GTD; Pregnancy-Related Tumors; Tumors and Pregnancy
Gestational trophoblastic disease (GTD) is a general term for rare tumors that form from the tissues surrounding fertilized egg. GTD is often found early and usually cured. Hydatidiform mole (HM) is the most common type of GTD. Learn more about GTD risk factors, symptoms and treatment.
Fibroids and allied tumours (myoma and adenomyoma)
Image by Lockyer, Cuthbert Henry Jones
Tumors and Pregnancy
Hydatidiform mole (2) complete type
Image by /Wikimedia
Hydatidiform mole (2) complete type
Image by /Wikimedia
Tumors and Pregnancy
Tumors during pregnancy are rare, but they can happen. Tumors can be either benign or malignant. Benign tumors aren't cancer. Malignant ones are. The most common cancers in pregnancy are breast cancer, cervical cancer, lymphoma, and melanoma. Cancer itself rarely harms the baby, and some cancer treatments are safe during pregnancy. You and your health care provider will work together to find the best treatment. Your options will depend on how far along the pregnancy is, as well as the type, size, and stage of your cancer.
Another type of tumor that women can get is called a gestational trophoblastic disease (GTD). It happens when a fertilized egg doesn't become a fetus. GTD is not always easy to find. It is usually benign, but some types can be malignant. The most common type of GTD is a molar pregnancy. In its early stages, it may look like a normal pregnancy. You should see your health care provider if you have vaginal bleeding (not menstrual bleeding).
Treatment depends on the type of tumor, whether it has spread to other places, and your overall health.
Source: National Cancer Institute
Additional Materials (8)
I'm Pregnant and I Have Cancer
Video by Northwell Health/YouTube
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Brain Tumor Discovered During Woman’s Pregnancy
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Pregnancy after a breast cancer diagnosis: Understanding risks
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Treating Pregnant Women with Breast Cancer - MedStar Health Cancer Network
Video by MedStar Health/YouTube
Fibroids and Endometriosis - How Tumors can Affect Pregnancy
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Fibroids & Pregnancy
Video by Lee Health/YouTube
Fibroids and allied tumours (myoma and adenomyoma)
Fibroids and allied tumours (myoma and adenomyoma)
Image by Lockyer, Cuthbert Henry Jones
3:18
I'm Pregnant and I Have Cancer
Northwell Health/YouTube
4:03
Cervical Cancer During Pregnancy | Ashley's Story
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1:11
Brain Tumor Discovered During Woman’s Pregnancy
Medical City Dallas/YouTube
1:01
Pregnancy after a breast cancer diagnosis: Understanding risks
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3:21
Treating Pregnant Women with Breast Cancer - MedStar Health Cancer Network
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3:41
Fibroids and Endometriosis - How Tumors can Affect Pregnancy
Wilcox Fertility/YouTube
1:40
Fibroids & Pregnancy
Lee Health/YouTube
Fibroids and allied tumours (myoma and adenomyoma)
Lockyer, Cuthbert Henry Jones
What Is GTD?
Early Pregnancy Uterus, fallopian tube, and cross section of ovary
Image by TheVisualMD
Early Pregnancy Uterus, fallopian tube, and cross section of ovary
Early Pregnancy Uterus, fallopian tube, and cross section of ovary
Image by TheVisualMD
What Is Gestational Trophoblastic Disease?
Gestational trophoblastic disease (GTD) is a group of rare diseases in which abnormal trophoblast cells grow inside the uterus after conception.
In gestational trophoblastic disease (GTD), a tumor develops inside the uterus from tissue that forms after conception (the joining of sperm and egg). This tissue is made of trophoblast cells and normally surrounds the fertilized egg in the uterus. Trophoblast cells help connect the fertilized egg to the wall of the uterus and form part of the placenta (the organ that passes nutrients from the mother to the fetus).
Sometimes there is a problem with the fertilized egg and trophoblast cells. Instead of a healthy fetus developing, a tumor forms. Until there are signs or symptoms of the tumor, the pregnancy will seem like a normal pregnancy.
Most GTD is benign (not cancer) and does not spread, but some types become malignant (cancer) and spread to nearby tissues or distant parts of the body.
Gestational trophoblastic disease (GTD) is a general term that includes different types of disease:
Hydatidiform Moles (HM)
Complete HM.
Partial HM.
Gestational Trophoblastic Neoplasia (GTN)
Invasive moles.
Choriocarcinomas.
Placental-site trophoblastic tumors (PSTT; very rare).
Epithelioid trophoblastic tumors (ETT; even more rare).
Source: National Cancer Institute (NCI)
Additional Materials (3)
What is Gestational Trophoblastic Disease?
Video by HenryFordTV/YouTube
Benign Gestational Trophoblastic Disease - CRASH! Medical Review Series
Association of Professors of Gynecology and Obstetrics (APGO)/YouTube
What Is Hydatidiform Mole?
Molar Pregnancy
Image by Hellerhoff
Molar Pregnancy
Hydatidiform mole on CT, axial view
Image by Hellerhoff
What Is Hydatidiform Mole?
Hydatidiform mole (HM) is the most common type of GTD.
HMs are slow-growing tumors that look like sacs of fluid. An HM is also called a molar pregnancy. The cause of hydatidiform moles is not known.
HMs may be complete or partial:
A complete HM forms when sperm fertilizes an egg that does not contain the mother’s DNA. The egg has DNA from the father and the cells that were meant to become the placenta are abnormal.
A partial HM forms when sperm fertilizes a normal egg and there are two sets of DNA from the father in the fertilized egg. Only part of the fetus forms and the cells that were meant to become the placenta are abnormal.
Most hydatidiform moles are benign, but they sometimes become cancer. Having one or more of the following risk factors increases the risk that a hydatidiform mole will become cancer:
A pregnancy before 20 or after 35 years of age.
A very high level of beta human chorionic gonadotropin (β-hCG), a hormone made by the body during pregnancy.
A large tumor in the uterus.
An ovarian cyst larger than 6 centimeters.
High blood pressure during pregnancy.
An overactive thyroid gland (extra thyroid hormone is made).
Severe nausea and vomiting during pregnancy.
Trophoblastic cells in the blood, which may block small blood vessels.
Serious blood clotting problems caused by the HM.
Source: National Cancer Institute (NCI)
Additional Materials (4)
Hydatidiform Mole Video
Video by Cristin Sanders/YouTube
241 Molar pregnancy, partial and complete hydatidiform mole - USMLE Step 1 - USMLE ACE FULL VIDEO
Video by USMLE ACE INC/YouTube
093014 WFSB Aaron Shafer on choriocarcinoma
Video by Hartford HealthCare/YouTube
Molar Pregnancy (v2)
Video by DrER.tv/YouTube
3:01
Hydatidiform Mole Video
Cristin Sanders/YouTube
5:27
241 Molar pregnancy, partial and complete hydatidiform mole - USMLE Step 1 - USMLE ACE FULL VIDEO
Micrograph of Trophoblast, decidua and a hydatidiform mole. H&E stain.
Interactive by Nephron
What Is Gestational Trophoblastic Neoplasia?
Gestational trophoblastic neoplasia (GTN) is a type of gestational trophoblastic disease (GTD) that is almost always malignant.
Gestational trophoblastic neoplasia (GTN) includes the following:
Invasive moles
Invasive moles are made up of trophoblast cells that grow into the muscle layer of the uterus. Invasive moles are more likely to grow and spread than a hydatidiform mole. Rarely, a complete or partial HM may become an invasive mole. Sometimes an invasive mole will disappear without treatment.
Choriocarcinomas
A choriocarcinoma is a malignant tumor that forms from trophoblast cells and spreads to the muscle layer of the uterus and nearby blood vessels. It may also spread to other parts of the body, such as the brain, lungs, liver, kidney, spleen, intestines, pelvis, or vagina. A choriocarcinoma is more likely to form in women who have had any of the following:
Molar pregnancy, especially with a complete hydatidiform mole.
Normal pregnancy.
Tubal pregnancy (the fertilized egg implants in the fallopian tube rather than the uterus).
Miscarriage.
Placental-site trophoblastic tumors
A placental-site trophoblastic tumor (PSTT) is a rare type of gestational trophoblastic neoplasia that forms where the placenta attaches to the uterus. The tumor forms from trophoblast cells and spreads into the muscle of the uterus and into blood vessels. It may also spread to the lungs, pelvis, or lymph nodes. A PSTT grows very slowly and signs or symptoms may appear months or years after a normal pregnancy.
Epithelioid trophoblastic tumors
An epithelioid trophoblastic tumor (ETT) is a very rare type of gestational trophoblastic neoplasia that may be benign or malignant. When the tumor is malignant, it may spread to the lungs.
Source: National Cancer Institute (NCI)
Additional Materials (2)
Topic 50: Gestational Trophoblastic Neoplasia
Video by Association of Professors of Gynecology and Obstetrics (APGO)/YouTube
093014 WFSB Aaron Shafer on choriocarcinoma
Video by Hartford HealthCare/YouTube
5:34
Topic 50: Gestational Trophoblastic Neoplasia
Association of Professors of Gynecology and Obstetrics (APGO)/YouTube
2:54
093014 WFSB Aaron Shafer on choriocarcinoma
Hartford HealthCare/YouTube
Risk Factors
CT images of hydatidiform moles - Molar pregnancy
Image by Hellerhoff
CT images of hydatidiform moles - Molar pregnancy
Hydatidiform mole on CT, sagittal view
Image by Hellerhoff
What Are the Risk Factors for Gestational Trophoblastic Disease?
Age and a previous molar pregnancy affect the risk of GTD.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk to your doctor if you think you may be at risk. Risk factors for GTD include the following:
Being pregnant when you are younger than 20 or older than 35 years of age.
Having a personal history of hydatidiform mole.
Source: National Cancer Institute (NCI)
Symptoms
A woman lying down near a toilet, implying nausea.
Image by Evil Erin
A woman lying down near a toilet, implying nausea.
A woman lying down near a toilet, implying nausea.
Image by Evil Erin
What Are the Signs and Symptoms of Gestational Trophoblastic Disease?
Signs of GTD include abnormal vaginal bleeding and a uterus that is larger than normal.
These and other signs and symptoms may be caused by gestational trophoblastic disease or by other conditions. Check with your doctor if you have any of the following:
Vaginal bleeding not related to menstruation.
A uterus that is larger than expected during pregnancy.
Pain or pressure in the pelvis.
Severe nausea and vomiting during pregnancy.
High blood pressure with headache and swelling of feet and hands early in the pregnancy.
Vaginal bleeding that continues for longer than normal after delivery.
Fatigue, shortness of breath, dizziness, and a fast or irregular heartbeat caused by anemia.
GTD sometimes causes an overactive thyroid. Signs and symptoms of an overactive thyroid include the following:
Fast or irregular heartbeat.
Shakiness.
Sweating.
Frequent bowel movements.
Trouble sleeping.
Feeling anxious or irritable.
Weight loss.
Source: National Cancer Institute (NCI)
Additional Materials (1)
Gestational Trophoblastic Disease (GTD)
Video by Obcast/YouTube
5:56
Gestational Trophoblastic Disease (GTD)
Obcast/YouTube
Diagnosis
Pelvic ultrasound
Image by TheVisualMD
Pelvic ultrasound
Pelvic ultrasound, a procedure that uses sound waves to look at organs and structures inside the pelvic region
Image by TheVisualMD
How Is Gestational Trophoblastic Disease Diagnosed?
Tests that examine the uterus are used to detect(find) and diagnose gestational trophoblastic disease.
The following tests and procedures may be used:
Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. A speculum is inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test of the cervix is usually done. The doctor or nurse also inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.Pelvic exam. A doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and presses on the lower abdomen with the other hand. This is done to feel the size, shape, and position of the uterus and ovaries. The vagina, cervix, fallopian tubes, and rectum are also checked.
Ultrasound exam of the pelvis: A procedure in which high-energy sound waves(ultrasound) are bounced off internal tissues or organs in the pelvis and make echoes. Theechoes form a picture of body tissues called a sonogram. Sometimes a transvaginal ultrasound (TVUS) will be done. For TVUS, an ultrasound transducer (probe) is inserted into the vagina to make the sonogram.
Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease. Blood is also tested to check the liver, kidney, and bone marrow.
Serum tumor marker test: A procedure in which a sample of blood is checked to measure the amounts of certain substances made by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the body. These are called tumor markers. For GTD, the blood is checked for the level of beta human chorionic gonadotropin (β-hCG), a hormone that is made by the body during pregnancy. β-hCG in the blood of a woman who is not pregnant may be a sign of GTD.
Urinalysis: A test to check the color of urine and itscontents, such as sugar, protein, blood, bacteria, and the level of β-hCG.
Source: National Cancer Institute (NCI)
Additional Materials (1)
What is Gestational Trophoblastic Disease?
Video by HenryFordTV/YouTube
0:54
What is Gestational Trophoblastic Disease?
HenryFordTV/YouTube
Pelvic Exam
Pelvic Exam
Also called: Pelvic Examination, Gynecological Exam
A pelvic exam is a doctor's visual and physical examination of a woman's reproductive organs. The exam may be performed as part of a regular checkup or can be done to investigate symptoms such as abnormal bleeding, unusual vaginal discharge, or pain. Pelvic exams are also done during pregnancy check-ups.
Pelvic Exam
Also called: Pelvic Examination, Gynecological Exam
A pelvic exam is a doctor's visual and physical examination of a woman's reproductive organs. The exam may be performed as part of a regular checkup or can be done to investigate symptoms such as abnormal bleeding, unusual vaginal discharge, or pain. Pelvic exams are also done during pregnancy check-ups.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result means that the uterus and ovaries are normal in size and location. The uterus can be moved slightly without causing pain. The vulva, vagina, and cervix look normal with no signs of infection, inflammation, or other abnormalities.
Related conditions
Pelvic Exam. NCI's Dictionary of Cancer Terms [accessed on Oct 03, 2021]
Pelvic Exam: Preparation, Process, and More. Healthline. [accessed on Oct 03, 2021]
What Is a Pelvic Exam? | Questions About Gynecology Exams. Planned Parenthood. [accessed on Jan 15, 2022]
Pelvic Exam | Michigan Medicine [accessed on Jan 15, 2022]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (10)
A cervical screening test - What can you expect?
Video by Healthchanneltv / cherishyourhealthtv/YouTube
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Video by IntermountainMoms/YouTube
Dr. Doe's Pelvic Exam
Video by sexplanations/YouTube
Pelvic Exam Illustration
Line drawing showing pelvic exam procedure.
Image by National Cancer Institute / Unknown Illustrator
Pelvic Exam
Leopold maneuvers
Image by Christian Gerhard Leopold
Screening for Cancer
Common Screening Tests and American Cancer Society Recommendations Breast cancer
Mammography: Women 40 and older should have a mammogram every year.
Clinical breast exam (breast exam performed by a medical professional): Women age 20-40 should have one every 3 years. Women 40 and older should have one every year.
Breast self-exam: Women age 20 and older should perform one each month (considered optional).
If you have a family history of breast cancer, talk to your healthcare professional about what type of screening you should have, and how often.
Image by TheVisualMD
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This media may include sensitive content
Healthy Cervix
The cervix is the lower portion of the uterus where it joins with the top of the vagina. The opening of the the cervix into the vagina is called the external os, and can vary in appearance from a small, circular opening in women who have not given birth, to a wider, more slit-like opening in women who have had children. Human papillomavirus (HPV) is associated with an increased risk of cervical cancer. Women should be screened for cellular changes of the cervix with a pap smear as part of a regular pelvic exam. Human papillomavirus (HPV) is a large group of related viruses that are often sexually transmitted. Most infections clear up quickly and cause few problems, though HPV can cause genital warts. Infection by certain types of HPV, however, can lead to cervical cancer. In 2006, the FDA approved an HPV vaccine (Gardisil) that protects against viral types that cause most cases of cervical cancer as well as genital warts. Public health experts recommend routine vaccination for girls ages 11-12 to ensure vaccine effectiveness.
