Cancer Indices Demystified: Normal Ranges and Misconceptions

Cancer indices are numerical values that indicate the risk or severity of cancer in a person. They are derived from various tests, such as blood tests, urine tests, imaging tests, or biopsies, that measure the levels or activity of certain biomarkers, such as tumor markers, hormones, enzymes, or genes. Cancer indices can help diagnose cancer, monitor its progression, evaluate its response to treatment, or predict its prognosis.

However, cancer indices are not definitive indicators of cancer. They can vary depending on many factors, such as age, gender, health condition, medication, diet, or lifestyle. They can also be influenced by the type, stage, location, or subtype of cancer. Therefore, cancer indices should be interpreted with caution and in conjunction with other clinical information and medical history.

In this article, you will learn about:

What is a Cancer Index?
Different Cancer Indices
What is the Normal Range for Cancer Indices?
How Accurate are Cancer Indices?
How to Lower Your Cancer Index Naturally?
Frequently Asked Questions
References

What is a Cancer Index?

The term “cancer index” refers to “serum tumor markers,” also known as tumor indices. These are specific proteins in the blood whose elevated levels are often associated with certain cancers. They are produced by cancer cells or by the body in response to cancer. Cancer indices can be used to monitor the effectiveness of treatment, detect recurrence, and estimate prognosis. However, cancer indices are not definitive tests for cancer diagnosis, as they can also be influenced by other factors, such as inflammation, infection, liver disease, pregnancy, and benign tumors. Likewise, a normal cancer index does not rule out the possibility of cancer, as some cancers do not produce detectable amounts of tumor markers. Therefore, cancer indices should be interpreted with caution and in conjunction with other clinical information, such as symptoms, physical examination, imaging, and biopsy.

Different Cancer Indices

Cancer indices are biomarkers that can be measured in blood or other body fluids to indicate the presence or progression of certain types of cancer. However, cancer indices are not definitive diagnostic tools, as they can be influenced by various factors and may not reflect the actual condition of the tumor. Therefore, cancer indices should be used in conjunction with other clinical examinations and imaging tests to confirm the diagnosis and treatment of cancer.

Common cancer indices and their applications include:

Cancer Index	Application	Limitations
AFP (Alpha-Fetoprotein)	Preliminary screening for liver cancer, especially hepatocellular carcinoma (HCC), the most common type of primary liver cancer. AFP is a protein produced by the liver and the fetus during development. AFP levels normally decrease after birth, but may increase in some liver diseases or cancers.	Elevated AFP can be related to conditions like liver cirrhosis, hepatitis, or pregnancy, which can affect the liver function and increase the production of AFP. Therefore, AFP alone is not sufficient to diagnose liver cancer, and other tests such as ultrasound, CT scan, MRI, or liver biopsy are needed to confirm the diagnosis.
CA19-9	Preliminary screening for pancreatic cancer, especially pancreatic ductal adenocarcinoma (PDAC), the most common type of pancreatic cancer. CA19-9 is a carbohydrate antigen that is expressed on the surface of some cells, including pancreatic cells. CA19-9 levels may increase in some pancreatic diseases or cancers.	Elevated CA19-9 levels can also be associated with other abdominal tumors or non-malignant conditions like cholangitis, pancreatitis, gallstones, or cystic fibrosis. Therefore, CA19-9 alone is not specific or sensitive enough to diagnose pancreatic cancer, and other tests such as endoscopic ultrasound, CT scan, MRI, or biopsy are needed to confirm the diagnosis.
CA153	Preliminary screening for breast cancer in women, especially invasive ductal carcinoma (IDC), the most common type of breast cancer. CA153 is a glycoprotein that is expressed on the surface of some cells, including breast cells. CA153 levels may increase in some breast diseases or cancers.	Elevated CA153 levels can occur in other cancers or non-malignant conditions related to breasts or ovaries, such as ovarian cancer, endometrial cancer, benign breast tumors, mastitis, or ovarian cysts. Therefore, CA153 alone is not reliable or accurate enough to diagnose breast cancer, and other tests such as breast self-exams, specialist examinations, mammography, ultrasound, or biopsy are crucial for comprehensive breast health assessment.
CA-125	Preliminary screening for ovarian cancer, especially epithelial ovarian cancer (EOC), the most common type of ovarian cancer. CA-125 is a glycoprotein that is expressed on the surface of some cells, including ovarian cells. CA-125 levels may increase in some ovarian diseases or cancers.	Elevated CA-125 levels can be related to other conditions like endometriosis, pelvic inflammatory diseases, uterine fibroids, menstruation, or pregnancy, which can affect the ovarian function and increase the production of CA-125. Therefore, CA-125 alone is not specific or sensitive enough to diagnose ovarian cancer, and other tests such as pelvic exams, ultrasound, CT scan, MRI, or biopsy are needed to confirm the diagnosis.
CEA (Carcinoembryonic Antigen)	Preliminary screening for colorectal and gastrointestinal cancers, especially adenocarcinomas, which are cancers that arise from glandular cells. CEA is a protein that is normally produced by the fetus during development, but may be re-expressed by some cancer cells. CEA levels may increase in some gastrointestinal diseases or cancers.	Elevated CEA values may be associated with smoking, gastritis, cirrhosis, or thyroid dysfunction, which can affect the metabolism and clearance of CEA. Therefore, CEA alone is not sufficient to diagnose colorectal or gastrointestinal cancers, and other tests such as colonoscopy, fecal occult blood tests, endoscopy, or biopsy are recommended for comprehensive gastrointestinal health assessment.
PSA (Prostate-Specific Antigen)	Used as an indicator for prostate cancer screening in men, especially prostate adenocarcinoma, the most common type of prostate cancer. PSA is a protein that is produced by the prostate gland and secreted into the semen. PSA levels may increase in some prostate diseases or cancers.	Elevated PSA can also be associated with conditions like prostate enlargement, inflammation, infection, or ejaculation, which can affect the prostate function and increase the production of PSA. Therefore, PSA alone is not specific or accurate enough to diagnose prostate cancer, and other tests such as rectal exams, prostate ultrasound, or biopsy are needed to confirm the diagnosis.

