PSMA)
PSMA is a substance found in all prostate cells. Blood levels increase with age and with prostate cancer. PSMA is a very sensitive marker, but so far it has not proven to be better than PSA, and its use in detecting or monitoring cancer is still being studied. Its current use is limited to being part of a nuclear scan (a type of imaging test) to look for the spread of prostate cancer in the body. Some potential immunotherapy treatments for prostate cancer based on this substance are now under study.

S-100
S-100 is a protein found in most melanoma cells. Tissue samples of suspected melanomas are often tested for this marker to help in diagnosis.

Some studies have shown that blood levels of S-100 are elevated in most patients with metastatic melanoma. The test is sometimes used to look for melanoma spread before, during, or after treatment.

TA-90
TA-90 is a protein found on the outer surface of melanoma cells. Like S-100, TA-90 can be used to look for the spread of melanoma. Its value in following melanoma is still being studied, and it is not widely used at this time. It is also being studied for use in other cancers such as colon and breast cancer.

Thyroglobulin
Thyroglobulin is a protein made by the thyroid gland. Normal blood levels depend on a person's age and gender. Thyroglobulin levels are elevated in many thyroid diseases, including some common forms of thyroid cancer.

Treatment for thyroid cancer often involves removal of the entire thyroid gland, sometimes along with radiation therapy. Thyroglobulin levels in the blood should fall to undetectable levels after treatment. A rise in the thyroglobulin level suggests the cancer may have returned. In people with metastatic thyroid cancer, thyroglobulin levels can also be followed over time to evaluate the results of treatment.

Some people's immune systems make antibodies against thyroglobulin, which can affect test results. Because of this, levels of anti-thyroglobulin antibodies are often measured at the same time.

Tissue Polypeptide Antigen (TPA)
TPA is a protein marker that is present in high levels in many rapidly dividing cells (such as cancer cells). The TPA blood test is sometimes used along with other tumor markers to help follow patients being treated for lung, bladder, and many other cancers. TPA levels are also elevated in some non-cancerous conditions.

Common Cancers and Associated Tumor Markers

Bladder Cancer
No urinary tumor markers are recommended for bladder cancer screening. But the bladder tumor antigen (BTA) and the NMP22 tests can be used along with cystoscopy (using a thin, lighted tube to look in the bladder for cancer) in diagnosing it.

These tests are also being used to follow some patients after treatment, though cystoscopy and urine cytology (using a microscope to look for cancer cells in the urine) are still recommended as the standard tests for diagnosis and follow-up. It is too early to tell if these tests will take the place of urine cytology and cystoscopy or if they will best be used along with these tests. Other tumor markers are also being studied in this setting.

For advanced cancer, some of the markers used for other cancers such as CEA, CA 125, CA 19-9, and TPA may be elevated and can be used to follow patients during and after treatment.

Breast Cancer
No tumor marker has been found to be useful for screening or for the diagnosis of early stage breast cancer.

At the time of diagnosis, breast cancer tissue is often tested for estrogen and progesterone receptors, as well as the HER2/neu antigen. These markers provide some information on how aggressive the cancer may be and how likely it is to respond to certain treatments.

The markers most commonly used to follow patients with advanced cancer or to detect recurrence are CA 15-3 and CEA. The CA 27.29 test is also used by some doctors. The CA 15-3 and CA 27.29 are probably equally sensitive, while the CEA is less sensitive.

These markers are most useful in measuring the results of treatment for patients with advanced disease. Generally speaking, blood levels go down if the cancer responds to treatment and rise if the cancer progresses.

Some doctors use these tests to look for signs of recurrence in women who have no symptoms of cancer after their first treatment. But most professional groups do not recommend using these markers to follow women already treated for early stage disease.

Colorectal Cancer
The markers most often elevated in advanced colorectal cancer are CEA and CA 19-9, but neither of these is useful as a screening test for colorectal cancer.

An elevated CEA before surgery may indicate a poorer prognosis. If it is high before surgery, the CEA should return to normal levels in about 4 to 6 weeks if all of the cancer has been removed.

Many doctors follow patients after surgery with CEA tests every 3 to 6 months or so to look for the return of the cancer. Patients are sometimes helped by finding a recurrence early so it can be removed by surgery, but for most patients the recurrence may be too widespread to be removed.

