Cancer Disease Cells in the Body - Essay Example

?   Evaluating the Use of Immunocytochemistry in the Search for the Identity of the Cancer of Unknown Primary (CUP) Immunocytochemistry is a clinical technique where the presence of a specific protein or antigen in cells is assessed by use of a specific antibody, which binds to it. This process is visualized and examinined under a microscope. Immunocytochemistry (ICC) is a valuable tool for determining cellular contents from individual body cells. Cells samples that can be analyzed include cultured cells, blood smears, swabs, aspirates, and cell suspensions. Sometimes patients present distinct tumors that carry a high index of suspicion that demonstrate distant, metastatic origin rather than primary tumors. In such cases, it becomes difficult to establish the clinical context and/or histological morphology of the tumour (Larsson, 2008, p. 46). This essay seeks to outline how immunocytochemistry can be used to confirm the identity of the primary tumour. By giving this discussion, the paper will make use of illustrative examples to explain the basis of this approach and discuss the advantages and limitations of the approach. Cancer patients who suffer from unknown primary cancer origin account for 3% of all cancer patients. These patients present a case of metastatic disease where a primary site cannot be detected at the time of diagnosis. A metastatic disease is a disease that spreads from one organ to another non-adjacent to it. Metastatic cancer is a cancer that spread from one place where it begins to another place in the body. A metastatic tumor or a metastasis is the tumor formed by metastatic cancer cells. The process where cancer cells spread to other parts of the body is also called metastasis. Metastatic cancer shares the same name and has the same type of cancer cells as the primary or original cancer (Richard, 2010). For example, lung cancer that spreads to the brains is called a metastatic lung cancer, not brain cancer. In addition, metastatic cancer cells and cells of the primary cancer, typically have some common molecular features, such as the appearance of certain proteins or presence of explicit chromosome changes. Although there are some types of metastatic cancer that are curable with the current cancer treatments, most are not. Nevertheless, there are available treatments for metastatic cancer patients (Arthur, 2008, p. 61). A primary cancer is the original place (organ or tissue) where cancer started. For example, a cancer starting in the breast is called primary breast cancer. If it spreads to the lungs, it would be called primary breast cancer metastatic to the lungs. In a number of cases, the original site of the cancer is unknown and is only discovered after they have spread to several parts of the body. In such a case, the tumor is referred a metastatic cancer of an unknown primary origin. In recent years, improved microscopic and other diagnostic techniques have made it possible to identify the origin of cancer in the body. According to statistics by National Cancer Society (2012), doctors can successfully determine 4 out of 5 cases first diagnosed as Cancer of unknown primary origin (CUP) their primary site. Some of the techniques doctors use is to determine the diagnostic tests that will be most helpful based on the part of the body where cancer cells are first found. Consequently, basic laboratory tests and imaging study with limited diagnostic procedures have proved to be sufficient for the diagnosis of this syndrome. The use of immunohistochemistry, as well as serum tumor markers of high specificity help to identify other tumors, is a highly recommended technique (National Cancer Society, 2012). Some cancer disease cells in the body releases certain substances into the bloodstream called tumor markers. There are numerous different tumor markers, but only a few of them are helpful in figuring out the origin of a cancer, such as: Prostate-specific antigen (PSA), CA-125, Human chorionic gonadotropin (HCG), Alpha-fetoprotein (AFP), and Chromogranin A (CgA). some of these tumor markers goes up with many different cancers, eg. Carcinoembryonic antigen (CEA), will go up in the presence of any adenocarcinoma source. Cancers of the lung, breast, colon ovarian, pancreas, among others can be adenocarcinomas and cause a rise in the CEA level (Coghlin & Murray 2010). Immunocytochemistry (ICC) is a type of Lab tests of biopsy samples where a pathologist first looks under the microscope the biopsy samples. In Immunocytochemistry thin slices of the biopsy tissue are attached to a glass microscope slides. The samples are then treated with antibodies (special proteins) designed to attach only to a specific substance (peptides or protein antigens) found in certain cancer cells. If the patient's cancer cells contain that specific substance, the antibody will attach itself to the cells. Chemicals are then added to the cells which the antibodies has attached itself so as it can change color. The doctor can then views the color change by use of the microscope. ICC allows doctors to evaluate whether cells in a particular sample express the specific antigen required. Where an immunopositive signal is present, ICC will also allow the doctors to determine the sub-cellular compartment is conveying the antigen. Doctors are often forced to use several different antibodies to determine the type of cancer on the slides. Immunocytochemistry is different from immunohistochemistry in one major aspect. The difference is that Immunocytochemistry is undertaken on intact cells samples whose most, if not all, of their extracellular matrix that surrounds them has been removed. This includes culture-grown cells, taken from a smear. In immunohistochemical, cells samples are sections of a biological tissue, where certain tissue architecture surrounds each cell. Difficulties with cytologic diagnoses of Cancer of unknown primary origin can be overcome by the application of immunocytochemical panels applied on smears. The performance of a panel of monoclonal antibodies can be assessed to differentiate primary cancer from metastatic carcinoma (MC) or regenerative nodules, and identify the date unknown primary sites of cancer that had metastasized to the other body organs. The application of immunocytochemical panels on the same slide done in the microscopic diagnosis is useful the routine assessment of CUP (Coghlin & Murray 2010) It is worth noting that prognosis for the majority of CUP cancer patients still remains poor, because not all tumors can be effectively distinguished with existing panels. However, several favorable outcomes by utilizing Immunocytochemistry techniques has shown which help to confirm the identity of the primary tumour. After the initial physical lab tests, the doctors, or pathologist will then classify cancer of unknown primary into 1 of the 5 main types: Adenocarcinoma Squamous cell carcinoma Poorly differentiated carcinoma Neuroendocrine carcinoma Poorly differentiated malignant neoplasm Conclusion After the primary cancer has been identified and confirmed by the help of Immunocytochemistry techniques, the appropriate treatment measures for cancer are put in place. Standard, or complementary, as well as alternative methods of cancer treatment are used. Some of the methods include; treatment by surgery, chemotherapy, immunotherapy, radiation therapy, and monoclonal antibody therapy. The type of treatment will depend on the location of the tumor, grade of the tumour, and stage of the disease (Arthur, 2008). There is still poor consensus on the extent of diagnostic evaluations in front of metastatic cancers without a primary mass. At the present immunohistochemistry (IHC) and Immunocytochemistry (ICC) are currently the standard method by which a putative primary origin can be postulated. Nevertheless, molecular diagnostics has rapidly improved over the last few years which will help in the identification of early metastases and offer the most appropriate pathological classification (Larsson, 2008). Bibliography Arthur, L. (2008) You can fight cancer: Vermont Nurse Connection. Washington Street. Davis Publishing Agency. Coghlin, C. & Murray. G. (2010) Current and emerging concepts in tumour metastasis. Journal of Pathology 2010; 222(1):1–15 Larsson, L. (2008) Immunocytochemistry: Theory and Practice London. Taylor & Francis Group National Cancer Society (2012) Metastaic Cancer. Retrieved on 10th December 2012, from www.cancer.gov/cancertopics/factsheet/Sites-Types/metastatic Richard, W. (2010) Immunocytochemistry: A Practical Guide for Biomedical Research. Berlin. Springer Publishers Read More