What is the Normal Range for Cancer Indices?

The cancer index is not a fixed value that can be used to diagnose cancer. It is a relative indicator that reflects the level of certain substances in the blood that may be associated with cancer. However, these substances can also be influenced by other factors, such as age, gender, lifestyle, and health conditions. Therefore, the cancer index should be interpreted with caution and in conjunction with other tests and examinations.

Different types of cancer indices have different normal ranges, which may vary slightly depending on the testing method and the reference standard used. The following table summarizes some of the common cancer indices, their normal ranges, the cancers they are related to, and the non-malignant conditions that can affect them.

Cancer Index	Normal Range	Associated Cancers	Non-malignant Conditions
CA-125 (Cancer Antigen 125)	＜35 u/ml	Ovarian, endometrial, breast	Pregnancy, endometriosis, uterine abnormalities, gynecological diseases, liver cirrhosis
CEA (Carcinoembryonic Antigen)	＜5 ng/ml (＜8 ng/ml for smokers)	Colorectal (most common), pancreatic, lung, stomach	Smoking, thyroid dysfunction, liver abscess, peptic ulcer, chronic bronchitis, diverticulitis, obstructive jaundice, alcoholic cirrhosis
AFP (Alpha-Fetoprotein)	＜20 ng/ml	Liver	Pregnancy, liver cirrhosis, acute hepatitis, chronic active hepatitis
CA19-9	＜37 u/ml	Pancreatic, bile duct, colorectal	Pancreatitis, cholangitis, gallstones
PSA (Prostate-Specific Antigen)	＜4 ng/ml	Prostate	Prostatitis, benign prostatic hyperplasia, ejaculation, urinary tract infection, prostate biopsy
CA 15-3 (Cancer Antigen 15-3)	＜22 u/ml	Breast, metastatic breast, colorectal, pancreatic, cervical, liver	Hepatitis, liver cirrhosis, diseases of the breast, ovary, or uterus

It is important to note that having a high or low cancer index does not necessarily mean that one has or does not have cancer. The cancer index is only one of the many tools that can help assess the risk of cancer and monitor the response to treatment. A definitive diagnosis of cancer can only be made by a biopsy, which is the removal and examination of a sample of tissue or cells from the body.

How Accurate are Cancer Indices?