CEA is also used to follow patients who are being treated for advanced or recurrent disease. The CEA level will go down if the treatment is working and will rise if the cancer progresses.

If the CEA is not elevated in patients with advanced or recurrent cancer, sometimes the CA 19-9 can be used to follow the disease.

Gestational Trophoblastic Disease
Trophoblastic tumors include molar pregnancies (a pregnancy that results in a tumor of the placenta) and the more aggressive choriocarcinoma. Human chorionic gonadotropin (HCG) is elevated in these tumors. HCG testing can be used to detect these cancers in women who are no longer pregnant and whose wombs do not shrink to normal size.

Measurements of HCG during treatment for trophoblastic disease are very useful in determining response to treatment.

Liver Cancer
Cancer that starts in the liver (known as hepatocellular carcinoma) is linked with chronic infections caused by hepatitis B and C viruses and with cirrhosis from various causes. This is a common type of cancer in Southeast Asia.

Liver cancers can cause elevated levels of alpha fetoprotein (AFP). Higher AFP levels occur in about 2 of 3 patients with liver cancer. An elevated AFP in someone with chronic hepatitis may suggest the diagnosis of this cancer, although further testing must be done along with a biopsy to prove that there is cancer.

Because liver cancer is not very common in the United States, AFP testing is not used to test the general population for this type of cancer. Screening with AFP has been successful in parts of Asia where liver cancer is common. Sometimes the cancer is found early enough so that the patient can be cured with surgery. Because of this success, some doctors in the United States may screen their patients with cirrhosis of the liver due to hepatitis B or C. A rising AFP level might indicate cancer.

AFP can be used to help determine the most appropriate treatment for liver cancer and to follow patients after curative surgery or other treatment.

Lung Cancer
No tumor markers have proven useful as screening tests for lung cancer.

Some of the tumor markers that may be elevated in lung cancer are the carcinoembryonic antigen (CEA) in non-small cell lung cancer and the neuron-specific enolase (NSE) in small cell lung cancer. Sometimes doctors will follow these markers to evaluate treatment results. There are many other markers that can also be followed. However, because lung cancer is fairly easily seen on chest x-rays or other imaging tests, tumor markers play a less important role.

Melanoma Skin Cancer
No tumor marker is of value in finding this disease early.

The markers TA-90, S-100, and some other markers can be used to test tissue samples to help diagnose melanoma in areas of concern.

Blood levels of TA-90 have been used to help find out if the melanoma has metastasized (spread). If the blood TA-90 level is high, there is a good chance the melanoma is metastatic. But TA-90 can sometimes be elevated in the absence of metastatic melanoma. Because of this, it has not yet been used to plan treatment or predict prognosis.

S-100 is also elevated in the blood when the disease is widespread. This marker can also be used to look for progression of the melanoma.

Multiple Myeloma
There are no tumor markers commonly used to screen for this disease, although tests for immunoglobulins can be used to help detect it or make a diagnosis. Protein electrophoresis and immunofixation can find these immune system proteins in the blood or urine of most patients with myeloma.

Pieces of immunoglobulins in the urine, called Bence Jones proteins, are found in some patients with multiple myeloma. Most people with myeloma also have detectable levels of immunoglobulins, called monoclonal proteins or M-proteins, in their blood. (These proteins lead to a monoclonal spike, or M spike, on the test readout.) These markers can help diagnose the disease, but a bone marrow biopsy may be needed to confirm the diagnosis. They are also helpful in tracking the course of the disease and its response to treatment.

Many patients with multiple myeloma also have higher blood levels of beta-2-microglobulin, which can also provide information on prognosis and the response to treatment.

Ovarian Cancer
Epithelial ovarian cancer (the most common form of ovarian cancer) is linked with elevated levels of CA 125. Other markers that are sometimes measured are CA 72-4 and LASA-P. CA 125, which is elevated in most women with advanced disease, is the standard marker that most doctors use. Ovarian cancer, even when advanced, is often confined to the abdomen and pelvis and hard to find through x-ray testing. Because of this, the CA 125 is often the easiest and most effective way to measure the response to treatment or to find a cancer that has come back.