Image by TheVisualMD
Uterus and Ovaries in Ultrasound
Ovarian cancer is the deadliest of gynecologic cancers. More than 21,000 new cases of ovarian cancer are diagnosed each year, with more than 15,000 deaths; less than 20% of cases are found at an early stage, when treatment is most effective. When ovarian cancer is suspected, a doctor will typically perform a pelvic exam to check for masses or growths on the ovaries. Other diagnostic tests include a transvaginal ultrasound, which produce detailed images of the ovaries and other reproductive organs.
Image by TheVisualMD
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This media may include sensitive content
Pap Test: Pap Smear (Pap Test)
A Pap smear, also called a Pap test, is a procedure to test for cervical cancer as well as a number of different types of infections. The test involves collecting cells from the cervix. A speculum is inserted into the vagina, and samples of cervical cells are collected and examined under a microscope for abnormalities. Detecting cervical cancer early with a Pap smear gives women a greater chance of being cured. A Pap smear can also detect changes in cervical cells that suggest cancer may develop in the future. The Pap smear is usually done in conjunction with a pelvic exam. In women over 30, the Pap smear may be combined with a test for human papillomavirus (HPV), a common sexually transmitted infection that may cause cervical cancer in some women.
Image by TheVisualMD
Women's Health Checkup
Doctors Examining Pregnant Woman
Image by Israel Defense Forces
2:13
A cervical screening test - What can you expect?
Healthchanneltv / cherishyourhealthtv/YouTube
2:21
How can I deal with the fear of getting a pelvic exam in the doctor's office?
A female pelvic ultrasound is a test that uses an ultrasound machine to assess the size, shape, and location of the organs and tissues inside a woman’s pelvis, including the uterus, cervix, fallopian tubes, ovaries, vagina, and bladder.
A female pelvic ultrasound is a test that uses an ultrasound machine to assess the size, shape, and location of the organs and tissues inside a woman’s pelvis, including the uterus, cervix, fallopian tubes, ovaries, vagina, and bladder.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
This means that your uterus, ovaries, and bladder are of a normal shape and size, without any abnormal masses or tissues.
Related conditions
A female pelvic ultrasound is a test that uses an ultrasound machine to examine the organs and tissues inside your pelvis, including your cervix, fallopian tubes, ovaries, uterus, vagina, and bladder.
Your doctor may want to order a female pelvic ultrasound to diagnose and assist in the treatment of a wide variety of conditions, such as:
Abnormalities in the structure of the uterus and endometrium (lining of the uterus)
Abnormalities in the structure of the ovaries
Growths such as fibroid tumors, cysts, and other types of tumors within the pelvis
Pelvic inflammatory disease (PID, which is an infection of your uterus, fallopian tubes, or ovaries)
Ectopic pregnancy (pregnancy that occurs outside of the uterus)
Abnormal bleeding or pelvic pain
Postmenopausal bleeding
Find an intrauterine contraceptive device (IUD)
As part of the work-up for infertility and assisted reproduction techniques
There are two ways to perform a female pelvic ultrasound, which are transabdominal (external, through the abdominal wall) and transvaginal (internal, through the vagina).
Transabdominal pelvic ultrasound
For the transabdominal pelvic ultrasound, you will be asked to unzip your pants, uncover your abdomen, and lie on your back on the medical exam table. Then, a healthcare practitioner will apply a water-based gel on the skin of your lower abdominal area and then place a small probe to visualize your pelvic organs on a screen.
Transvaginal pelvic ultrasound
For the transvaginal pelvic ultrasound, you will be asked to remove your underwear and lie on your back. Then, a healthcare practitioner will apply a water-based gel on a probe that has been previously covered with a plastic/latex sheath, and the probe will be carefully inserted on your vagina. During the procedure, the healthcare practitioner will move the probe a little bit to examine your organs properly.
Either of these procedures usually takes no more than 20 minutes, and there is no need for an anesthetic because they’re painless.
For the transabdominal pelvic ultrasound you must have a full bladder; therefore, you will be asked to drink about 32 ounces of liquid at least 1 hour before the exam.
For the transvaginal pelvic ultrasound your bladder must be empty, so you will be asked to urinate right before the exam.
There are no risks related to a female pelvic ultrasound test.
A normal result means that your uterus, ovaries, and bladder are of a normal shape and size, without any abnormal masses or tissues.
An abnormal result indicates that a problem was detected, including but not limited to:
Fibroid tumors
Cysts
Ovarian torsion
Pelvic masses
Pelvic inflammatory disease
Ectopic pregnancy
Miscarriage
Free liquid in the pelvic cavity
Endometrial hyperplasia, which is a thickening of the endometrium
This test can provide information about the location, size, and structure of pelvic masses, but cannot provide a definite diagnosis of cancer or several other conditions.
Pelvic Ultrasound: Purpose, Procedure, Risks, Results [accessed on Dec 27, 2018]
Pelvic Ultrasound [accessed on Dec 27, 2018]
Pelvic Ultrasound | Johns Hopkins Medicine Health Library [accessed on Dec 27, 2018]
Transvaginal Ultrasound: Purpose, Procedure, and Results [accessed on Dec 27, 2018]
Pelvic Ultrasound - StatPearls - NCBI Bookshelf [accessed on Dec 27, 2018]
HEM Ultrasound | Female Pelvic Ultrasound [accessed on Dec 27, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (1)
What to Expect From a Female Pelvic Ultrasound Exam
Video by RAYUS Radiology™/YouTube
2:19
What to Expect From a Female Pelvic Ultrasound Exam
RAYUS Radiology™/YouTube
Urinalysis Test
Urinalysis Test
Also called: Urine Test
A urine test is used to help diagnose a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. It evaluates many characteristics, macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye). It is a routine exam for your health check-up, before surgery, or when pregnant.
Urinalysis Test
Also called: Urine Test
A urine test is used to help diagnose a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. It evaluates many characteristics, macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye). It is a routine exam for your health check-up, before surgery, or when pregnant.
A urinalysis test consists in the evaluation of the macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye, can be seen through a microscope) characteristics of a urine sample to detect and measure various substances and compounds that the body filter through the kidneys.
Usually, these characteristics are done as a single panel and are not done separately as it had been before. This test can be used to make an overall health evaluation of the urinary tract, but it also helps diagnose and monitor many other conditions.
The structure of the test includes:
Macroscopic aspects:
Color
Appearance
Odor
Chemical examination:
pH
Density
Proteins
Glucose
Urobilinogen
Bilirubin
Leucocytes
Nitrites
Blood
Ketones
Microscopic aspects include:
Blood cells (white and red cells)
Epithelial cells
Bacteria
Crystals or casts
The most common uses of the urine test are:
Overall check up
To monitor pregnant women
If you have signs and symptoms of urinary tract infection (pelvic pain, dark urine, painful urination, blood in urine, frequent urination)
To monitor a medical condition, such as diabetes or kidney disease
Drug screening
You will need to give a clean catch urine sample.
This requires following these simple steps;
Clean your genitals
Start to urinate in the toilet
Stop halfway through
Collect about two ounces of midstream urine in the container
Stop again and close the container
Last, finish peeing in the toilet
You also need to be careful not to touch your genitals with the container to avoid possible contamination with external microorganisms.
No preparation is required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
Macroscopic findings
Appearance (Clarity): normal urine is typically clear. If the urine seems to be cloudy or with floating particles, it may be indicative of urinary tract infection.
Color: most often shades of yellow. Unusual colors might be because of certain foods, medications or a specific condition.
Odor: normally it is relatively mild and not too noticeable.
Chemical examination
pH: this measures the acidity. Under normal conditions, the urine is acidic with pH levels that range from 4.5 to 8.0
Density (specific gravity): this measures how diluted or concentrated is your urine. Normal urine density is usually from 1.003 to 1.035.
Proteins: urine can have small amounts of proteins; however, finding high protein levels may indicate kidney disease or diabetes mellitus.
Glucose: no glucose should be found in the urine of a healthy individual.
Urobilinogen: normal results range from 0.1 to 1.0 mg/dL.
Bilirubin: no bilirubin should be found in the urine of a healthy individual. Positive findings may suggest liver disease.
Nitrite: no nitrites should be found in the urine of a healthy individual. When positive is highly indicative of urinary tract infection.
Ketones: normally is not found. However, it can be positive if you have been fasting for long periods of time, or if you have diabetes mellitus.
Microscopic aspects
Red blood cells (RBC’s): is not unusual to find RBCs in a urine sample; however, 3 or more red blood cells are regarded as a sign of hematuria (blood loss through urine).
White blood cells (WBC’s): under normal conditions, this parameter should be negative. A positive result is suggestive of urinary tract infection.
Epithelial cells: from 1 to 5 squamous/hpf is considered to be normal. Higher results may indicate contamination of the urine sample by improper collection methods.
Bacteria: it is normal to find up to 1+ bacteria; more than this is abnormal and should be analyzed to discern whether is caused by an infection or by improper sample storage.
Crystals or casts: no crystals or casts should be found in the urine of healthy individuals. When present, it may be indicative of kidney disease or kidney stones.
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, and the time elapsed between the urine collection and its evaluation in the laboratory.
Mayo Clinic: Urinalysis [accessed on Aug 19, 2018]
Urinalysis: A Comprehensive Review; Am Fam Physician. 2005 Mar 15;71(6):1153-1162. [accessed on Aug 19, 2018]
University of Utah: Urinalysis [accessed on Aug 19, 2018]
Additional Materials (22)
Urine Hydration chart
Image by Aishik Rehman/Wikimedia
Test Tube Containing Urine
Visualization of a test tube containing urine. Urine comprises mainly of water - 96% and the remaining 4% is urea and sodium.
Image by TheVisualMD
Urine in Vial
Urine is tested for a variety of reasons and can reveal a wealth of information about the source individual. More than 100 different tests can be done on urine. In addition to visual characteristics, for example color and clarity, urine may be examined for the presence of glucose, nitrites, or ketones. Microscopic examination may reveal the presence of red or white blood cells, or bacteria, yeast cells, or parasites. Urine samples may contain tumor markers, which can suggest cancer.
Image by TheVisualMD
White blood cells seen under a microscope from a urine sample. Bigger cells are skin cells (epithelial cells)
White blood cells seen under a microscope from a urine sample. Bigger cells are skin cells (epithelial cells)
Image by Bobjgalindo
Abundant uric acid crystals in a human urine sample
Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.
Image by Doruk Salancı
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.
Image by Doruk Salancı
Struvite crystals (urine)
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.
Image by Doruk Salancı
Uric acid crystals (urine)
Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.
Image by Doruk Salancı
Urine samples
Each day our kidneys filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Urine samples are evaluated visually, for color, clarity and concentration; chemically, for various substances, such as glucose and proteins, in solution; and microscopically, for signs of bacteria, crystals and other contaminants.
Image by TheVisualMD
Male Figure with Urinary System
Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.
Image by TheVisualMD
Urine collection container
Image by frolicsomepl/Pixabay
Cancer screening
Screening for Cancer: Urine Tests : Urine samples may contain tumor markers, which can suggest cancer. Urinalysis is commonly a part of routine health screening. It is simply an analysis of the urine that can be performed in many healthcare settings including doctors' offices, urgent care facilities, laboratories, and hospitals. Urinalysis can disclose evidence of diseases, even some that have not caused significant signs or symptoms.
Image by TheVisualMD
Sensitive content
This media may include sensitive content
Male Urinary System
Image of a male showing his urinary system. The urinary system, also known as the excretory system, produces, stores, and eliminates urine. It also helps to maintain the fluid balance in humans. The male urinary system consists of two kidneys, ureters, a urinary bladder, prostate, and urethra.
Image by TheVisualMD
Nephron of Kidney
The nephron is composed of looping and folding tubules that at first glance look like an impossibly tangled knot of highways, side roads and interchanges. But in fact, the nephron directs the traffic flow effortlessly. When stretched out, a nephron would be almost a couple of feet in length and there are about a million nephrons in each kidney. A nephron is composed of two basic parts: the glomerulus and the tubule. The glomerulus, part of the vascular system, is a tuft of capillaries that filters the wastes and fluid from the blood. The tubules then catch, concentrate and excrete the waste into the urine. The walls of the tubules are made of specialized cells, which serve as \"check points\" for the waste flowing by them. Hormonal sensors in these cells determine which substances should be excreted as waste and which substances will be reabsorbed into the blood to nourish the body's cells. The specific materials the cells are assigned to reabsorb or secrete include water and essential nutrients, salts and minerals, depending on where in the tubules the cells are located. From the glomerulus until the collecting duct, intricate and minute calculations are at constant play within the nephron. The production of urine does not just result in a waste product but also protects the fine balance of substances required to keep the body healthy.
Image by TheVisualMD
Fluid Filtration
Each day our kidneys filter about 200 quarts of blood to extract about 2 quarts of waste, which is then eliminated as urine. The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli. The kidneys also play a key role in maintaining the body's fluid balance within a very narrow range. Even a 1% increase in blood sodium, for example, will make a person thirsty enough to take a drink in order to return the fluid balance to normal.
Image by TheVisualMD
Ammonia, Urine
Ammonia is a waste product generated by intestinal bacteria during the digestion of protein. From the intestine, ammonia is transported to the liver, where it is converted into urea, which is then excreted in the urine by the kidneys. The conversion and elimination of ammonia can be impaired by liver disease or kidney damage, which can result in a dangerous build up of ammonia.
Image by TheVisualMD
Pyuria
Urine may contain pus (a condition known as pyuria) as seen from a person with sepsis due to a urinary tract infection.
Image by James Heilman, MD
Urine
Sample of human urine
Image by Markhamilton
Interpretation of the Urinalysis (Part 1) - Introduction and Inspection
Video by Strong Medicine/YouTube
Interpretation of the Urinalysis (Part 2) - The Dipstick
Video by Strong Medicine/YouTube
How to collect a mid-stream urine sample for a urinary tract infection test
Video by Pathology Tests Explained/YouTube
How to collect a first-void or first-pass urine sample
Video by Pathology Tests Explained/YouTube
Urine Hydration chart
Aishik Rehman/Wikimedia
Test Tube Containing Urine
TheVisualMD
Urine in Vial
TheVisualMD
White blood cells seen under a microscope from a urine sample. Bigger cells are skin cells (epithelial cells)
Bobjgalindo
Abundant uric acid crystals in a human urine sample
Doruk Salancı
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample
Doruk Salancı
Struvite crystals (urine)
Doruk Salancı
Uric acid crystals (urine)
Doruk Salancı
Urine samples
TheVisualMD
Male Figure with Urinary System
TheVisualMD
Urine collection container
frolicsomepl/Pixabay
Cancer screening
TheVisualMD
Sensitive content
This media may include sensitive content
Male Urinary System
TheVisualMD
Nephron of Kidney
TheVisualMD
Fluid Filtration
TheVisualMD
Ammonia, Urine
TheVisualMD
Pyuria
James Heilman, MD
Urine
Markhamilton
6:10
Interpretation of the Urinalysis (Part 1) - Introduction and Inspection
Strong Medicine/YouTube
16:36
Interpretation of the Urinalysis (Part 2) - The Dipstick
Strong Medicine/YouTube
1:03
How to collect a mid-stream urine sample for a urinary tract infection test
Pathology Tests Explained/YouTube
1:06
How to collect a first-void or first-pass urine sample
A glucose in urine test measures the amount of glucose (sugar) in your urine. The test is used to monitor both type 1 and type 2 diabetes.
