TUMOR MARKERS & CANCER SCREENING

AAR Healthcare is a leading medical service provider and is one of the largest providers of outpatient healthcare services in East Africa, with a network of 40 outpatient centres and 2 hospitals. In Kenya, AAR Healthcare has 21 outpatient centres serving over 300,000 patients annually from across the social divide.

At AAR Healthcare, we employ professional medical staff and use internationally approved disease management protocols and drug formulary supported by the state of the art information technology systems to provide consistent treatment for our patients from anywhere in East Africa.

Established in 1984, AAR Healthcare has a strong history in clinical risk management and provision of preventive care embodied in our robust health promotion program that runs in all 21-outpatient centres in Kenya. This ensures that our clients receive quality affordable healthcare all under one roof. Our outpatient centres have qualified medical doctors, specialists, radiology services, fully functional laboratories and pharmacies. We have integrated internal and external international quality assurance programs into all our operations.

The AAR wellness program is designed to promote and support the health, safety and well being of our patients and help meet the unique needs of each of them, whether they are healthy or dealing with a new or ongoing health issue. Every year, we screen >5,000 people for lifestyle illnesses including but not limited to diabetes, hypertension, cancer and kidney disease. The individuals found to have high health risks or confirmed disease are identified and enrolled in a health promotion program, which includes linkage with medical doctors and specialists for treatment.

TUMOR MARKERS & CANCER SCREENING

What are tumor markers?

Tumor markers are chemicals typically produced by cancerous cells in the body. The level of the tumor markers can be measured in the blood, urine, saliva or other body fluids. Some tumor markers may be produced by non-cancer cells therefore; high levels of a tumor marker would need further investigation to ascertain whether the cause is cancer.

For example, we use the PSA (Prostate-Specific Antigen) test to screen for cancer of the prostate however; prostate gland infections also cause a rise in PSA levels, therefore, further investigation is usually required to differentiate whether the high level of PSA is due to cancer or infection.

Typically, doctors have used tumor markers to confirm the diagnosis of cancer when they suspect cancer for example when there is a growth or other symptoms and signs of cancer. It is important to note that the symptoms of cancer usually come in the late stages of the disease; early on, cancer has no symptoms.Tumor markers are also used to monitor cancer treatment including response to treatment and to check if the cancer has come back after treatment.

Which tumor markers are available?

There are as many tumor markers as there are types of cancers. Some of the tumor markers include PSA(Prostate-Specific Antigen), CEA (Carcinoembryonic Antigen), CA19–9, CA125, CA 15–3, AFP (Alpha-fetoprotein), BHCG (Human chorionic gonadotropin) and many more.

PSA is associated with prostate cancer, CEA is associated with colorectal/ lung/ thyroid/ pancreas/stomach cancers and CA 19–9 is associated with pancreatic cancers. BHCG is the hormone produced by the placenta during pregnancy but if it is high when a woman is not pregnant, it is associated with cancer in the uterus (womb).

Although tumor markers help detect the presence of cancer, they are no definitive diagnostic tests. The diagnosis of cancer must be confirmed by other specific tests.

Cancer Screening tests:

The goal of a screening test is to find cancer early when it is the most treatable and before it has had a chance to grow and spread. Screening tests detect potential health disorders in large numbers of apparently healthy people who do not have any symptoms of the disease. It begins with an invitation to participate and ends with the treatment of individuals with confirmed illness or follow up for high-risk individuals. The ideal screening test is a delicate balance of specificity& sensitivity of the tests, accessibility (availability & cost), acceptability (most people would feel comfortable doing it) and the local context (WHO).

In 2018 there were 48,000 new cases of cancer reported in Kenya and 33,000 deaths (Globocan 2018). Women accounted for nearly 60% of the new cases and close to 60% of the deaths. 60–80% of cases in Kenya are detected late; the burden of cancer in Kenya is heavy.

Healthcare professionals recommend regular screening for cancer to detect cancer early. Although the cancer screening tests are few and there are different approaches to screening, the currently available tests are a starting point. The good news is that the future is promising. More precise cancer screening tests are under development and screening and cancer prevention regimens will soon be matched to the individualized risk of cancer due to known genetic and environmental factors.