Cancer indices are not definitive tests for cancer diagnosis; they are only indicators of abnormal cell growth or activity in the body. Most cancers require “imaging tests and pathological samples to confirm the presence and type of malignant tumors.” One exception is AFP, which can be used to diagnose liver cancer when it is elevated in patients with chronic hepatitis B or C and liver imaging shows suspicious lesions. However, this is not a universal rule and other factors may affect the accuracy of AFP. Therefore, it is important to consult a doctor before drawing any conclusions from cancer indices.

Cancer indices are more useful for monitoring the response and progression of cancer treatment. A decrease in cancer indices usually means that the treatment is effective and the cancer cells are dying or shrinking. An increase in cancer indices may indicate a recurrence or resistance to treatment, or a new cancer development. However, cancer indices can also fluctuate due to non-cancerous causes, such as inflammation, infection, or benign tumors. Therefore, cancer indices should always be interpreted in conjunction with other clinical information, such as symptoms, physical examination, imaging tests, and pathological samples.

How to Lower Your Cancer Index Naturally?

Lowering your cancer index naturally means reducing the risk factors that may contribute to cancer development or growth. Some of the common risk factors include smoking, alcohol consumption, obesity, physical inactivity, exposure to environmental toxins, chronic inflammation, and genetic mutations. By modifying your lifestyle and habits, you can lower your cancer index and improve your overall health and well-being. Here are some natural ways to lower your cancer index:

Quit smoking and avoid secondhand smoke. Smoking is the leading cause of lung cancer and many other cancers. It damages the DNA of cells and makes them more prone to mutations and malignancy. Quitting smoking can lower your cancer index and reduce the risk of cancer recurrence and death.
Limit alcohol intake. Alcohol is a carcinogen that can increase the risk of cancers of the mouth, throat, esophagus, liver, breast, and colon. It can also interfere with the metabolism of other nutrients and hormones, and affect the immune system. Limiting alcohol intake to no more than one drink per day for women and two drinks per day for men can lower your cancer index and protect your liver and other organs.
Maintain a healthy weight and exercise regularly. Obesity is a risk factor for many cancers, especially those of the breast, endometrium, colon, kidney, and pancreas. It can cause chronic inflammation, hormonal imbalance, insulin resistance, and oxidative stress, all of which can promote cancer growth. Exercise can help you lose weight and improve your metabolism, immunity, and mood. It can also lower the levels of some cancer indices, such as CEA, CA 15-3, and CA 125.
Eat a balanced and nutritious diet. A diet rich in fruits, vegetables, whole grains, legumes, nuts, seeds, and lean proteins can provide you with antioxidants, vitamins, minerals, fiber, and phytochemicals that can protect your cells from damage and inflammation. A diet low in processed foods, red meat, salt, sugar, and trans fats can prevent obesity, diabetes, cardiovascular disease, and cancer. Some foods that can lower your cancer index include cruciferous vegetables, berries, garlic, turmeric, green tea, and flaxseeds.
Avoid exposure to environmental toxins. Some chemicals, pollutants, radiation, and viruses can cause cancer by damaging the DNA of cells or altering their function. Examples include asbestos, benzene, radon, ultraviolet rays, human papillomavirus (HPV), and hepatitis B and C viruses. You can lower your cancer index by avoiding or minimizing your exposure to these carcinogens, and by taking preventive measures, such as wearing protective gear, applying sunscreen, and getting vaccinated.

Frequently Asked Questions

Can cancer index be affected by other factors?

Yes, cancer index can be influenced by various factors, such as age, gender, lifestyle, inflammation, infection, and medication. For example, some studies have shown that smoking can increase the levels of certain cancer indices, such as CEA and CA 19-9 . Similarly, inflammation or infection can cause a temporary rise in some cancer indices, such as CA 125 and CA 15-3 . Therefore, it is important to consider the context and the history of the patient when interpreting the results of cancer index tests.

How often should I check my cancer index?

The frequency of checking your cancer index depends on your individual situation and your doctor’s recommendation. Generally, cancer index tests are not used for screening or diagnosing cancer, but for monitoring the response to treatment or the recurrence of cancer. Therefore, you may need to check your cancer index more often if you have a history of cancer or if you are undergoing cancer therapy. However, there is no definitive guideline on how often you should check your cancer index, as different cancers and different cancer indices may require different intervals. You should consult your doctor for the best advice on your specific case.

What are the symptoms of high cancer index?