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Use the slider below to see how your results affect your
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mg/dL
15
Your result is Negative.
Glucose is not usually found in urine. If it is, further testing is needed.
Related conditions
A glucose in urine test measures the amount of glucose in your urine. Glucose is a type of sugar. It is your body's main source of energy. A hormone called insulin helps move glucose from your bloodstream into your cells. If too much glucose gets into the blood, the extra glucose will be eliminated through your urine. A urine glucose test can be used to help determine if blood glucose levels are too high, which may be a sign of diabetes.
A glucose in urine test may be part of a urinalysis, a test that measures different cells, chemicals, and other substances in your urine. Urinalysis is often included as part of a routine exam. A glucose in urine test may also be used to screen for diabetes. However, a urine glucose test is not as accurate as a blood glucose test. It may be ordered if blood glucose testing is difficult or not possible. Some people can't get blood drawn because their veins are too small or too scarred from repeated punctures. Other people avoid blood tests due to extreme anxiety or fear of needles.
You may get a glucose in urine test as part of your regular checkup or if you have symptoms of diabetes and cannot take a blood glucose test. Symptoms of diabetes include:
Increased thirst
More frequent urination
Blurred vision
Fatigue
You may also need a urinalysis, which includes a glucose in urine test, if you are pregnant. If high levels of glucose in urine are found, it may indicate gestational diabetes. Gestational diabetes is form of diabetes that happens only during pregnancy. Blood glucose testing can be used to confirm a diagnosis of gestational diabetes. Most pregnant women are tested for gestational diabetes with a blood glucose test, between their 24th and 28th weeks of pregnancy.
If your urine glucose test is part of a urinalysis, you will need to provide a sample of your urine. During your office visit, you will receive a container in which to collect the urine and special instructions to ensure the sample is sterile. These instructions are often referred to as the "clean catch method." The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amount.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
Your health care provider may ask you to monitor your urine glucose at home with a test kit. He or she will provide you with either a kit or a recommendation of which kit to buy. Your urine glucose test kit will include instructions on how to perform the test and a package of strips for testing. Be sure to follow the kit instructions carefully, and talk to your health care provider if you have any questions.
You don't need any special preparations for this test.
There is no known risk to having a glucose in urine test.
Glucose is not normally found in urine. If results show glucose, it may be a sign of:
Diabetes
Pregnancy. As many half of all pregnant women have some glucose in their urine during pregnancy. Too much glucose may indicate gestational diabetes.
A kidney disorder
A urine glucose test is only a screening test. If glucose is found in your urine, your provider will order a blood glucose test to help make a diagnosis.
https://medlineplus.gov/lab-tests/glucose-in-urine-test/ [accessed on Sep 15, 2019]
https://medlineplus.gov/ency/article/003581.htm [accessed on Sep 15, 2019]
https://www.labcorp.com/test-menu/26061/glucose-quantitative-urine [accessed on Sep 15, 2019]
https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=glucose_urine [accessed on Sep 15, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (6)
Abdomen Revealing Pancreas and Kidney
Sugar is one of the nutrients your body uses for energy. It is the product of the body's breakdown of complex carbohydrates and is circulated in the blood to all your cells. Although blood sugar levels change depending on whether you just ate or exercised, in general, your body keeps the sugar levels within a narrow range. Not enough sugar - hypoglycemia - and you can get hungry, shaky, sweaty, tired, and even faint. Too much sugar - hyperglycemia - is a cardiovascular risk factor leading to arteriosclerosis (hardening of the arteries). To control blood sugar levels, your body depends on a hormone called insulin.
Image by TheVisualMD
Diabetes Symptoms
(left to right) Fatigue: dehydration, lack of ability to utilize glucose for energy and other factors cause fatigue; weight loss: because it can't use glucose for energy, the body breaks down muscle instead; constant hunger: diabetes prevents glucose from entering cells, leading to constant hunger due to cell starvation; increased thirst: too much urination leaves tissues dehydrated and causes increased thirst; frequent urination: fluids are drawn from tissues and the kidneys constantly filter out glucose, leading to frequent urination.
Image by TheVisualMD
Male Figure with Urinary System
Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.
Image by TheVisualMD
Kidney Glomeruli, Compromised Filtration
Our kidneys are remarkable filters. Each day, they filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Proteins are also normally filtered out of the blood and recycled in the body by the kidneys. When kidneys are diseased or damaged, however, their ability to filter out proteins is compromised, which allows protein to then leak into urine.
Image by TheVisualMD
Diseased and Aging Kidney Tissue Comparisons
As a person ages, the number of nephrons, the kidneys' vital filters, decreases, as does the overall amount of tissue in the kidneys. A healthy aging kidney will not function like a 20-year-old kidney, but it can still do its job. The difference between an aging kidney in a healthy body and a kidney damaged by hypertension or diabetes can be as stark as the difference between someone who is a picture of health and someone who is debilitated by illness.
Image by TheVisualMD
Glomerulonephritis
Our kidneys filter about 200 quarts of blood each day to extract about 2 quarts of waste, which is then eliminated as urine. The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli. Glomerulonephritis is the inflammation of these tiny filters and can be caused by diabetes and chronic high blood pressure or, in acute cases, infection. When kidney function declines, waste products normally filtered out and excreted into the urine begin instead to accumulate in the blood.
Image by TheVisualMD
Abdomen Revealing Pancreas and Kidney
TheVisualMD
Diabetes Symptoms
TheVisualMD
Male Figure with Urinary System
TheVisualMD
Kidney Glomeruli, Compromised Filtration
TheVisualMD
Diseased and Aging Kidney Tissue Comparisons
TheVisualMD
Glomerulonephritis
TheVisualMD
Bilirubin in Urine Test
Bilirubin in Urine Test
Also called: Total Urine Bilirubin, Bilirubin
Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver. When the liver is damaged, bilirubin can leak into your urine. A bilirubin in urine test can help detect liver disease.
Bilirubin in Urine Test
Also called: Total Urine Bilirubin, Bilirubin
Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver. When the liver is damaged, bilirubin can leak into your urine. A bilirubin in urine test can help detect liver disease.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Bilirubin is not normally found in the urine.
Related conditions
A bilirubin in urine test measures the levels of bilirubin in your urine. Bilirubin is a yellowish substance made during the body's normal process of breaking down red blood cells. Bilirubin is found in bile, a fluid in your liver that helps you digest food. If your liver is healthy, it will remove most of the bilirubin from your body. If your liver is damaged, bilirubin can leak into the blood and urine. Bilirubin in urine may be a sign of liver disease.
A bilirubin in urine test is often part of a urinalysis, a test that measures different cells, chemicals, and other substances in your urine. Urinalysis is often included as part of a routine exam. This test may also be used to check for liver problems.
Your health care provider may have ordered a bilirubin in urine test as part of your regular checkup, or if you have symptoms of liver disease. These symptoms include:
Jaundice, a condition that causes your skin and eyes to turn yellow
Dark-colored urine
Abdominal pain
Nausea and vomiting
Fatigue
Because bilirubin in urine can indicate liver damage before other symptoms appear, your health care provider may order a bilirubin in urine test if you are at a higher risk for liver damage. Risk factors for liver disease include:
Family history of liver disease
Heavy drinking
Exposure or possible exposure to hepatitis virus
Obesity
Diabetes
Taking certain medicines that can cause liver damage
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container to your health care provider.
You don't need any special preparations to test for bilirubin in urine. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having a urinalysis or a bilirubin in urine test.
If bilirubin is found in your urine, it may indicate:
A liver disease such as hepatitis
A blockage in the structures that carry bile from your liver
A problem with liver function
A bilirubin in urine test is only one measure of liver function. If your results are abnormal, your health care provider may order additional blood and urine tests, including a liver panel. A liver panel is a series of blood tests that measure various enzymes, proteins, and substances in the liver. It is often used to detect liver disease.
Bilirubin in Urine: MedlinePlus Lab Test Information [accessed on Aug 22, 2021]
https://medlineplus.gov/ency/article/003595.htm [accessed on Aug 22, 2021]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Ketones in Urine Test
Ketones in Urine Test
Also called: Urine Ketones, Ketone Bodies (Urine), Ketones Urine Test
Ketones in urine may indicate a problem with the body's ability to burn energy. Diabetics are at a higher risk for developing urine ketones. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.
Ketones in Urine Test
Also called: Urine Ketones, Ketone Bodies (Urine), Ketones Urine Test
Ketones in urine may indicate a problem with the body's ability to burn energy. Diabetics are at a higher risk for developing urine ketones. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.
{"label":"Ketones in Urine Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"N","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":20},"text":"A negative test result is normal.","conditions":[]},{"flag":"borderline","label":{"short":"S","long":"Small","orientation":"horizontal"},"values":{"min":20,"max":40},"text":"An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large.","conditions":["Fasting or starvation","High protein or low carbohydrate diet","Vomiting over a long period (such as during early pregnancy)","Acute or severe illnesses, such as sepsis or burns","High fevers","Hyperthyroidism","Nursing a baby, if the mother does not eat and drink enough"]},{"flag":"abnormal","label":{"short":"M","long":"Moderate","orientation":"horizontal"},"values":{"min":40,"max":60},"text":"An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large.","conditions":["Fasting or starvation","High protein or low carbohydrate diet","Vomiting over a long period (such as during early pregnancy)","Acute or severe illnesses, such as sepsis or burns","High fevers","Hyperthyroidism","Nursing a baby, if the mother does not eat and drink enough"]},{"flag":"abnormal","label":{"short":"L","long":"Large","orientation":"horizontal"},"values":{"min":60,"max":80},"text":"An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large.","conditions":["Fasting or starvation","High protein or low carbohydrate diet","Vomiting over a long period (such as during early pregnancy)","Acute or severe illnesses, such as sepsis or burns","High fevers","Hyperthyroidism","Nursing a baby, if the mother does not eat and drink enough"]}],"value":10}[{"normal":0},{"borderline":0},{"abnormal":0},{"abnormal":1}]
Use the slider below to see how your results affect your
health.
Your result is Normal.
A negative test result is normal.
Related conditions
The test measures ketone levels in your urine. Normally, your body burns glucose (sugar) for energy. If your cells don't get enough glucose, your body burns fat for energy instead. This produces a substance called ketones, which can show up in your blood and urine. High ketone levels in urine may indicate diabetic ketoacidosis (DKA), a complication of diabetes that can lead to a coma or even death. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.
The test is often used to help monitor people at a higher risk of developing ketones. These include people with type 1 or type 2 diabetes. If you have diabetes, ketones in urine can mean that you are not getting enough insulin. If you don't have diabetes, you may still be at risk for developing ketones if you:
Experience chronic vomiting and/or diarrhea
Have a digestive disorder
Participate in strenuous exercise
Are on a very low-carbohydrate diet
Have an eating disorder
Are pregnant
Your health care provider may order a ketones in urine test if you have diabetes or other risk factors for developing ketones. You may also need this test if you have symptoms of ketoacidosis. These include:
Nausea or vomiting
Abdominal pain
Confusion
Trouble breathing
Feeling extremely sleepy
People with type 1 diabetes are at a higher risk for ketoacidosis.
A ketones in urine test can be done in the home as well as in a lab. If in a lab, you will be given instructions to provide a "clean catch" sample. The clean catch method generally includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amount.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
If you do the test at home, follow the instructions that are in your test kit. Your kit will include a package of strips for testing. You will either be instructed to provide a clean catch sample in a container as described above or to put the test strip directly in the stream of your urine. Talk to your health care provider about specific instructions.
You may have to fast (not eat or drink) for a certain period of time before taking a ketones in urine test. Ask your health care provider if you need to fast or do any other type of preparation before your test.
There is no known risk to having a ketones in urine test.
Your test results may be a specific number or listed as a "small," "moderate," or "large" amount of ketones. Normal results can vary, depending on your on your diet, activity level, and other factors. Because high ketone levels can be dangerous, be sure to talk to your health care provider about what is normal for you and what your results mean.
Ketone test kits are available at most pharmacies without a prescription. If you are planning to test for ketones at home, ask your health care provider for recommendations on which kit would be best for you. At-home urine tests are easy to perform and can provide accurate results as long as you carefully follow all instructions.
Ketones in Urine: MedlinePlus Lab Test Information [accessed on Sep 15, 2019]
https://medlineplus.gov/ency/article/003585.htm [accessed on Sep 15, 2019]
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=ketone_bodies_urine [accessed on Sep 15, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
DKA - Diabetic Ketoacidosis
Video by DrER.tv/YouTube
Symptoms of Ketoacidosis
Video by Diabetes.co.uk/YouTube
Diabetes & Associated Complications
Video by Boehringer Ingelheim/YouTube
Acute complications of diabetes - Diabetic ketoacidosis | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
A medical illustration depicting a ketone urine test
A medical illustration depicting a ketone urine test
Image by BruceBlaus
5:46
DKA - Diabetic Ketoacidosis
DrER.tv/YouTube
1:00
Symptoms of Ketoacidosis
Diabetes.co.uk/YouTube
5:50
Diabetes & Associated Complications
Boehringer Ingelheim/YouTube
11:26
Acute complications of diabetes - Diabetic ketoacidosis | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
A medical illustration depicting a ketone urine test
BruceBlaus
Urine Specific Gravity Test
Urine Specific Gravity Test
Also called: Urine SG, Specific Gravity of Urine, Urine Density
A urine specific gravity test measures the concentration of solutes in your urine, which shows if your kidneys are properly diluting urine. This test is a partial analysis used in case of suspected kidney disorder.
Urine Specific Gravity Test
Also called: Urine SG, Specific Gravity of Urine, Urine Density
A urine specific gravity test measures the concentration of solutes in your urine, which shows if your kidneys are properly diluting urine. This test is a partial analysis used in case of suspected kidney disorder.
{"label":"Urine Specific Gravity Reference Range","scale":"lin","step":0.01,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0.8,"max":1.002},"text":"Your urine is too diluted.","conditions":["Diabetes","Kidney disorders","Glomerulonephritis","Pyelonephritis","Kidney failure","Overhydration"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":1.002,"max":1.03},"text":"Normal results can slightly vary from laboratory to laboratory.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":1.03,"max":1.2},"text":"Your urine is too concentrated. ","conditions":["Liver disease","Adrenal glands disorder","Heart disease","Dehydration","Shock"]}],"value":1.02}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
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1.002
1.03
Your result is Normal.
Normal results can slightly vary from laboratory to laboratory.
Related conditions
In the kidneys, most of the water, ions, and nutrients are returned to the body while waste products and excess ions are excreted through the urine.
Normally, the color of urine is straw-yellow but it may be affected by several situations, including infections, intake of certain foods or medications, or insufficient or excessive fluid intake. Your urine color may reflect how concentrated or diluted is your urine.
A urine specific gravity (SG) test is used to compare the density of your urine to the normal density of water. The result gives an overview of the concentration of the solutes (particles) in your urine. In other words, it shows how well your kidneys are diluting urine.
A shift in the urine SG test result may give the first indication that your kidneys are not working properly. However, if a kidney disorder is suspected, further tests should be taken to confirm or exclude certain disease.
A urine specific gravity test is mainly used as a partial analysis to assess the kidney’s ability to concentrate and dilute urine. Thus, it can be used to help detect certain disorders or diseases of the urinary tract.
