The New "Smoke Detector" for Cancer

One of the latest and possibly greatest innovations in oncology is a new "smoke detector" providing early warning for early treatment of cancer. This new device may reveal cancer 10 years before symptoms become evident.

Requiring just a single drop of blood from a finger stick and costing just £35 ($42), this new cancer diagnosis method developed by scientists in the oncology department at the University of Swansea in Wales analyzes red blood cells for mutations that can be detected in just a couple of hours. The test is currently being used to diagnose esophageal cancer and is in testing for use in detecting pancreatic cancer, but scientists believe it will be useful for early diagnosis of lung cancer, breast cancer, melanoma, and liver cancer and more.

What's special about the new approach to diagnosing cancer? To answer that question, it helps to understand some of the limitations of our current methods of early cancer diagnosis with biomarkers. You may have heard of some of these tests.

• Alpha Fetoprotein (also known as AFP) is a protein made by the fetus in the womb that disappears in the baby’s bloodstream after birth. It shows up in some non-cancerous conditions, such as cirrhosis of the liver and viral hepatitis. It also appears in 60 percent of men in the early stages of testicular cancer and in 80 percent of cases of advanced testicular cancer.
• Cancer Antigen 125 (CA-125) is a protein that can be made by cancer cells. However, it can also be made by healthy cells. It can be manufactured developmentally abnormal cells that have not yet become cancerous in the abdomen in both sexes. In women, it also can appear in the cervix or uterus with or without cancer. This protein appears in over 50 percent of women in the earliest stages of ovarian cancer.

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• Cancer Antigen 15-3 (CA 15-3) is also a protein that is sometimes made by cancer cells and sometimes made by healthy cells. It  appears in some but not all cases of sarcoidosis, tuberculosis, and liver disease. It can be detected in approximately 19 percent of early-stage cases of breast cancer and 95 percent of late-stage cases of breast cancer.
• Cancer Antigen 19-9 (CA 19-9) likewise sometimes made by healthy cells and sometimes made by cancerous cells and sometimes made when there is a disease that isn’t cancer. CA 19-9 can be detected in non-cancerous liver disease or pancreatitis, although not in all cases. It appears in about 60 to 70 percent of cases of biliary cancer and 80 to 90 percent of cases of pancreatic cancer.
• Human chorionic gonadotrophin (HCG) naturally occurs in the bloodstream. Levels rise sharply in pregnancy, in ovarian cancer, and in testicular cancer.
• Neuron-Specific Enolase (NSE) is almost always an indicator of cancer. However, it is not specific. It can be detected in small cell lung cancer. It also appears when therelarge lung tumors, and in some but not all cases of Hodgkin’s disease, non-Hodgkin lymphoma, pancreatic cancer, and medullary thyroid cancer.

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Continuing the list of ambiguous tests for cancer, many people suspected of having cancer are tested for the following:

• Interleukin-6 (IL-6) is a marker of inflammation, and inflammation is a sign of advanced cancer. However, IL-6 levels are also elevated in arthritis, atherosclerosis, burns, infections, and tissue injury.
• Matrix metalloproteinase 2 (MMP2) and matrix metalloproteinase 9 (MMP9) measure enzymes that help break down proteins. Levels of these two enzymes are elevated when cancer has become metastatic, "breaking out" of the tissues that previously confined it. However, these enzymes are also elevated autoimmune disease, cardiovascular disease, and pregnancy.
• Vascular endothelial growth factor (VEGF) stimulates the growth of new blood vessels. Tumors turning metastatic develop their own blood supply with the help of VEGF. However, VEGF levels are also elevated in diabetic retinopathy, macular degeneration, and rheumatoid arthritis.

There is one more test for cancer that also leads to about as much misunderstanding as accurate diagnosis. The familiar prostate specific antigen (PSA) indicates inflammation of the prostate, but it doesn’t indicate the specific source of the inflammation of the prostate. Sometimes a finger exam is enough to raise PSA levels temporarily. High PSA levels do not necessarily mean men have prostate cancer. Low PSA levels do not necessarily mean they do not.

Every biomarker for cancer generates false positives. They are present when the people being tested don't have cancer. Sometimes these tests generate more than four times as many false positives as true indications of the disease. You don't want to have people living in terror of a disease that will never happen, or to begin treatment of a disease that does not exist, especially when a test can't distinguish between cancer and pregnancy, even in men.

The new test, developed in a lab led by Dr. Hassan Haboubi, doesn't look for indicators with ambiguous interpretations. Instead, it measures a single protein in the blood that determines the "stickiness" of red blood cells in the bloodstream. This protein acts a little like Velcro, by binding proteins to red blood cells so the red blood cells can carry them throughout the body. Without this "Velcro," red blood cells can't deliver the regulators that counteract pre-cancerous changes in cancer throughout the body. 

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Dr. Haboubi and his collaborators identified an antibody that can "stick" to this protein on the surface of red blood cells. When they expose a blood sample to the antigen and the cells come back "naked," then there are good indications that they have the mutation that keeps them from assisting the body in stopping cancer development. Most people who have this mutation, Haboubi says, almost inevitably develop cancer over the next 10 years.

As this article is being written, the test is only available in the United Kingdom and only validated for predicting the future risk of one of the hardest kinds of cancer to treat, esophageal cancer. In the near future, the test will have been validated for many more forms of cancer and made available around the world. This test is a major advancement in the early detection of cancer that can lead to preventive action without needless worry.