AN HEMOGLOBIN TEST FOR CANCER SCREENING (ISSN 2753-8176 (online))

Ana Pedro1,2

1.Gwyntwr1386 Pharmacy, Regus Chester Business Park, Heronsway, Chester, CH49QR, UK.

info@gwyntwr1386.com

Under normal circumstances and at normal ambient oxygen tension, the red blood cell life span and the rate of effective red blood cell production determine the circulating red blood cell mass. Anemia, which can be defined in a functional way as the lack of sufficient red blood cells to maintain adequate tissue oxygenation, develops when the demand for new red blood cells exceeds the capacity of the bone marrow to produce them. Acquired anemia is always a consequence of a pimary disorder, which must be identified to make sure that a corrective therapy is administered. In patients with solid tumors, anemia can be caused by blood loss which can be either intrinsic or iatrogenic, iron or folic acid deficiency or hemolysis (autoimmune, traumatic, or drug-induced); or bone marrow failure due to tumor encroachment, myelofibrosis, or marrow necrosis; infection; inflammation; or simply the presence of a cancer elsewhere in the body. Also, for any degree of anemia, a patient with cancer produces much less erythropoietin than expected and, therefore, cannot compensate for impaired red blood cell production. Inflammation or infection can exacerbate this situation. Curiously, anemia in patients with cancer appears to behave much like that in patients with chronic renal failure who become anemic because of the inability of the kidneys to produce erythropoietin adequately.The cause of impaired erythropoietin production in patients with cancer might be due in part to the production of inflammatory cytokines in response to the tumor. Such cytokines also would be expected to blunt the ability of the bone marrow to respond to the available circulating erythropoietin (1).

Anemia is a common diagnosis in patients with cancer and is often multifactorial, caused by direct effects of the malignancy, products secondary to the malignancy, the effects of treatment, or other factors (2). Anaemia and cancer, have often been linked, due to the ability of cancer cells to sequester iron, thereby limiting iron availability for RBC (red blood cell) production (3).Anaemia is characteristically prevalent in cancer patients, of practically all cancer types to varying grades, resulting in low quality of life and poor prognosis (3)

We also discovered that different hemoglobin subunit expression varies accorddingly to different types of cancers and different stages of cancer progression (4).

Therefore, detecting anaemia can be a good screening method for any type of cancer detection.

Minimally invasive anaemia detection methods require blood sampling using techniques such as finger pricks. The cyanmethemoglobin, or hemiglobincyanide (HiCN) method, is currently used as a reference method for evaluating new instruments and alternative methods for hemoglobin (Hb) level measurement in a standardized guideline provided by Clinical and Laboratory Standards Institute titled CLSI H15-A3 and International Committee for Standardization in Haematology (ICSH) (5).

References:

1. https://pubmed.ncbi.nlm.nih.gov/8202724/

2. https://pubmed.ncbi.nlm.nih.gov/33201870/

3. Basak and Kanwar (2022). Iron imbalance in cancer: Intersection of deficiency and overload. https://doi.org/10.1002/cam4.4761

4.Pedro A (2023). A Review of The Role of Hemoglobin in Different types of Cancer ISSN 2753-8176 (online), DOI:10.13140/RG.2.2.24610.20164.

5. An et al (2021). Emerging Point-of-Care Technologies for Anemia Detection. Lab Chip. 2021 May 18; 21(10): 1843–1865. doi:10.1039/d0lc01235a.