Your doctor may order a urine specific gravity test as part of your routine health checkup, or to help diagnose or monitor the following conditions:
Urinary tract infection
Dehydration or overhydration
Kidney infection (pyelonephritis)
Kidney failure
Shifts in sodium levels (hypernatremia or hyponatremia)
Diabetes
Shock
Heart failure
Testing for urine specific gravity starts with mid-stream urine sample collection. It is recommended that the sample is collected in the morning when the urine concentration is the highest.
To collect the urine sample, you need to clean your genitals and then discard the first stream of urine into the toilet (this is done to “clean” your urethra), proceeding then to collect about two ounces of midstream urine in the container. You need to be careful not to touch your genitals with the container to avoid possible contamination with external germs. Once you have collected enough urine, put the container cap on and then you can finish emptying your bladder into the toilet.
After the collection, the sample is transported to the laboratory.
Your doctor may ask you to stop taking certain medications and foods before the test.
There are no risks related to a urine gravity test.
The normal value for urine specific gravity is 1.002-1.030.
Lower-than-normal values of urine gravity may indicate:
Higher-than-normal urine gravity test results may refer to an increased level of some substances in your urine, such as proteins, bacteria, glucose, urine crystals, red and white blood cells. These findings may occur in cases of:
Liver disease
Adrenal glands disorder
Heart disease
Dehydration (not consuming enough water, or losing too much fluid through sweating, vomiting, or diarrhea)
Shock
Certain foods may affect the color of your urine; therefore, it's advised not to eat foods such as beet, rhubarb, blackberries, carrots or lava beans before giving a urine sample.
Sometimes doctors may choose a urine osmolality test instead of a urine specific gravity test. The urine osmolarity test is more specific and could help your doctor to diagnose certain disorders more accurately.
https://medlineplus.gov/ency/article/003587.htm [accessed on Oct 09, 2021]
Urine Specific Gravity Test: Overview, Tests, and Procedure [accessed on Oct 29, 2018]
Urine specific gravity test: Procedure and results [accessed on Oct 29, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (20)
Hematuria
Hematuria Trauma : Gross hematuria due to kidney trauma.
Image by James Heilman, MD
Hematuria by anatomic location
Source of Hematuria by anatomic location
Image by Copene
Phenazopyridine
Pyridiumurine : The characteristic color of urine after taking pyridium.
Image by James Heilman, MD
Drawing of a kidney with an inset of a nephron
The glomeruli are sets of looping blood vessels in nephrons--the tiny working units of the kidneys that filter wastes and remove extra fluid from the blood.
Image by NIDDK Image Library
Urine samples
Each day our kidneys filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Urine samples are evaluated visually, for color, clarity and concentration; chemically, for various substances, such as glucose and proteins, in solution; and microscopically, for signs of bacteria, crystals and other contaminants.
Image by TheVisualMD
Urine in Vial
Urine is tested for a variety of reasons and can reveal a wealth of information about the source individual. More than 100 different tests can be done on urine. In addition to visual characteristics, for example color and clarity, urine may be examined for the presence of glucose, nitrites, or ketones. Microscopic examination may reveal the presence of red or white blood cells, or bacteria, yeast cells, or parasites. Urine samples may contain tumor markers, which can suggest cancer.
Image by TheVisualMD
Ureteropelvic junction obstruction
Drawing of a swollen kidney that results from ureteropelvic junction obstruction. The point of blockage is labeled UPJ obstruction. UPJ obstruction occurs when urine is blocked where the ureter joins the kidney.
Image by NIDDK Image Library
Bilirubin, Jaundice Urine
When damaged or dying red blood cells are broken down, bilirubin, a yellow pigment and component of hemoglobin, is released into the bloodstream. Bilirubin is usually eliminated from the body by the liver as a component of bile, which is released into the small intestine to aid digestion. Under normal circumstances, very little, if any, bilirubin is excreted in the urine, but in cases of liver damage or a blockage of the bile ducts, some bilirubin can leak out and appear in the urine, turning it a darker color.
Image by TheVisualMD
Urine Color Chart
Urine Color Chart - Hydration
Image by OpenStax College
Healthy vs Damaged Kidney
A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine.
Urine Test for Albumin
If you are at risk for kidney disease, your provider may check your urine for albumin.
Albumin is a protein found in your blood. A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. The less albumin in your urine, the better. Having albumin in the urine is called albuminuria.
A diagram showing a healthy kidney with albumin only found in blood, and a damaged kidney that has albumin in both blood and urine.
A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine.
A health care provider can check for albumin in your urine in two ways:
Dipstick test for albumin. A provider uses a urine sample to look for albumin in your urine. You collect the urine sample in a container in a health care provider’s office or lab. For the test, a provider places a strip of chemically treated paper, called a dipstick, into the urine. The dipstick changes color if albumin is present in the urine.
Urine albumin-to-creatinine ratio (UACR). This test measures and compares the amount of albumin with the amount of creatinine in your urine sample. Providers use your UACR to estimate how much albumin would pass into your urine over 24 hours. A urine albumin result of
30 mg/g or less is normal
more than 30 mg/g may be a sign of kidney disease
If you have albumin in your urine, your provider may want you to repeat the urine test one or two more times to confirm the results. Talk with your provider about what your specific numbers mean for you.
If you have kidney disease, measuring the albumin in your urine helps your provider know which treatment is best for you. A urine albumin level that stays the same or goes down may mean that treatments are working.
Image by The National Institute of Diabetes and Digestive and Kidney Diseases/NIH
Drawing of a urine sample and dipstick
A strip of chemically treated paper will change color when dipped in urine with too much protein.
Image by NIDDK Image Library
Struvite crystals (urine)
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.
Image by Doruk Salancı
Uric acid crystals (urine)
Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.
Image by Doruk Salancı
Male Figure with Urinary System
Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.
Image by TheVisualMD
Adequate water intake and kidney health
Adequate water intake and kidney health. Replacing the water lost through sweating and waste elimination is vital to our health. Remaining hydrated is one way to help prevent kidney stones, which can form when certain waste minerals are highly concentrated in the urine. In this 3-D visualization, a clear bottle pours water into a model of a human kidney.
Image by TheVisualMD
Urine
Sample of human urine
Image by Markhamilton
Urine Culture: Preventing UTIs
There are a number of ways you can help to prevent UTIs. Drinking plenty of liquids, especially water, not only aids your kidneys in filtering out wastes, it also dilutes your urine and makes you urinate more frequently. This flushes out bacteria and other pathogens from your urinary tract and helps to prevent infections. Urinating after having sex also helps to flush out bacteria. Women should wipe from front to back when using the toilet and change tampons and pads frequently during their periods.
Image by TheVisualMD
formation of urine
Anatomy and physiology of animals Summary of the processes involved in the formation of urine.
Image by Sunshineconnelly
male's urinary system
Urinary system in the male. Urine flows from the kidneys via the ureters into the bladder where it is stored. When urinating, urine flows through the urethra (longer in males, shorter in females) to exit the body
Image by BruceBlaus
Urine of patient with porphyria
Change in urine color before and after sun exposure Left figure is urine of the first day. Right figure is urine after sun exposure for 3 days. Urine color changed to “port wine” color after sun exposure. This color change is due to increased concentrations of porphyrin intermediates in the urine, indicating an abnormality in production and a partial block within the enzymatic porphyrin chain with metabolite formation. The urine color usually becomes darker with acute illness, even dark reddish or brown after sun exposure.
Image by Chen GL, Yang DH, Wu JY, Kuo CW, Hsu WH
Hematuria
James Heilman, MD
Hematuria by anatomic location
Copene
Phenazopyridine
James Heilman, MD
Drawing of a kidney with an inset of a nephron
NIDDK Image Library
Urine samples
TheVisualMD
Urine in Vial
TheVisualMD
Ureteropelvic junction obstruction
NIDDK Image Library
Bilirubin, Jaundice Urine
TheVisualMD
Urine Color Chart
OpenStax College
Healthy vs Damaged Kidney
The National Institute of Diabetes and Digestive and Kidney Diseases/NIH
Drawing of a urine sample and dipstick
NIDDK Image Library
Struvite crystals (urine)
Doruk Salancı
Uric acid crystals (urine)
Doruk Salancı
Male Figure with Urinary System
TheVisualMD
Adequate water intake and kidney health
TheVisualMD
Urine
Markhamilton
Urine Culture: Preventing UTIs
TheVisualMD
formation of urine
Sunshineconnelly
male's urinary system
BruceBlaus
Urine of patient with porphyria
Chen GL, Yang DH, Wu JY, Kuo CW, Hsu WH
Blood in Urine Test
Blood in Urine Test
Also called: Hematuria, Bloody urine
A blood in urine test is part of a urinalysis, a test that measures different cells, chemicals, and other substances in urine. Most causes of blood in your urine are not serious, but sometimes red or white blood cells in your urine can mean that you have a medical condition that needs treatment, such as a kidney disease, urinary tract infection,
Blood in Urine Test
Also called: Hematuria, Bloody urine
A blood in urine test is part of a urinalysis, a test that measures different cells, chemicals, and other substances in urine. Most causes of blood in your urine are not serious, but sometimes red or white blood cells in your urine can mean that you have a medical condition that needs treatment, such as a kidney disease, urinary tract infection,
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Related conditions
A test called a urinalysis can detect whether there is blood in your urine. A urinalysis checks a sample of your urine for different cells, chemicals, and other substances, including blood. Most causes of blood in your urine are not serious, but sometimes red or white blood cells in your urine can mean that you have a medical condition that needs treatment, such as a kidney disease, urinary tract infection, or liver disease.
A urinalysis, which includes a test for blood in urine, may be done as part of a regular checkup or to check for disorders of the urinary tract, kidney, or liver.
Your health care provider may have ordered a urinalysis as part of a routine exam. You may also need this test if you have seen blood in your urine or have other symptoms of a urinary disorder. These symptoms include:
Painful urination
Frequent urination
Back pain
Abdominal pain
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." It includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the needed amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
You don't need any special preparations before getting a test for blood in your urine. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having a urinalysis or a blood in urine test.
There are a variety of factors that can cause red or white blood cells to be present in the urine. Many are not cause for concern. Small amounts of blood in the urine may be due to certain medicines, intense exercise, sexual activity, or menstruation. If larger amounts of blood are found, your health care provider may request further testing.
Increased red blood cells in urine may indicate:
A viral infection
Inflammation of the kidney or bladder
A blood disorder
Bladder or kidney cancer
Increased white blood cells in urine may indicate:
A bacterial urinary tract infection. This is the most common cause of a high white blood cell count in urine.
Inflammation of the urinary tract or kidneys
To learn what your results mean, talk to your health care provider.
A blood in urine test is usually part of a typical urinalysis. In addition to checking for blood, a urinalysis measures other substances in the urine, including proteins, acid and sugar levels, cell fragments, and crystals.
Lab Tests Online: Blood in Urine (Hematuria) [accessed on Aug 19, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (12)
Urine Color Chart
Urine Color Chart - Hydration
Image by OpenStax College
Hematuria (Blood in the Urine)
Video by mdconversation/YouTube
Blood in the Urine: What does it mean?
Video by Frederick Memorial Hospital/YouTube
Blood in the Urine
Video by St. Mark's Hospital/YouTube
Hematuria
Microscopic hematuria
Image by Bobjgalindo
Hematuria
Hematuria Trauma : Gross hematuria due to kidney trauma.
Image by James Heilman, MD
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Image by Bobjgalindo
Hematuria by anatomic location
Source of Hematuria by anatomic location
Image by Copene
Microphotography - sample of urine with hematuria
Microphotography - sample of urine with hematuria
Image by J3D3
This browser does not support the video element.
Bleeding Tissue
Blood continues to flow into tissue after the piercing needle has left the finger. Camera starts off looking at the cut edges of bleeding capillaries in the tissue and then looks down at the cavity where blood is beginning to pool.
Video by TheVisualMD
Microhematuria
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Image by Bobjgalindo
Phenazopyridine
Pyridiumurine : The characteristic color of urine after taking pyridium.
Image by James Heilman, MD
Urine Color Chart
OpenStax College
12:53
Hematuria (Blood in the Urine)
mdconversation/YouTube
0:50
Blood in the Urine: What does it mean?
Frederick Memorial Hospital/YouTube
2:24
Blood in the Urine
St. Mark's Hospital/YouTube
Hematuria
Bobjgalindo
Hematuria
James Heilman, MD
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Bobjgalindo
Hematuria by anatomic location
Copene
Microphotography - sample of urine with hematuria
J3D3
0:08
Bleeding Tissue
TheVisualMD
Microhematuria
Bobjgalindo
Phenazopyridine
James Heilman, MD
PH of Urine Test
PH of Urine Test
Also called: Acid Loading Test, Urine pH, Alkaline Urine Test, Acidic Urine Test
A urine pH test is used to detect a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. Any pH higher than 8 is basic or alkaline, and any under 6 is acidic. A urine pH test is carried out as a part of a urinalysis.
PH of Urine Test
Also called: Acid Loading Test, Urine pH, Alkaline Urine Test, Acidic Urine Test
A urine pH test is used to detect a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. Any pH higher than 8 is basic or alkaline, and any under 6 is acidic. A urine pH test is carried out as a part of a urinalysis.
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Use the slider below to see how your results affect your
health.
pH
4.5
8
Your result is Normal.
A normal urine pH range is between 4.5 and 8.0.
Related conditions
A urine pH test is the analysis of the acidity/alkalinity of the urine. It is part of the chemical examination in a urinalysis. This test can be used to make an overall health evaluation of the urinary tract, but it also helps diagnose and monitor many other conditions.
Some of the most common uses of the urine pH test are:
Evaluate the risk of developing kidney stones (nephrolithiasis)
Assessment of metabolic acidosis
Monitor treatment of uric acid kidney stones
Help identify crystals in the urine
You will need to provide a urine sample.
No preparations are required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
Under normal conditions, the urine is acidic with pH levels that range from 4.5 to 8.0
A high urine pH (alkaline urine) can be found in people who eat large quantities of citrus fruit and vegetables. Other causes include:
Kidney failure
Urinary tract infection
Kidney stones made up from calcium carbonate, calcium phosphate, and struvite (magnesium ammonium phosphate)
Respiratory alkalosis
Metabolic alkalosis
A low urine pH (acid urine) can be found in people who eat large quantities of meat. Other causes include:
Metabolic acidosis
Respiratory acidosis
Kidney stones made up from xanthine, cystine, and uric acid
Diabetes
Diarrhea
Starvation
Fanconi syndrome
Milkman syndrome
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, and the time elapsed between the urine collection and its evaluation in the laboratory.
013037: pH, Urine | LabCorp [accessed on Jan 04, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Protein in Urine Test
Protein in Urine Test
Also called: Urine Protein
A protein in urine test measures how much protein is in your urine. A large amount of protein can indicate a problem with your kidneys.
Protein in Urine Test
Also called: Urine Protein
A protein in urine test measures how much protein is in your urine. A large amount of protein can indicate a problem with your kidneys.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Normal results vary based on the laboratory and the method used.
Related conditions
A protein in urine test measures how much protein is in your urine. Proteins are substances that are essential for your body to function properly. Protein is normally found in the blood. If there is a problem with your kidneys, protein can leak into your urine. While a small amount is normal, a large amount of protein in urine may indicate kidney disease.
A protein in urine test is often part of a urinalysis, a test that measures different cells, chemicals, and substances in your urine. Urinalysis is often included as part of a routine exam. This test may also be used to look for or to monitor kidney disease.
Your health care provider may have ordered a protein test as part of your regular checkup, or if you have symptoms of kidney disease. These symptoms include:
Difficulty urinating
Frequent urination, especially at night
Nausea and vomiting
Loss of appetite
Swelling in the hands and feet
Fatigue
Itching
A protein in urine test can be done in the home as well as in a lab. If in a lab, you will receive instructions to provide a "clean catch" sample. The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
If at home, you will use a test kit. The kit will include a package of strips for testing and instructions on how to provide a clean catch sample. Talk to your health care provider if you have any questions.