CA 125 is also being used by some doctors to screen for ovarian cancer in women with a strong family history of ovarian cancers. Such women usually get regular ultrasounds for early detection along with CA 125 measurements.

CA 125 is being studied as a screening tool in women who have no family history of ovarian cancer. At the present time, most medical groups do not recommend CA 125 testing for ovarian cancer screening because it is not clear whether it will detect the cancer early enough to increase the cure rate. Another problem with this test is that ovarian cancer is not common, and the CA 125 level can be elevated in other cancers and other conditions. Therefore, an elevated CA 125 is more likely to be due to some other cause, even though a lot testing might be needed to rule out ovarian cancer.

The second most common group of ovarian cancers is the germ cell tumors. Patients with these cancers often have elevated levels of HCG and/or AFP, which are useful in diagnosis and follow-up.

Pancreatic Cancer
No markers have been found to be helpful in screening for pancreatic cancer.

The CA 19-9 marker is the most useful marker for pancreatic cancer. Most people with pancreatic cancer have elevated levels of this marker in their blood. The higher the level, the more likely the disease has spread.

It is also useful in patient follow-up. Patients whose CA 19-9 levels drop to normal after surgery have a much better outlook than those people whose CA 19-9 remains elevated after surgery. This marker can also be used to follow the effects of treatment on more advanced disease.

Some doctors also follow the level of CEA in the blood, but it may not be as helpful as the CA 19-9 level.

Prostate Cancer
The most commonly used marker to detect prostate cancer is the prostate-specific antigen (PSA). Prostate cancer can often be detected in its early stages by measuring blood levels of PSA. Levels above 4 ng/mL suggest cancer may be present, while levels above 10 ng/mL strongly suggest cancer. Doctors usually advise that men with elevated PSA levels have their prostate gland biopsied to find out if there is cancer.

Prostate cancer is often a slow growing cancer that is found in older men. For this reason, it is not clear if screening with PSA actually saves lives. Some doctors believe that screening may cause more harm than good. It may lead some men to get treated for cancers that would never have caused them problems, and the treatment itself can have major side effects.

PSA is very useful in monitoring recurrent disease. After surgery, the PSA level should be undetectable or near undetectable (0 or very close to 0). Those treated with radiation therapy should also have a significant drop in PSA after treatment. A rise in PSA after treatment could mean the disease is coming back and that more treatment should be considered. The PSA can also be used to follow the response to treatment for more advanced disease.

Another marker being studied for following prostate cancer is the prostate-specific membrane antigen (PSMA). It's not yet clear how useful it will be.

In rare cases, prostate cancers that do not cause abnormal blood PSA levels and do not respond well to hormone therapy turn out to have neuroendocrine features. Men with these cancers may have higher than normal levels of chromogranin A. These cancers are more likely to respond to certain chemotherapy drugs.

Prostatic acid phosphatase (PAP) is an older, less sensitive marker which is no longer used very much.

Stomach (Gastric) Cancer
No marker has been developed specifically for this cancer. Some other digestive cancer markers may be elevated, such as CEA, CA 72-4, and/or CA 19-9. If the levels of these markers are elevated at the time of diagnosis, the levels can be followed while the cancer is being treated.

Testicular Cancer
Tumor markers are very important in this cancer and are used by doctors to follow its course. The markers usually elevated in the blood of men with testicular cancer are human chorionic gonadotropin (HCG) and alpha fetoprotein (AFP). There are different kinds of testicular cancers, and they differ in the level and kind of marker that is elevated.

Seminoma
About 10% of men with seminoma, a type of testicular cancer, will have elevated HCG. None will have elevated AFP.

Non-seminoma
More than half of men with early stage disease will have elevated HCG or AFP or both. The amount of the marker found in the blood does not necessarily help in predicting outcome. The markers will be elevated in most men with more advanced disease.

HCG is almost always elevated and AFP is never elevated in choriocarcinoma, a subtype of non-seminoma. As with the other non-seminomas, the amount of the marker found in the blood does not necessarily help in predicting outcome. In contrast AFP, but not HCG, is elevated in another subtype known as yolk sac tumor or endodermal sinus tumor.