A high cancer index does not necessarily mean that you have cancer, as there are many other possible causes of elevated cancer index levels. However, if you have a high cancer index and you also experience other symptoms that may indicate cancer, you should seek medical attention as soon as possible. Some of the common symptoms of cancer include:

Unexplained weight loss: Losing weight without trying or without any change in your diet or exercise routine can be a sign of cancer, especially if it is more than 10% of your body weight in six months or less.
Chronic fatigue: Feeling tired all the time, even after resting or sleeping, can be a sign of cancer, as cancer cells can consume a lot of energy and oxygen from your body.
Persistent pain: Having pain that does not go away or gets worse over time can be a sign of cancer, especially if it is in a specific area or organ, such as the abdomen, chest, back, or bones.
Changes in bowel or bladder habits: Having diarrhea, constipation, blood in the stool, difficulty urinating, or blood in the urine can be a sign of cancer, especially if it is in the colon, rectum, bladder, or kidney.
Lumps or swellings: Having lumps or swellings in any part of your body, such as the breast, testicle, neck, armpit, or groin, can be a sign of cancer, especially if they are hard, painless, or growing.

These are not the only symptoms of cancer, and having these symptoms does not necessarily mean that you have cancer. However, if you have any of these symptoms and a high cancer index, you should not ignore them and see your doctor as soon as possible.

What are the best foods to eat to prevent cancer?

There is no single food that can prevent cancer, but there are some dietary patterns that can help reduce your risk of developing cancer. According to the World Health Organization (WHO), some of the best foods to eat to prevent cancer are:

Fruits and vegetables: Eating at least five servings of fruits and vegetables per day can provide you with antioxidants, vitamins, minerals, and fiber that can protect your cells from damage and inflammation. Some of the fruits and vegetables that have been shown to have anti-cancer effects include berries, citrus fruits, cruciferous vegetables, leafy greens, and tomatoes.
Whole grains and legumes: Eating whole grains and legumes, such as oats, barley, quinoa, beans, lentils, and soy, can provide you with complex carbohydrates, protein, fiber, and phytochemicals that can modulate your hormone levels, lower your blood sugar, and enhance your immune system. Some of the whole grains and legumes that have been shown to have anti-cancer effects include oats, barley, rye, buckwheat, flaxseed, soy, and chickpeas.
Nuts and seeds: Eating nuts and seeds, such as almonds, walnuts, pistachios, sunflower seeds, and sesame seeds, can provide you with healthy fats, protein, fiber, and minerals that can lower your cholesterol, blood pressure, and inflammation. Some of the nuts and seeds that have been shown to have anti-cancer effects include walnuts, almonds, pistachios, flaxseed, and sesame seeds.
Herbs and spices: Adding herbs and spices, such as garlic, ginger, turmeric, cinnamon, rosemary, and basil, to your food can provide you with antioxidants, anti-inflammatory, and antimicrobial compounds that can modulate your gene expression, inhibit cancer cell growth, and enhance your detoxification. Some of the herbs and spices that have been shown to have anti-cancer effects include garlic, ginger, turmeric, cinnamon, rosemary, and basil.

These are not the only foods that can prevent cancer, and eating these foods does not guarantee that you will not get cancer. However, eating a balanced and varied diet that includes these foods can help you maintain a healthy weight, boost your immune system, and lower your risk of developing cancer.

References

Chen, J. G., Zhang, S. W., Chen, W. Q., He, Y. T., Feng, X. S., Liu, S. Q., … & Chen, J. H. (2019). AFP elevation is associated with high risk of hepatocellular carcinoma in patients with hepatitis B viral infection: a Chinese population-based cohort study. Cancer medicine, 8(1), 229-238.
Chen, J. G., Zhang, S. W., Chen, W. Q., He, Y. T., Feng, X. S., Liu, S. Q., … & Chen, J. H. (2019). AFP elevation is associated with high risk of hepatocellular carcinoma in patients with hepatitis B viral infection: a Chinese population-based cohort study. Cancer medicine, 8(1), 229-238.
American Cancer Society. (2020). Tests for Liver Cancer.
Wang, Y., Li, J., Xia, Y., Gong, R., Wang, K., Yan, Z., … & Liu, G. (2013). Prognostic nomogram for intrahepatic cholangiocarcinoma after partial hepatectomy. Journal of Clinical Oncology, 31(9), 1188.

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