Your health care provider may also request you collect all your urine during a 24-hour period. This "24-hour urine sample test" is used because the amounts of substances in urine, including protein, can vary throughout the day. Collecting several samples in a day may provide a more accurate picture of your urine content.
You don't need any special preparations to test for protein in urine. If your health care provider has ordered a 24-hour urine sample, you will get specific instructions on how to provide and store your samples.
There is no known risk to having a urinalysis or a urine in protein test.
If a large amount of protein is found in your urine sample, it doesn't necessarily mean that you have a medical problem needing treatment. Strenuous exercise, diet, stress, pregnancy, and other factors can cause a temporary rise in urine protein levels. Your health care provider may recommend additional urinalysis tests if a high level of protein is found. This testing may include a 24-hour urine sample test.
If your urine protein levels are consistently high, it may indicate kidney damage or other medical condition. These include:
Urinary tract infection
Lupus
High blood pressure
Preeclampsia, a serious complication of pregnancy, marked by high blood pressure. If it is not treated, preeclampsia can be life-threatening to the mother and baby.
Diabetes
Certain types of cancer
To learn what your results mean, talk to your health care provider.
If you will be doing your urine test at home, ask your health care provider for recommendations on which test kit would be best for you. At-home urine tests are easy to do and provide accurate results as long as you carefully follow all instructions.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (2)
Urine Color Chart
Urine Color Chart - Hydration
Image by OpenStax College
When kidneys are diseased or damaged, their ability to filter out proteins is compromised, which allows protein to then leak into urine.
Urine Total Protein Test for Diseased Glomerulus : The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli, which remove waste products from the blood while preventing the loss of other components, including proteins, which are recycled in the body. When kidneys are diseased or damaged, however, their ability to filter out proteins is compromised, which allows protein to then leak into urine.
Image by TheVisualMD
Urine Color Chart
OpenStax College
When kidneys are diseased or damaged, their ability to filter out proteins is compromised, which allows protein to then leak into urine.
TheVisualMD
Urobilinogen Test
Urobilinogen Test
Also called: Urinary Urobilinogen
A urobilinogen in urine test looks for liver disease or damage. It may be included in a routine exam or if a liver problem is suspected.
Urobilinogen Test
Also called: Urinary Urobilinogen
A urobilinogen in urine test looks for liver disease or damage. It may be included in a routine exam or if a liver problem is suspected.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
A urobilinogen in urine test measures the amount of urobilinogen in a urine sample. Urobilinogen is formed from the reduction of bilirubin. Bilirubin is a yellowish substance found in your liver that helps break down red blood cells. Normal urine contains some urobilinogen. If there is little or no urobilinogen in urine, it can mean your liver isn't working correctly. Too much urobilinogen in urine can indicate a liver disease such as hepatitis or cirrhosis.
A urobilinogen test may part of a urinalysis, a test that measures different cells, chemicals, and other substances in your urine. A urinalysis is often part of a routine exam.
Your health care provider may have ordered this test as part of your regular checkup, to monitor an existing liver condition, or if you have symptoms of a liver disease. These include:
Jaundice, a condition that causes your skin and eyes to turn yellow
Nausea and/or vomiting
Dark colored urine
Pain and swelling in the abdomen
Itchy skin
Your health care provider will need to collect a sample of your urine. He or she will provide you with special instructions to ensure the sample is sterile. These instructions are often called as the "clean catch method." The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
You don't need any special preparations. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having this test.
If your test results show too little or no urobilinogen in your urine, it may indicate:
A blockage in the structures that carry bile from your liver
A blockage in the blood flow of the liver
A problem with liver function
If your test results show a higher-than-normal level of urobilinogen, it may indicate:
Hepatitis
Cirrhosis
Liver damage due to drugs
Hemolytic anemia, a condition in which red blood cells are destroyed before they can be replaced. This leaves the body without enough healthy red blood cells
If your results are abnormal, it does not necessarily indicate you have a medical condition requiring treatment. Be sure to tell your health care provider about any medicines and supplements you are taking, as these can affect your results. If you are a woman, you should tell your health care provider if you are menstruating.
This test is only one measure of liver function. If your health care provider thinks you might have a liver disease, additional urine and blood tests may be ordered.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (4)
Bilirubin Metabolism
Video by Armando Hasudungan/YouTube
Urinalysis
Kidneys and Related Conditions : The value of routine urinalysis is that abnormal levels of substances such as protein or glucose, for example, will often appear in the urine before patients are aware they may have a problem. It is also used to detect disorders of the urinary tract, most commonly infections. Abnormal urine screens are typically followed up by more specific diagnostic tests.
Image by TheVisualMD
Alkaline Phosphatase, Liver
The liver is the body's central chemical plant, filtering blood and removing toxins, storing sugars, lipids, and vitamins, and producing important blood proteins. Liver function is typically evaluated by a panel of tests, including one for alkaline phosphatase (ALP), an enzyme made in liver cells, that help doctors distinguish among the many different possible causes of liver damage. Many types of liver damage, including hepatitis, cirrhosis, liver cancer or drug toxicity, can elevate ALP levels.
Image by TheVisualMD
Liver and Gallbladder with Associated Vessel
The liver is the body's central chemical plant, filtering blood and removing toxins, storing sugars, lipids, and vitamins, and producing important blood proteins such as albumin as well as those involved in blood clotting. The liver also produces most of body's cholesterol (the rest comes from food) as well as a quart of bile each day, a greenish-brown, alkaline fluid that aids digestion. The gallbladder stores bile for release into the small intestine; bile contains cholesterol, bile salts, and bilirubin, a yellowish pigment produced by the breakdown of red blood cells.
Image by TheVisualMD
8:44
Bilirubin Metabolism
Armando Hasudungan/YouTube
Urinalysis
TheVisualMD
Alkaline Phosphatase, Liver
TheVisualMD
Liver and Gallbladder with Associated Vessel
TheVisualMD
Nitrites in Urine Test
Nitrites in Urine Test
Also called: Urine Nitrite
A nitrites in urine test is part of a urinalysis, a test that measures different substances in urine. If nitrites are present, it may indicate an infection.
Nitrites in Urine Test
Also called: Urine Nitrite
A nitrites in urine test is part of a urinalysis, a test that measures different substances in urine. If nitrites are present, it may indicate an infection.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Even if no nitrites are found, you still may have an infection, because bacteria don't always change nitrates into nitrites.
Related conditions
A urinalysis, also called a urine test, can detect the presence of nitrites in the urine. Normal urine contains chemicals called nitrates. If bacteria enter the urinary tract, nitrates can turn into different, similarly named chemicals called nitrites. Nitrites in urine may be a sign of a urinary tract infection (UTI).
UTIs are one of the most common types of infections, especially in women. Fortunately, most UTIs are not serious and are usually treated with antibiotics. It's important to see your health care provider if you have symptoms of a UTI so you can start treatment right away.
Other names: urine test, urine analysis, microscopic urine analysis, microscopic examination of urine, UA
A urinalysis, which includes a test for nitrites in urine, may be part of a regular exam. It may also be used to check for a UTI.
Your health care provider may have ordered a urinalysis as part of a routine checkup or if you have symptoms of a UTI. Symptoms of a UTI may include:
Frequent urge to urinate, but little urine comes out
Painful urination
Dark, cloudy, or reddish colored urine
Bad smelling urine
Weakness and fatigue, particularly in older women and men
Fever
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider
You don't need any special preparations to test for nitrites in urine. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having a urinalysis or a nitrites in urine test.
If there are nitrites in your urine, it may mean that you have a UTI. However, even if no nitrites are found, you still may have an infection, because bacteria don't always change nitrates into nitrites. If you have symptoms of a UTI, your health care provider will also look at other results of your urinalysis, especially the white blood cell count. A high white blood cell count in urine is another possible sign of an infection. To learn what your results mean, talk to your health care provider.
If a urinalysis is part of your regular checkup, your urine will be tested for a variety of substances along with nitrites. These include red and white blood cells, proteins, acid and sugar levels, cell fragments, and crystals in your urine.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (2)
Urine Color Chart
Urine Color Chart - Hydration
Image by OpenStax College
Lower urinary tract infection (cystitis) - an Osmosis preview
Video by Osmosis/YouTube
Urine Color Chart
OpenStax College
0:45
Lower urinary tract infection (cystitis) - an Osmosis preview
Osmosis/YouTube
Red Blood Cells in Urine Test
Red Blood Cells in Urine Test
Also called: RBC urine
Red blood cells (RBCs), also known as erythrocytes, may also be found in a urinalysis, or a urine test. High levels of RBCs in your urine indicates that you have hematuria.
Red Blood Cells in Urine Test
Also called: RBC urine
Red blood cells (RBCs), also known as erythrocytes, may also be found in a urinalysis, or a urine test. High levels of RBCs in your urine indicates that you have hematuria.
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Use the slider below to see how your results affect your
health.
{cells}/uL
5
25
Your result is Normal.
This indicates that only small traces of blood was found in your urine. It is considered normal and does not require further investigation.
Related conditions
Red blood cells (RBCs), also known as erythrocytes, are cells that can be found circulating in the blood. They are produced in the bone marrow (the spongy tissue inside some of your bones), and their function is to carry a protein called hemoglobin through the body, which in turn delivers oxygen to the tissues and organs.
This test is part of the microscopic characteristics evaluated in a urinalysis, or urine test. This means that RBCs are invisible to the naked eye, and can only be seen through a microscope.
This test is not usually ordered alone but rather as part of a urinalysis. It can be helpful in the following cases:
Overall check up
To monitor pregnant women
If you have signs and symptoms of urinary tract infection (pelvic pain, dark urine, painful urination, blood in urine, frequent urination)
To monitor a medical condition, such as diabetes or kidney disease
You will need to give a clean catch urine sample.
This requires following these simple steps;
Clean your genitals
Start to urinate in the toilet
Stop halfway through
Collect about two ounces of midstream urine in the container
Stop again and close the container
Last, finish peeing in the toilet
You also need to be careful not to touch your genitals with the container to avoid possible contamination with external microorganisms.
No preparation is required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
Is not unusual to find RBCs in a urine sample; however, 3 or more red blood cells per high-powered field are regarded as a sign of hematuria (blood loss through urine).; further information should be gathered to make a diagnose.
Presence of RBC’s in urine may be due to:
Glomerular disorders
Glomerulonephritis
Systemic lupus erythematosus
Renal disorders
Polycystic kidney disease
Benign prostatic hyperplasia
Cancer
Cystitis
Pyelonephritis
Nephrolithiasis
Prostatitis
Intake or certain drugs
Trauma
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, menstruation traces, and the time elapsed between the urine collection and its evaluation in the laboratory.
Urinalysis: Reference Range, Interpretation, Collection and Panels [accessed on Jan 10, 2019]
Urinalysis [accessed on Jan 10, 2019]
Urinalysis: A Comprehensive Review - - American Family Physician [accessed on Jan 10, 2019]
https://www.cambridgeshireandpeterboroughccg.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=7479 [accessed on Jan 10, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
Hematuria
Hematuria Trauma : Gross hematuria due to kidney trauma.
Image by James Heilman, MD
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Image by Bobjgalindo
Hematuria by anatomic location
Source of Hematuria by anatomic location
Image by Copene
Microhematuria
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Image by Bobjgalindo
Phenazopyridine
Pyridiumurine : The characteristic color of urine after taking pyridium.
Image by James Heilman, MD
Hematuria
James Heilman, MD
Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.
Bobjgalindo
Hematuria by anatomic location
Copene
Microhematuria
Bobjgalindo
Phenazopyridine
James Heilman, MD
White Blood Cells, Urine Test
White Blood Cells, Urine Test
Also called: Leukocytes in Urine
White blood cells (WBCs), also known as leukocytes, may also be found in a urinalysis, or a urine test. High levels of WBCs in your urine suggest that you have a urinary tract infection (UTI).
White Blood Cells, Urine Test
Also called: Leukocytes in Urine
White blood cells (WBCs), also known as leukocytes, may also be found in a urinalysis, or a urine test. High levels of WBCs in your urine suggest that you have a urinary tract infection (UTI).
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Use the slider below to see how your results affect your
health.
{cells}/uL
10
100
Your result is Normal.
Normal reference ranges can slightly vary depending on the laboratory and the method used for testing.
Related conditions
White blood cells (WBCs), also known as leukocytes, are part of the immune system. These cells protect your body against viruses, bacteria, parasites, fungus, and any other strange organism or substance that may want to enter into your system.
This test is part of the microscopic characteristics evaluated in a urinalysis, or urine test. This means that WBCs are invisible to the naked eye, and can only be seen through a microscope.
This test is not ordered alone but rather as part of a urinalysis. It can be helpful in the following cases:
Overall check up
To monitor pregnant women
If you have signs and symptoms of urinary tract infection (pelvic pain, dark urine, painful urination, blood in urine, frequent urination)
You will need to give a clean catch urine sample.
This requires following these simple steps;
Clean your genitals
Start to urinate in the toilet
Stop halfway through
Collect about two ounces of midstream urine in the container
Stop again and close the container
Last, finish peeing in the toilet
You also need to be careful not to touch your genitals with the container to avoid possible contamination with external microorganisms.
No preparation is required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
The normal range for WBCs in urine is:
<10 WBC/µl: not significant
10-100 WBC/µl: usually not significant but still requires further clinical assessment
>100 WBC/µl: suggestive of infection
It is also considered normal to have less than 5 WBCs/hpf. A high number of WBCs may indicate a urinary tract infection or inflammation, especially if bacteria is also present.
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, and the time elapsed between the urine collection and its evaluation in the laboratory.
Urinalysis: Reference Range, Interpretation, Collection and Panels [accessed on Jan 10, 2019]
Urinalysis [accessed on Jan 10, 2019]
Urinalysis: A Comprehensive Review - - American Family Physician [accessed on Jan 10, 2019]
https://www.cambridgeshireandpeterboroughccg.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=7479 [accessed on Jan 10, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (1)
Pyuria
Pyuria : White blood cells seen under a microscope from a urine sample.
Image by Bobjgalindo
Pyuria
Bobjgalindo
Epithelial Cells in Urine Test
Epithelial Cells in Urine Test
The test measures the amount of epithelial cells in urine. A large amount may indicate an infection, kidney disease, or other serious medical condition. This test is part of a urinalysis, a test that measures different substances in your urine.
Epithelial Cells in Urine Test
The test measures the amount of epithelial cells in urine. A large amount may indicate an infection, kidney disease, or other serious medical condition. This test is part of a urinalysis, a test that measures different substances in your urine.
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Use the slider below to see how your results affect your
health.
Your result is Few.
"Few" cells are generally considered in the normal range.
Related conditions
Epithelial cells are a type of cell that lines the surfaces of your body. They are found on your skin, blood vessels, urinary tract, and organs. An epithelial cells in urine test looks at urine under a microscope to see if the number of your epithelial cells is in the normal range. It's normal to have a small amount of epithelial cells in your urine. A large amount may indicate an infection, kidney disease, or other serious medical condition.
An epithelial cells in urine test is a part of a urinalysis, a test that measures different substances in your urine. A urinalysis may include a visual examination of your urine sample, tests for certain chemicals, and an examination of urine cells under a microscope. An epithelial cells in urine test is part of a microscopic exam of urine.
