28Sep 2023 by Ronny Allan No Comments
First and only FDA-cleared, fully automated chromogranin A assay

First and only FDA-cleared, fully automated chromogranin A assay

A Spotlight on NENs - Testing Series, Clinical Trials and Research, Patient Advocacy
There has been controversy about the utility of Chromogranin A for many years now.  Specialists have been critical about its use but to be fair even those less critical still confirm that alone it would not be trusted to formally diagnose Neuroendocrine Cancer.  That said, it was still controversial when certain US guidelines were updated to recommend it is not regularly tested.  It's well known for being a sensitive but non-specific marker for most tumours of Neuroendocrine type, the non-specificity is mostly due to the other conditions, some of which are highly prevalent in many countries, including but not limited to the use of proton pump inhibitors, heart disease and kidney disease.  Another criticism has been the lack of faith in using it to assess reaction to treatment.I have to say,…
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24May 2023 by Ronny Allan No Comments
A spotlight on Chromogranin A

A spotlight on Chromogranin A

A Spotlight on NENs - Testing Series, Patient Advocacy
What is Chromogranin A? Chromogranin A (CgA) is an acidic protein released along with catecholamines from chromaffin cells and nerve terminals. This statement alone might explain why it's a good marker to use with Neuroendocrine Neoplasms.  It is said to be a measure of tumour bulk. Depending on the test kit being used, you may also see test results for Chromogranin B (CgB) alongside CgA. CgB is said to be less affected by false positives and forms a useful adjunct to the more established chromogranin A measurement.  The brand of test kit which includes CgB tends to be confined to Europe. Immunohistochemical Testing.  CgA is one the most commonly used immunohistochemical (IHC) markers for neuroendocrine cells and their tumours.  You may find the mention of CgA in your biopsy reports…
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11Jul 2020 by Ronny Allan 5 Comments
The NETest® – a Chromogranin A replacement and more?

The NETest® – a Chromogranin A replacement and more?

A Spotlight on NENs - Testing Series, Clinical Trials and Research, Patient Advocacy
Update 20th Aug 2023.NEW YORK – Wren Laboratories announced Thursday that it finalized a distribution agreement with Kindstar Globalgene Technology to distribute Wren's blood-based neuroendocrine tumor NETest throughout China. Click the link below. https://wrenlaboratories.com/netest-expanded-to-china/Tumour Markers GeneralFor some years the gold standard tumour marker for Neuroendocrine Neoplasms (NENs) has been and remains today, Chromogranin A (and for certain scenarios Chromogranin B and C can provide some additional clues).  Pancreastatin, which is actually a molecule of Chromogranin A, is another marker touted but appears to be limited to USA. Its main advantage is the ability to better handle the effects of Proton Pump Inhibitor (PPI) use which is prevalent in the general population.  As we move to a new era of molecular/genetic tumour markers, there's a danger that NENs will be left behind,…
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05Feb 2019 by Ronny Allan 1 Comment
Proton Pump Inhibitors (…..and H2 Blockers) the NET Effect

Proton Pump Inhibitors (…..and H2 Blockers) the NET Effect

The NET Effect Series, Treatment
What are Proton pump inhibitors (PPIs)?Proton pump inhibitors (PPIs) are among the most commonly used medications in the world. They reduce the production of acid by blocking the enzyme in the wall of the stomach that produces acid. Acid is necessary for the formation of most ulcers in the oesophagus, stomach, and duodenum, and the reduction of acid with PPIs prevents ulcers and allows any ulcers that exist in the oesophagus, stomach, and duodenum to heal. PPIs are prescribed to treat acid-related conditions such as:Esophageal, duodenal and stomach ulcersNSAID-associated ulcerUlcersGastroesophageal reflux disease (GERD)Zollinger-Ellison Syndrome - ZES (note this is a syndrome associated with a functioning duodenal or pancreatic NET known as a Gastrinoma)They also are used in combination with antibiotics for eradicating Helicobacter pylori, a bacterium that together with acid…
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19May 2017 by Ronny Allan 5 Comments
ASCO 2017 – Let’s talk about NETs #ASCO17

ASCO 2017 – Let’s talk about NETs #ASCO17

Clinical Trials and Research
ASCO (American Society of Clinical Oncology) is one of the biggest cancer conferences in the world normally bringing together more than 30,000 oncology professionals from around the world to discuss state-of-the-art treatment modalities, new therapies, and ongoing controversies in the field.  As Neuroendorine Tumors is on a roll in terms of new treatments and continued research, we appear to be well represented with over 20 'extracts' submitted for review and display.  This is fairly complex stuff but much of it will be familiar to many.  I've filtered and extracted all the Neuroendocrine stuff into one list providing you with an easy to peruse table of contents, complete with relevant linkages if you need to read more.  For many the extract title and conclusion will be sufficiently educational or at least…
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28Sep 2016 by Ronny Allan 23 Comments
Neuroendocrine Cancer – tumour markers and hormone levels

Neuroendocrine Cancer – tumour markers and hormone levels

A Spotlight on NENs - Testing Series, Patient Advocacy
BackgroundSome people on hear the terms "tumour markers" and "hormone levels" when they are diagnosed with Neuroendocrine Cancer.  Most of them will have had a form of medical testing at some point in their life, i.e. the sampling and testing of blood, urine, saliva, stool or body tissue. In a nutshell, the medical staff are just measuring the content of a 'substance' and then taking a view whether this is normal or not based on pre-determined ranges. These tests are normally done as a physician's reaction to symptom presentation or maintenance/surveillance of an existing diagnosed condition. Sometimes, abnormal results will lead to more specialist tests.In cancer, these tests are frequently called 'markers'. Most tumour markers are made by normal cells as well as by cancer cells; however, they are produced at…
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16Oct 2014 by Ronny Allan 14 Comments
Neuroendocrine Cancer – Horrible Hormones

Neuroendocrine Cancer – Horrible Hormones

Patient Advocacy
Hormonal imbalances are quite common in many conditions including day to day stuff. With Neuroendocrine Cancer, it can be a real challenge both at diagnostic and maintenance phases.  In addition to the cancer angle, there's some strange stuff going on, inexplicable, frightening for the patient, an unwanted ingredient causing chaos!Until I was diagnosed with metastatic Neuroendocrine Cancer, I didn't have a clue about hormones - it's one of those things you just take for granted. However, hormones are vital to human health (male and female) and it's only when things go wrong you suddenly appreciate how important they are.  Hormones are involved in many conditions, not just an issue with Neuroendocrine Tumours (NETs) but the presence of over-secreting hormones (often called peptides throughout) is useful to aid a diagnosis, albeit…
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