Self Instructional Manual for Cancer Registrars - SEER - National ...

Blood Serum Studies
Automation and modern advances in medical technology enable the physician to obtain
a complete battery of laboratory tests from the patient's blood. Listed below are a few of
the studies you may want to check to assess the diagnosis or spread of cancer.
Serum Calcium. Calcium circulates in the blood in equilibrium with the calcium in the
bone. Patients with cancer have a tendency to develop an excess of calcium in the blood
(hypercalcemia), particularly with lung and breast cancers, reflecting metastatic disease of
the bone. When bone is replaced with malignant cells, calcium is released in an increased
amount in the blood circulation. Normal values are 8.5-10.5 mg/100 ml (slightly higher for
children).
Serum Alkaline Phosphatase. Alkaline phosphatase is an intracellular enzyme which
becomes elevated when there is destruction of cells. The key areas where it is produced are
the liver and bones. An elevated alkaline phosphatase is indicative of bone and liver
abnormalities. See page 116 for normal values.
Senzm Acid Phosphatase. Elevated serum levels of acid phosphatase are seen in patients
with carcinoma of the prostate that has extended beyond the prostatic capsule. Patients
with prostatic carcinoma still confined within the capsule usually have a normal serum level.
However, patients with benign prostatic hypertrophy may have slight elevations of the serum
acid phosphatase level after vigorous prostatic "massage." Since other tissues may also
release acid phosphatase into the serum, minor elevations may reflect an origin other than
the prostate. Acid phosphatase determination has been used diagnostically to help
determine the resectability of prostatic cancers. Cancers which have extended beyond the
prostatic capsule, i.e., to the bone, are not generally treated by prostatectomy. See page 116
for normal values.
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