Your health care provider may have ordered an epithelial cells in urine test as part of your regular checkup or if your visual or chemical urine tests showed abnormal results. You may also need this test if you have symptoms of a urinary or kidney disorder. These symptoms may include:
Frequent and/or painful urination
Abdominal pain
Back pain
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
Wash your hands.
Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container. The container will have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
You don't need any special preparations for the test. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having the test.
Results are often reported as an approximate amount, such as "few," moderate," or "many" cells. "Few" cells are generally considered in the normal range. "Moderate" or "many" cells may indicate a medical condition such as:
Urinary tract infection
Yeast infection
Kidney disease
Liver disease
Certain types of cancer
If your results are not in the normal range, it doesn't necessarily mean that you have a medical condition that requires treatment. You may need more tests before you can get a diagnosis. To learn what your results mean, talk to your health care provider.
There are three types of epithelial cells that line the urinary tract. They are called transitional cells, renal tubular cells, and squamous cells. If there are squamous epithelial cells in your urine, it may mean your sample was contaminated. This means that the sample contains cells from the urethra (in men) or the vaginal opening (in women). It can happen if you do not clean well enough when using the clean catch method.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
Uric acid crystals (urine)
Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.
Image by Doruk Salancı
Struvite crystals (urine)
Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.
Image by Doruk Salancı
Urine Test
Image by frolicsomepl/Pixabay
Urine
Sample of human urine
Image by Markhamilton
Cancer screening
Screening for Cancer: Urine Tests : Urine samples may contain tumor markers, which can suggest cancer. Urinalysis is commonly a part of routine health screening. It is simply an analysis of the urine that can be performed in many healthcare settings including doctors' offices, urgent care facilities, laboratories, and hospitals. Urinalysis can disclose evidence of diseases, even some that have not caused significant signs or symptoms.
Image by TheVisualMD
Uric acid crystals (urine)
Doruk Salancı
Struvite crystals (urine)
Doruk Salancı
Urine Test
frolicsomepl/Pixabay
Urine
Markhamilton
Cancer screening
TheVisualMD
Urinary Casts Test
Urinary Casts Test
Also called: Urine Casts
Urinary casts are tiny structures that can be seen in a urine test (urinalysis) when certain kidney diseases or conditions are present.
Urinary Casts Test
Also called: Urine Casts
Urinary casts are tiny structures that can be seen in a urine test (urinalysis) when certain kidney diseases or conditions are present.
Use the slider below to see how your results affect your
health.
Your result is Negative.
Related conditions
Urinary casts are tiny cylindrical, tube-shaped structures that are produced by the kidneys and may be found in a urinalysis test when certain diseases or conditions are present.
This test usually forms part of a urine test (urinalysis), which can be ordered as part of a normal routine check-up, or when kidney diseases are suspected.
You will be asked to provide a urine sample by urinating into a sterile urine container.
To adequately do this, you need to clean your genitals, and then discard the first stream of urine into the toilet (this is done to “clean” your urethra), proceeding then to collect about two ounces of midstream urine in the container.
No fasting or other preparations are necessary for this test. Follow the instructions provided by your healthcare professional.
There are no known risks associated with this test.
Hyaline casts: the presence of a few of these casts is usually normal and can occur in physiologic states (e.g., after exercise).
Fatty casts: these casts can be found in people who have lipids (fat) in the urine and are usually related to a kidney disease complication, such as nephrotic syndrome, glomerulonephritis, or other forms of chronic renal diseases.
Granular casts: these casts might be found after exercise, but also when certain kidney diseases are present.
Red blood cell casts: these casts are related to a very small amount of bleeding from the kidney. Red blood cell casts are seen in many kidney diseases.
Epithelial cell casts: the apparition of these casts implies damage to cells in the kidneys. These casts are seen in conditions such as heavy metal poisoning, and kidney transplant rejection, among others.
Waxy casts: these casts can be found in people with long-term (chronic) kidney disease and chronic kidney failure.
White blood cell (WBC) casts: these casts can be found when acute kidney infections are present.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Tumor Markers
Tumor Marker Tests
Tumor markers are substances made by cancer cells or normal cells in response to cancer in the body. These tests can help find out if your cancer has spread, if treatment is working, or if cancer has returned after you've finished treatment.
Tumor Marker Tests
Tumor markers are substances made by cancer cells or normal cells in response to cancer in the body. These tests can help find out if your cancer has spread, if treatment is working, or if cancer has returned after you've finished treatment.
These tests look for tumor markers, sometimes called cancer markers, in the blood, urine, or body tissues. Tumor markers are substances made by cancer cells or by normal cells in response to cancer in the body. Some tumor markers are specific to one type of cancer. Others can be found in several types of cancers.
Because tumor markers can also show up in certain noncancerous conditions, tumor marker tests are not usually used to diagnose cancer or screen people at low risk of the disease. These tests are most often done on people already diagnosed with cancer. Tumor markers can help find out if your cancer has spread, whether your treatment is working, or if your cancer has come back after you've finished treatment.
Tumor marker tests are most often used to:
Plan your treatment. If tumor marker levels go down, it usually means the treatment is working.
Help find out if a cancer has spread to other tissues
Help predict the likely outcome or course of your disease
Check to see if your cancer has come back after successful treatment
Screen people at high risk for cancer. Risk factors can include family history and previous diagnosis of another type of cancer
You may need a tumor marker test if you are currently being treated for cancer, have finished cancer treatment, or have a high risk of getting cancer because of family history or other reasons.
The type of test you get will depend on your health, health history, and symptoms you may have. Below are some of the most common types of tumor markers and what they are used for.
CA 125 (cancer antigen 125)
Tumor marker for:
ovarian cancer
Used to:
See if cancer treatment is working
See if cancer has come back after you've finished treatment
CA 15-3 and CA 27-29 (cancer antigens 15-3 and 27-29)
Tumor markers for:
breast cancer
Used to:
Monitor treatment in women with advanced breast cancer
PSA (prostate-specific antigen)
Tumor marker for:
prostate cancer
Used to:
Screen for prostate cancer
Help diagnose prostate cancer
Monitor treatment
Check to see if cancer has come back after you've finished treatment
CEA (carcinoembryonic antigen)
Tumor marker for:
colorectal cancer, and also for cancers of the lung, stomach, thyroid, pancreas, breast, and ovary
Used to:
See if cancer treatment is working
See if cancer has come back after you've finished treatment
AFP (Alpha-fetoprotein)
Tumor marker for:
liver cancer, and cancers of the ovary or testicles
Used to:
Help diagnose liver cancer
Find out if cancer has spread (the stage of cancer)
See if cancer treatment is working
Predict chances for recovery
B2M (Beta 2-microglobulin)
Tumor marker for:
multiple myeloma, some lymphomas, and leukemias
Used to:
See if cancer treatment is working
Predict chances for recovery
There are different ways to test for tumor markers. Blood tests are the most common type of tumor marker tests. Urine tests or biopsies may also be used to check for tumor markers. A biopsy is a minor procedure that involves removing a small piece of tissue for testing.
If you are getting a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
If you are getting a urine test, ask your health care provider for instructions on how to provide your sample.
If you are getting a biopsy, a health care provider will take out a small piece of tissue by cutting or scraping the skin. If your provider needs to test tissue from inside your body, he or she may use a special needle to withdraw the sample.
You usually don't need any special preparations for a blood or urine test. If you are getting a biopsy, you may need to fast (not eat or drink) for several hours before the procedure. Talk to your health care provider if you have any questions about preparing for your test.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
There is no risk to a urine test.
If you have had a biopsy, you may have a little bruising or bleeding at biopsy site. You may also have a little discomfort at the site for a day or two.
Depending in what type of test you had and how it was used, your results may:
Help diagnose the type or stage of your cancer.
Show whether your cancer treatment is working.
Help plan future treatment.
Show if your cancer has returned after you've finished treatment.
If you have questions about your results, talk to your health care provider.
Tumor markers can be very useful, but the information they provide can be limited because:
Some noncancerous conditions can cause tumor markers.
Some people with cancer don't have tumor markers.
Not all types of cancer have tumor markers.
So, tumor markers are almost always used with other tests to help diagnose and monitor cancer.
Tumor Markers - National Cancer Institute [accessed on Oct 04, 2018]
Tumor Markers [accessed on Oct 04, 2018]
Additional Materials (7)
What to Know About Germ Cell Tumor Markers, with Timothy Gilligan, MD
Video by Cancer.Net/YouTube
Why Don't We Have Cancer-Sniffing Dogs?
Video by SciShow/YouTube
Tumor Markers in Cancer Detection, Diagnosis and Management
Video by USMLEVideoLectures/YouTube
Tumor Markers in Cancer diagnosis and Monitoring
Video by Pathology Simplified/YouTube
Clinical Chemistry - Tumor Markers as Diagnostic Tests for Cancer
Video by قناة لابوتيوب LaboTube Channel/YouTube
Understanding CA-125 Screening for Ovarian Cancer
Video by Roswell Park Comprehensive Cancer Center/YouTube
Tracking cancer with a blood test
Video by Cancer Research UK/YouTube
3:07
What to Know About Germ Cell Tumor Markers, with Timothy Gilligan, MD
Cancer.Net/YouTube
6:33
Why Don't We Have Cancer-Sniffing Dogs?
SciShow/YouTube
9:15
Tumor Markers in Cancer Detection, Diagnosis and Management
USMLEVideoLectures/YouTube
9:47
Tumor Markers in Cancer diagnosis and Monitoring
Pathology Simplified/YouTube
4:49
Clinical Chemistry - Tumor Markers as Diagnostic Tests for Cancer
قناة لابوتيوب LaboTube Channel/YouTube
2:25
Understanding CA-125 Screening for Ovarian Cancer
Roswell Park Comprehensive Cancer Center/YouTube
1:49
Tracking cancer with a blood test
Cancer Research UK/YouTube
Alpha Fetoprotein (AFP) Tumor Marker Test
Alpha Fetoprotein (AFP) Tumor Marker Test
Also called: AFP Tumor Marker, Alpha-Fetoprotein Tumor Marker, Alpha-Fetoprotein-L3 Percent
An AFP (alpha-fetoprotein) tumor marker test measures the level of AFP in your blood. High levels of AFP can be a sign of liver cancer, cancer of the ovaries or testicles, and noncancerous liver disorders.
Alpha Fetoprotein (AFP) Tumor Marker Test
Also called: AFP Tumor Marker, Alpha-Fetoprotein Tumor Marker, Alpha-Fetoprotein-L3 Percent
An AFP (alpha-fetoprotein) tumor marker test measures the level of AFP in your blood. High levels of AFP can be a sign of liver cancer, cancer of the ovaries or testicles, and noncancerous liver disorders.
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Use the slider below to see how your results affect your
health.
ng/mL
8.3
Your result is Normal.
AFP is normally elevated in pregnant women since it is produced by the fetus. However, AFP is not usually found in the blood of adults.
Related conditions
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Use the slider below to see how your results affect your
health.
%
10
Your result is Negative.
Normal results can vary depending on the method used for testing by the laboratory.
Related conditions
An AFP tumor marker test is a blood test that measures the level of AFP (alpha-fetoprotein) in a sample of your blood. It's usually used to help diagnose certain types of cancer and to check how well treatment is working.
AFP is a protein that the liver makes when its cells are growing and dividing to make new cells. AFP is normally high in unborn babies. After birth, AFP levels drop very low. Healthy children and adults who aren't pregnant have very little AFP in their blood.
AFP in non-pregnant people is mainly measured as a tumor marker. Tumor markers are substances that are often made by cancer cells or by normal cells in response to cancer. High levels of AFP can be a sign of cancer of the liver, ovaries or testicles.
An AFP tumor marker test cannot be used by itself to screen for or diagnose cancer. That's because other conditions can increase AFP levels, including liver diseases that aren't cancer. And some people who do have liver, ovarian, or testicular cancer will have normal AFP levels. So, an AFP tumor marker test can't rule out cancer for sure. But when used with other tests and exams, AFP tumor marker testing can help diagnose and monitor cancers that cause high AFP levels.
Other names: total AFP, alpha-fetoprotein-L3 Percent
An AFP tumor marker test may be used during the diagnosis and/or treatment of cancer of the liver, ovaries, or testicles that make high levels of AFP. It is used to:
Help confirm or rule out a cancer diagnosis when used with other exams and tests.
Predict how cancer may behave over time.
Monitor cancer treatment. AFP levels often go up if cancer is growing and go down when treatment is working.
Check whether cancer has returned after treatment.
In certain cases, results from an AFP tumor marker test may be used to guide treatment choices for specific types of cancer. The test may also be used to monitor your health if you have chronic (long lasting) hepatitis or cirrhosis of the liver. These conditions aren't cancer, but they increase your risk of developing liver cancer.
You may need an AFP tumor marker test if:
A physical exam and/or other tests suggest that you may have cancer of the liver, ovaries, or testicles.
You are currently being treated for a cancer that causes high AFP levels. Measuring your AFP test can show how well your treatment is working.
You have completed treatment for a cancer that increased your AFP level. You may need an AFP tumor marker test from time to time to check whether your cancer is coming back.
If you have chronic hepatitis or cirrhosis, you have a higher risk of developing liver cancer. A very high level of AFP or a sudden increase can be an early sign of liver cancer. Most medical experts don't recommend measuring AFP levels to screen for cancer in these diseases. But, some health care providers may still use an AFP tumor marker test with other tests to watch for liver cancer.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't need any special preparations for an AFP tumor marker test.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
If you haven't been diagnosed with cancer, test results that show:
High levels of AFP may be a sign of cancer of the liver, ovaries, or testicles. But having a high AFP level doesn't mean you have cancer or that you will get cancer. Liver injury and liver diseases that aren't cancer can also cause high AFP levels. Less often, high levels of AFP may be a sign of other cancers, including lymphoma or lung cancer. Your provider will use your medical history and other test results to make a diagnosis.
Normal levels of AFP mean you're less likely to have a cancer that causes high AFP levels. But a normal test result doesn't rule out cancer because some people with these cancers have normal AFP levels.
If you're being treated for a cancer that increased your AFP levels, you may be tested several times during treatment. Your provider will look at all your AFP test results to see how your levels have changed over time. If your results show:
Your AFP levels are increasing, it may mean that your treatment isn't working.
Your AFP levels are decreasing, it may mean your treatment is working.
Your AFP levels have stayed the same, it may mean your disease is stable and hasn't gotten better or worse.
If you've finished treatment for cancer that caused high AFP levels and your test results are:
Not normal, it may mean that you still have some cancer in your body.
Higher now than they were shortly after treatment, it may mean your cancer is growing again.
If you have a long-lasting liver disease that's not cancer, you may need other tests to check for liver cancer if your test results show a sudden increase in AFP or your level is very high.
Ask your provider to explain what your test results mean for your health.
In the U.S., the most common AFP tumor marker test measures all forms of AFP in your blood. A less common AFP test may be used to check the risk of liver cancer in people who have chronic liver disease. It measures a form of AFP called L3.
An AFP-L3 percent test (AFP-L3%) compares the amount of L3 to the amount of total AFP in your blood. If the portion of L3 increases, it may mean you have a high risk of developing a serious form of the most common liver cancer called hepatocellular carcinoma.
You may have heard of another type of AFP test that's used during pregnancy. This test measures total AFP levels in the blood, but it's not a tumor marker test for cancer. It's used to check for the risk of certain birth defects in an unborn baby.
Alpha Fetoprotein (AFP) Tumor Marker Test: MedlinePlus Medical Test [accessed on Feb 12, 2024]
Lab Tests Online: Alpha-fetoprotein (AFP) Tumor Marker [accessed on Aug 24, 2018]
URMC / Encyclopedia / Alpha-Fetoprotein Tumor Marker (Blood) [accessed on Aug 24, 2018]
Arrieta, Oscar et al. “The Progressive Elevation of Alpha Fetoprotein for the Diagnosis of Hepatocellular Carcinoma in Patients with Liver Cirrhosis.” BMC Cancer 7 (2007): 28. PMC. Web. 24 Aug. 2018. [accessed on Aug 24, 2018]
AAFP: Serum Tumor Markers; Am Fam Physician. 2003 Sep 15;68(6):1075-1082. [accessed on Aug 24, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (6)
Genes and Genetic Defects
Genetic testing isn't new. In the 1960s, doctors were able to test newborn babies for certain rare single-gene disorders, such as phenylketonuria (PKU), a rare metabolic disease that causes mental retardation. (PKU can be prevented with a special diet if it's detected early, which was why it was critical to test newborns.)
Image by TheVisualMD
This browser does not support the video element.
Prenatal Diagnostic Testing
If a pregnant woman has an abnormal genetic screening test result, a doctor may suggest a prenatal diagnostic test be done to determine with more certainly whether or not a fetus has a particular disorder. There are two main diagnostic testing procedures, chorionic villus sampling (CVS) and amniocentesis. Both of these tests involve collecting a sample from inside the womb, which is then examined to detect diseases such as Down Syndrome, Edwards Syndrome, neural tube defects, cystic fibrosis, fragile-x, and spinal muscular atrophy. Prenatal diagnostic tests provide valuable information on the health of the fetus and can help alleviate the stress of expectant parents.
Video by TheVisualMD
Mapping Your Future: Screening for Disease Risk
Image by TheVisualMD
Amniocentesis
Amniocentesis is a prenatal test that gathers information about a fetus` health from a sample of amniotic fluid. Amniotic fluid is the fluid that surrounds the fetus in the uterus. It contains cells from the fetus that naturally slough off during development. If a woman is at high risk for a genetic disease, a doctor may recommend an "amnio" to determine whether a fetus has certain genetic disorders, such as cystic fibrosis, among other diseases.
Image by TheVisualMD
Megacystis
Megacystis in fetus : Ultrasound revealing megacystis in a fetus with Down syndrome.
Image by X.Compagnion
Maternal Serum Screening (MSS)
Video by Washington State Department of Health/YouTube
Genes and Genetic Defects
TheVisualMD
4:34
Prenatal Diagnostic Testing
TheVisualMD
Mapping Your Future: Screening for Disease Risk
TheVisualMD
Amniocentesis
TheVisualMD
Megacystis
X.Compagnion
3:57
Maternal Serum Screening (MSS)
Washington State Department of Health/YouTube
Beta 2 Microglobulin (B2M) Tumor Marker Test
Beta 2 Microglobulin (B2M) Tumor Marker Test
Also called: Beta-2 Microglobulin, β2-Microglobulin, B2M, B2MG, Thymotaxin
The test measures the amount of beta-2 microglobulin (B2M) in your body fluids, usually in the blood. B2M is found on most of the cells in your body in small amounts. High levels of B2M in body fluids may be indicative of certain cancers. The B2M tumor marker is used to determine prognosis and follow response to treatment.
Beta 2 Microglobulin (B2M) Tumor Marker Test
Also called: Beta-2 Microglobulin, β2-Microglobulin, B2M, B2MG, Thymotaxin
The test measures the amount of beta-2 microglobulin (B2M) in your body fluids, usually in the blood. B2M is found on most of the cells in your body in small amounts. High levels of B2M in body fluids may be indicative of certain cancers. The B2M tumor marker is used to determine prognosis and follow response to treatment.
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Use the slider below to see how your results affect your
health.
μg/mL
2.7
Your result is Normal.
Healthy people have small amounts of B2M in their blood. Normal results vary based on the laboratory and the method used.
Related conditions
{"label":"B2M (cerebrospinal fluid) reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0.7,"max":1.8},"text":"Normal results vary based on the laboratory and the method used.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":1.8,"max":5},"text":"Increased levels of B2M means that a disease is likely to be present, and further testing needs to be done. Usually, higher levels correspond with higher stages of the disease; hence, worse prognosis.","conditions":["Non-Hodgkin lymphoma","Acute lymphocytic leukemia","HIV progression","Chronic inflammation","Multiple sclerosis","Acute viral infection","Neurologic processes"]}],"units":[{"printSymbol":"\u03bcg\/mL","code":"ug\/mL","name":"microgram per milliliter"}],"value":1.3,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
μg/mL
1.8
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
{"label":"B2M (urine) reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":300},"text":"Healthy people have small amounts of B2M in their blood. Normal results vary based on the laboratory and the method used.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":300,"max":500},"text":"Increased urine B2M levels indicate kidney damage, and further testing needs to be done. Usually, higher levels correspond with higher stages of the disease; hence, worse prognosis.","conditions":["Renal tubular damage","Pyelonephritis","Balkan nephropathy","Exposure to cadmium","Exposure to mercury","Exposure to lithium","Aminoglycoside toxicity"]}],"units":[{"printSymbol":"\u03bcg\/L","code":"ug\/L","name":"microgram per liter"}],"value":150,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
μg/L
300
Your result is Normal.
Healthy people have small amounts of B2M in their blood. Normal results vary based on the laboratory and the method used.
Related conditions
A beta-2 microglobulin tumor marker test measures the amount of a protein called beta-2 microglobulin (B2M) in your body fluids. The test usually uses a sample of your blood. It may also be done using urine (pee) or in rare cases cerebrospinal fluid (CSF).
B2M is a type of tumor marker. Tumor markers are substances that are often made by cancer cells or by normal cells in response to cancer in the body. B2M is found on most of the cells in your body. Normally, you have only small amounts of B2M in your blood and urine. High levels of B2M in body fluids are often caused by these blood and bone marrow cancers:
Multiple myeloma
Chronic lymphocytic leukemia (CLL)
Certain types of lymphoma
A beta-2 microglobulin tumor marker test can't diagnose cancer or any other condition. That's because there are so many conditions that can cause high levels of B2M. But if you've already been diagnosed with one of these blood and bone marrow cancers, a B2M test can provide important information about your cancer including:
How much cancer you have in your body and how fast it's growing
How your cancer may behave in the future
How much your treatment is helping
This information can help you and your health care provider plan your care.
Other names: total beta-2 microglobulin, β2-microglobulin, B2M, B2MG, thymotaxin
A beta-2 microglobulin tumor marker test is most often used if you have been diagnosed with certain cancers of the bone marrow or blood. Testing your B2M levels can help:
Find out how much cancer is in your body
Predict how your cancer will develop
Pick your treatment and check whether it's working
Check whether cancer has spread to your brain and/or spinal cord (This is done only if you have symptoms.)
If you have been diagnosed with multiple myeloma, chronic lymphocytic leukemia, or certain types of lymphoma, you may need a B2M test to find out how serious your disease is. B2M testing can help monitor your cancer and check whether your treatment is working.
If you have multiple myeloma, you may need a B2M test to see whether your cancer is spreading. A test of a urine sample may also be needed to check whether your disease is affecting your kidneys.
A beta-2 microglobulin test usually uses a sample of your blood. In certain cases, you may need to provide a 24-hour urine sample, which means collecting all your urine for a full day. If your provider suspects that cancer has spread to your brain or spine, you may have a cerebrospinal fluid (CSF) analysis.
For a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
For a 24-hour urine sample, you will be given a special container to collect your urine and instructions on how to collect and store your samples. Your provider will tell you what time to start. The test generally includes the following steps:
To begin, urinate (pee) in the toilet as usual. Do not collect this urine. Write down the time you urinated.
For the next 24 hours, collect all your urine in the container.
During the collection period, store the urine container in the refrigerator or in a cooler with ice.
24 hours after starting the test, try to urinate if you can. This is the last urine collection for the test.
Return the container with your urine to your provider's office or the laboratory as instructed.
For a cerebrospinal fluid (CSF) analysis, a provider will do a procedure called a spinal tap (also known as a lumbar puncture). A spinal tap is usually done in a hospital. A provider numbs your skin with medicine and uses a thin, hollow needle to remove some fluid from between the bones in your lower spine. You usually go home the same day.
For blood and urine tests, there are no special preparations.
For a CSF analysis (spinal tap), you may be asked to empty your bladder (pee) and bowels (poop) before the test.
With a blood test, there is very little risk. After the test, you may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
With a urine test, there is no known risk.
With a CSF analysis, there is very little risk from a spinal tap. You may feel a little pinch or pressure when the needle is inserted. After the test, you may feel some pain or tenderness in your back or have some bleeding where the needle was inserted. You may also get a headache. The headache may last for several hours or up to a week or more. Your provider may suggest treatment to relieve the pain.
If your B2M levels were measured to learn about your cancer:
The higher your B2M levels, the more cancer you have in your body. Higher levels are linked to cancers that tend to grow faster.
If you have multiple myeloma, higher levels of B2M are linked with kidney problems.
If your B2M levels were measured to check how well your treatment is working, your provider may look at several test results over time to look for a trend:
Increasing B2M levels may mean your treatment is not working.
Decreasing B2M levels may mean your treatment is working.
B2M levels that don't change may mean that your disease is stable and hasn't gotten better or worse.
If you have questions about your test results, talk with your provider.
B2M levels may be higher than normal in many conditions that aren't cancer. The amount of B2M in body fluids may be measured in conditions such as:
Kidney disease
HIV/AIDS
Multiple sclerosis
Beta 2 Microglobulin (B2M) Tumor Marker Test: MedlinePlus Medical Test [accessed on Jan 20, 2024]
Tumor Marker Tests in Common Use - NCI. National Cancer Institute. Dec 7, 2023 [accessed on Jan 20, 2024]
Beta 2 Microglobulin (B2M) Test. City of Hope. [accessed on Jan 20, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (1)
Electrophoresis - concentration - b-Globulin
Beta globulins are a group of globular proteins in plasma that are more mobile in alkaline or electrically charged solutions than gamma globulins, but less mobile than alpha globulins. Examples of beta globulins include beta-2 microglobulin, plasminogen, angiostatins, properdin, sex hormone-binding globulin, & transferrin.
Image by TheVisualMD
Electrophoresis - concentration - b-Globulin
TheVisualMD
CA-125 Blood Test
CA-125 Blood Test
Also called: CA-125 Tumor Marker, Glycoprotein Antigen, Ovarian Cancer Antigen
This test measures the amount of a protein called CA-125 in the blood. CA-125 levels are high in many women with ovarian cancer. It is not a screening test, but it can help find out if cancer treatment is working.
CA-125 Blood Test
Also called: CA-125 Tumor Marker, Glycoprotein Antigen, Ovarian Cancer Antigen
This test measures the amount of a protein called CA-125 in the blood. CA-125 levels are high in many women with ovarian cancer. It is not a screening test, but it can help find out if cancer treatment is working.
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Use the slider below to see how your results affect your
health.
(i.U.)/mL
35
Your result is Normal.
Having a normal CA-125 result doesn't mean you don't have ovarian cancer. Some women with early ovarian cancer have a normal CA-125 level.
Related conditions
This test measures the amount of a protein called CA-125 (cancer antigen 125) in a sample of your blood. CA-125 is a type of tumor marker. High levels of certain tumor markers in your blood may be a sign of cancer. If you have cancer, measuring certain tumor markers may help provide important information about how to treat your disease.
High levels of CA-125 are often found in people who have ovarian cancer. The ovaries are a pair of female reproductive glands that store ova (eggs) and make female hormones. Ovarian cancer happens when the cells in an ovary begin to grow out of control.
If you have ovarian cancer, CA-125 blood tests can help show whether your treatment is working.
Other names: cancer antigen 125, glycoprotein antigen, ovarian cancer antigen, CA-125 tumor marker
A CA-125 blood test may be used:
To see if ovarian cancer treatment is working and to check for ovarian cancer that has come back. This is the most common use of CA-125 blood testing.
To learn more about a growth or lump in your pelvis (the area below your belly). If a suspicious lump shows up on imaging, such as an ultrasound, your health care provider may check your CA-125 levels along with other tests to find out whether the lump could be ovarian cancer. But a CA-125 blood test alone can't diagnose cancer.
To screen for ovarian cancer if you're risk is very high. If your family health history includes ovarian cancer, your provider may suggest a CA-125 blood test and other tests to look for signs of cancer. But a CA-125 test is not used as a routine screening test for people who don't have a high risk for ovarian cancer. That's because many common conditions that aren't cancer can also cause high CA-125 levels, such as endometriosis or even a menstrual period.
If you've been diagnosed with ovarian cancer, you may have several CA-125 blood tests:
During your treatment to see if your cancer is going away. If CA-125 levels go down, it usually means your treatment is working
After your treatment, to check whether your cancer has returned
If you have a lump in your pelvis that could be ovarian cancer, you may need a CA-125 test to help find out if it could be ovarian cancer. But only a biopsy can diagnose ovarian cancer.
If you have a very high risk of getting ovarian cancer, your health care provider may suggest checking your CA-125 levels. If they're high, you'll probably need more tests to find out if you have cancer. You're more likely to get ovarian cancer if you:
Have a mother or sister, or two or more other relatives who had ovarian cancer
Have family members who have had breast cancer or colorectal cancer (colon cancer)
Have inherited certain gene changes or conditions that increase your risk of ovarian cancer, such as:
Changes in your genes, including BRCA 1 or BRCA 2 genes
Lynch syndrome (also called hereditary non-polyposis colorectal cancer), an inherited disorder that increases the risk for many types of cancer
Have had breast, uterine (uterus), or colorectal cancer
If you're concerned about getting ovarian cancer, talk with your provider about your risk.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't need any special preparations for a CA-125 blood test.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Your provider will review your CA-125 test results along with other information about your condition. Together, you can discuss how your results affect your diagnosis, treatment, and need for more testing.
In general:
If you are being treated for ovarian cancer, and the results of several tests show that your CA-125 levels are going down, it usually means that the treatment is helping. If your levels go up or stay the same over time, it may mean that the treatment isn't working.
If you have finished your treatment for ovarian cancer and your CA-125 levels begin to increase over time, your cancer may be coming back.
If you have a high risk for ovarian cancer or have a suspicious pelvic lump, a high CA-125 levels could be a sign of cancer. Your provider will usually order more tests to make a diagnosis.
A high CA-125 level doesn't always mean cancer. Other conditions may increase CA-125, including:
Endometriosis
Pelvic inflammatory disease (PID)
Uterine fibroids
Liver disease
Pregnancy
Your menstrual period, at certain times during your cycle
A normal CA-125 test result doesn't rule out ovarian cancer. That's because CA-125 levels may be low in the early stages of cancer. And not everyone with ovarian cancer makes high levels of CA-125.
Talk with your provider if you have questions about your results.
The most common type of ovarian cancer is epithelial ovarian cancer. If you have been treated for this type of cancer, you may be tested for a tumor marker called HE4 along with CA-125. Some studies show that measuring both tumor markers provides more accurate information to check whether treatment is working and to look for the return of this type of cancer.
CA 125 Blood Test (Ovarian Cancer): MedlinePlus Lab Test Information [accessed on Nov 05, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (8)
Ovarian Cancer
Ovarian cancer is the deadliest of gynecologic cancers. More than 21,000 new cases of ovarian cancer are diagnosed each year, with more than 15,000 deaths. A particular blood protein called cancer antigen 125 (CA-125) is often elevated in women with ovarian cancer, though small amounts of CA-125 are produced by normal tissues throughout the body and levels of CA-125 can be elevated by other conditions. The CA-125 test is used primarily to monitor the effectiveness of treatment for ovarian cancer. There are three different kinds of ovarian cancer: the most common type is epithelial ovarian cancer (90%) which originates from the surface epithelium of the ovary and is more likely to affect older women; germ cell ovarian cancer (5%), which originates from the cells that produce eggs and is more likely to affect younger women; and stromal ovarian cancer (5%), which originates from the connective tissue within the ovary. After age, the most important risk factor for ovarian cancer is family history. Ovarian cancer is relatively uncommon, but is the fifth leading cause of cancer death in women, partly due to diagnosis difficulty; its symptoms are vague, and ovarian cancer can shed cells that can invade other internal organs long before the presence of disease is even suspected.
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CA-125: Ovaries and Uterus
The cancer antigen 125 test (CA-125) is used to monitor treatment for ovarian cancer. If blood levels of CA-125 fall during treatment, it usually means the cancer is responding; if levels rise after treatment is complete, it may indicate that the cancer has returned.
Image by TheVisualMD
CA-125: Uterus and Ovaries in Ultrasound
When ovarian cancer is suspected, a doctor will typically perform a pelvic exam to check for masses or growths on the ovaries. Other diagnostic tests include a transvaginal ultrasound, which produce detailed images of the ovaries and other reproductive organs.
Image by TheVisualMD
CA-125: Female Reproductive System - A carbohydrate antigen that occurs in tumors of the ovary as well as in breast, kidney, and gastrointestinal tract tumors and normal tissue. While it is tumor-associated, it is not tumor-specific and may have a protective function against particles and infectious agents at mucosal surfaces. (NCBI/NIH)
As our understanding of cancer has deepened and treatment options expanded, the emphasis has shifted to early detection and aggressive treatment. The hope is that earlier and more accurate diagnoses will push survival rates for ovarian cancer higher.
Image by TheVisualMD
Ovarian Cancer Fact Sheet
Ovarian cancer is cancer that begins in the ovaries.
The ovaries make female hormones and produce a
woman’s eggs. Ovarian cancer is a serious cancer that
is more common in older women. Treatment is most
effective when the cancer is found early.
Document by Office on Women's Health, U.S. Department of Health and Human Services
Ovarian Cancer: Symptoms and Treatment
Video by MainMD/YouTube
Premature Ovarian Aging and Early Menopause
Video by Center for Human Reproduction/YouTube
Ovarian cancer: beyond resistance
Video by nature video/YouTube
Ovarian Cancer
TheVisualMD
CA-125: Ovaries and Uterus
TheVisualMD
CA-125: Uterus and Ovaries in Ultrasound
TheVisualMD
CA-125: Female Reproductive System - A carbohydrate antigen that occurs in tumors of the ovary as well as in breast, kidney, and gastrointestinal tract tumors and normal tissue. While it is tumor-associated, it is not tumor-specific and may have a protective function against particles and infectious agents at mucosal surfaces. (NCBI/NIH)
TheVisualMD
Ovarian Cancer Fact Sheet
Office on Women's Health, U.S. Department of Health and Human Services
3:04
Ovarian Cancer: Symptoms and Treatment
MainMD/YouTube
5:09
Premature Ovarian Aging and Early Menopause
Center for Human Reproduction/YouTube
2:22
Ovarian cancer: beyond resistance
nature video/YouTube
CA 15-3 Test
CA 15-3 Test
Also called: CA 15-3 Tumor Marker, Cancer Antigen 15-3, Cancer Antigen-Breast
CA 15-3 testing is mostly used in women who have been diagnosed with invasive breast cancer to monitor the response to treatment and to help watch for recurrence of the disease.
CA 15-3 Test
Also called: CA 15-3 Tumor Marker, Cancer Antigen 15-3, Cancer Antigen-Breast
CA 15-3 testing is mostly used in women who have been diagnosed with invasive breast cancer to monitor the response to treatment and to help watch for recurrence of the disease.
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Use the slider below to see how your results affect your
health.
(i.U.)/mL
30
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
Suggests limited tumor burden (less cancer is present)
Suggests breast-cancer patient is responding well to treatment
Cancer antigen 15-3 (CA 15-3) is a protein that is produced by normal breast cells, and its production increases when cancerous breast tumors are present. Therefore, this antigen can be used as a tumor marker (meaning that if you have high levels of it, there is a good chance that you have cancer).
This test measures CA 15-3 levels in a sample of your blood.
Since not all women with breast cancer will have an increased CA 15-3 level, this test is not useful in all cases and should not be used as a screening tool to detect breast cancer in healthy women.
Hence, your doctor might want to test your CA 15-3 levels to monitor your response to treatment after the diagnosis of advanced breast cancer has already been made and to control whether the disease has recurred.
A small amount of blood will be drawn from a vein in your arm by using a needle.
No fasting is needed. Your doctor may recommend you not to take multivitamins or dietary supplements containing biotin (vitamin B7) for 12 hours prior to the test.
Only the risks related to blood extraction, which are temporary discomfort, bruising, little bleeding, and risk of infection in the place where the needle was inserted.
Normal values of CA 15-3 are less than 30 units/mL. However, reference ranges can slightly vary from laboratory to laboratory.
Usually, the more advanced the breast cancer is, the higher the CA 15-3 level will be. The highest levels of CA 15-3 often are seen when the disease has already spread to other tissues (metastasized).
Nevertheless, besides breast cancer, CA 15-3 levels can be mild to moderately increased in other conditions, including:
Colon cancer
Lung cancer
Pancreatic cancer
Ovarian cancer
Prostate cancer
Liver cancer
Liver disease (hepatitis, cirrhosis)
Benign breast disease
Having normal or elevated CA 15-3 levels does not discard or confirm the presence of cancer as this antigen should not be interpreted alone, but rather taking into consideration other tests and procedures.
Some women with breast cancer can have normal CA 15-3 levels because it may be too early in the disease process for this antigen to be detected, or the woman may fall in the category of individuals with advanced breast cancer whose tumor do not shed CA 15-3.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
Cancer
Cancer is a group of diseases characterized by uncontrolled cell growth.
Image by National Human Genome Research Institute (NHGRI)
CA 15-3: Breast Tumor Size When Found by Imaging or Touch
The foods in the image represent the average size of breast cancer tumors when discovered by mammogram, by regular breast self-exam, or by accident. Breast calcifications too small to be felt can be seen as white spots on a mammogram, as shown by the sesame seeds (far left). The blueberry represents the average size of a lump detected by routine mammogram (.43 inches/1.1 cm). The hazelnut shows average tumor size when discovered in a first mammogram (.59 inches/1.5 cm). The grape represents average tumor size when detected by regular breast self-exam (.83 inches/2.1 cm), and the strawberry shows average tumor size when found accidentally (1.42 inches/3.6 cm).
Image by TheVisualMD
Sensitive content
This media may include sensitive content
CA 15-3: Breast Tissue and Lymph Node Network
Breast tissue isn't found only in the breast itself: It extends from the breastbone to the armpit, and from below the collarbone to the level of the sixth or seventh rib. The breast contains lymphatic vessels that drain into a network of lymph nodes. These nodes are located around the edges of the breast, in the underarm area, and near the collarbone. Breast cancer often spreads first to the underarm lymph nodes. That's why breast self-examination should include feeling and checking the appearance of the underarm area, with arm only slightly raised.
Image by TheVisualMD
What Are Tumor Markers for Breast Cancer?
Video by Breast Cancer Answers®/YouTube
Biomarker Testing
Video by Merck/YouTube
Cancer
National Human Genome Research Institute (NHGRI)
CA 15-3: Breast Tumor Size When Found by Imaging or Touch
TheVisualMD
Sensitive content
This media may include sensitive content
CA 15-3: Breast Tissue and Lymph Node Network
TheVisualMD
2:42
What Are Tumor Markers for Breast Cancer?
Breast Cancer Answers®/YouTube
1:36
Biomarker Testing
Merck/YouTube
CA 19-9 Blood Test
CA 19-9 Blood Test
Also called: CA 19-9 Tumor Marker, Carbohydrate Antigen 19-9, Pancreatic Cancer Antigen
CA 19-9 testing is mostly used to monitor the effectiveness of treatment in individuals who have been diagnosed with pancreatic cancer. However, this antigen can also be elevated in other conditions, diseases, or types of cancer.
CA 19-9 Blood Test
Also called: CA 19-9 Tumor Marker, Carbohydrate Antigen 19-9, Pancreatic Cancer Antigen
CA 19-9 testing is mostly used to monitor the effectiveness of treatment in individuals who have been diagnosed with pancreatic cancer. However, this antigen can also be elevated in other conditions, diseases, or types of cancer.
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Use the slider below to see how your results affect your
health.
U/mL
35
75
Your result is Low.
Low amounts of CA 19.9 may be detected in healthy people. Low or stable counts may also indicate positive response to treatment or stabilized tumor growth.
Related conditions
A CA 19-9 test measures the amount of a protein called CA 19-9 (cancer antigen 19-9) in a sample of your blood. CA 19-9 is a type of tumor marker. Tumor markers are substances made by cancer cells or by normal cells in response to cancer in your body.
Healthy people can have small amounts of CA 19-9 in their blood. High levels of CA 19-9 are often a sign of pancreatic cancer. But high levels can also be a sign of other types of cancer or certain conditions that aren't cancer. For example, gallstones and cirrhosis of the liver can cause high CA 19-9 levels.
Because high levels of CA 19-9 can mean different things, the test is not used by itself to screen for or diagnose cancer or other diseases. But it can help monitor your cancer and check how well your treatment is working.
Other names: cancer antigen 19-9, carbohydrate antigen 19-9, CA 199 measurement, CA 19-9 radioimmunoassay (RIA)
CA 19-9 blood tests may be used to:
Monitor certain types of cancer and cancer treatment. CA 19-9 levels often go up as cancer grows and go down as tumors shrink.
Help predict how cancer may behave over time.
Check whether cancer has returned after treatment.
Help diagnose certain cancers and other diseases when used with other tests.
Some people do not make CA 19-9 even when they have a cancer that usually produces high levels of CA 19-9. For these people, a CA 19-9 tumor marker test is not useful.
You may need a CA 19-9 blood test if you've been diagnosed with pancreatic cancer or another type of cancer that causes high CA 19-9. These include cancers of the:
Bile duct
Colon and rectum
Stomach
Ovaries
Bladder
During cancer treatment, your health care provider may test you on a regular basis to see if your treatment is working.
After your treatment is complete, you may need to have CA 19-9 tests to check whether the cancer has come back. High levels of CA 19-9 may be one of the first signs that cancer cells are growing again.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
Usually, you don't need any special preparations for a CA 19-9 blood test. But ask your provider to be sure. If you take certain vitamins, you may need to stop them before the test.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
If you're being treated for cancer, you may be tested several times during your treatment. Your provider will look at all your test results to see how your CA 19-9 levels have changed. Your results may show:
Your levels of CA 19-9 are increasing. This may mean your tumor is growing, and/or your treatment is not working. More tests are usually needed to find out for sure.
Your levels of CA 19-9 are decreasing. This may mean your tumor is shrinking and your treatment is working.
Your levels of CA 19-9 have stayed the same. This may mean your disease is stable and hasn't gotten better or worse.
Your CA 19-9 levels decreased after treatment, but increased later. This may mean your cancer has come back or grown. You'll need more tests to check whether cancer is really causing the higher level of CA 19-9.
If you don't have cancer but your test results show a high level of CA 19-9, you may not a health problem that needs treatment. Healthy people can have high CA 19-9 levels. But high levels may be a sign of a condition, such as:
Pancreatitis, inflammation of the pancreas
Gallstones
Bile duct disease, including a blockage or infection
Liver disease
Cystic fibrosis
Talk with your provider about what your results may mean.
If your provider thinks you may have one of these conditions, you will probably need other tests to find out for sure.
Labs use different methods to measure the amount of CA 19-9 in your blood sample. The test method can affect your results. If you're having regular tests to monitor cancer, it's important to have your tests done the same way, and usually in the same lab. This allows your provider to compare your results over time. Your test report usually says what method was used to measure your CA 19-9 levels. If you have any questions about how your tests are done, talk with your provider.
CA 19-9 Blood Test (Pancreatic Cancer): MedlinePlus Lab Test Information [accessed on Nov 05, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (7)
Pancreatic Cancer
Pancreatic Cancer: In Situ : The summary staging system categorizes cancer (shown here in the pancreas) according to its spread. In situ cancer is present only in cells in which it began.
Image by TheVisualMD
Amylase, Pancreatic Cancer
Amylase is one of several enzymes produced by the pancreas and secreted into the digestive tract to help break down nutrients (amylase is also produced by the salivary glands). The enzyme is usually present in the blood and urine only in small quantities, but when pancreatic tissue is injured, inflamed (pancreatitis) or when the pancreatic duct is blocked or a tumor is present, amylase can leak into the blood and urine. As cancerous tissue overwhelms the pancreas, its function is compromised and enzyme levels fall.
Image by TheVisualMD
Sensitive content
This media may include sensitive content
Pancreas joined to the small bowel after pylorus preserving surgery for pancreatic cancer
Diagram showing the pancreas joined to the small bowel after pylorus preserving surgery for pancreatic cancer
Image by Cancer Research UK / Wikimedia Commons
Pancreatic Cancer
Cancer Types _ Pancreatic Cancer Cells or Tissue _ Abnormal Cells or Tissue
Image by Dr. Lance Liotta Laboratory _ NCI
Doctor explains Ca 19-9 blood test used in PANCREATIC CANCER | LAB TESTS explained
Video by Doctor O'Donovan/YouTube
Diagnosing Pancreatic Tumors and Cysts - Mayo Clinic
Video by Mayo Clinic/YouTube
T1 stage - the tumor is inside the pancreas and is 2cm or less in any direction.
T2 stage - the cancer is more than 2cm but no more than 4cm in size in any direction.
T3 stage - the cancer is more than 4cm in size.
T4 stage - the cancer has grown outside the pancreas, into the nearby large blood vessels.
Node (N) describes whether the cancer has spread to the lymph nodes. It is further divided into N0 and N1 stages.
Metastasis (M) describes whether the cancer has spread to a different part of the body. It is further divided into M0 and M1 stages.
1
2
3
4
5
6
TNM Staging for Pancreatic Cancer
TNM stands for Tumour, Node, Metastasis. This system describes the size of a primary tumour (T), whether there are lymph nodes with cancer cells in them (N) and whether the cancer has spread to a different part of the body (M).
Interactive by Cancer Research UK
Pancreatic Cancer
TheVisualMD
Amylase, Pancreatic Cancer
TheVisualMD
Sensitive content
This media may include sensitive content
Pancreas joined to the small bowel after pylorus preserving surgery for pancreatic cancer
Cancer Research UK / Wikimedia Commons
Pancreatic Cancer
Dr. Lance Liotta Laboratory _ NCI
5:17
Doctor explains Ca 19-9 blood test used in PANCREATIC CANCER | LAB TESTS explained
Doctor O'Donovan/YouTube
5:55
Diagnosing Pancreatic Tumors and Cysts - Mayo Clinic
Mayo Clinic/YouTube
TNM Staging for Pancreatic Cancer
Cancer Research UK
CEA Test
CEA Test
Also called: Carcinoembryonic Antigen, CEA Assay, CEA Tumor Marker
A CEA (carcinoembryonic antigen) test measures CEA in a sample of blood or other body fluid. It helps check if treatment for certain cancers is working. The test is most commonly used in colorectal cancer.
CEA Test
Also called: Carcinoembryonic Antigen, CEA Assay, CEA Tumor Marker
A CEA (carcinoembryonic antigen) test measures CEA in a sample of blood or other body fluid. It helps check if treatment for certain cancers is working. The test is most commonly used in colorectal cancer.
{"label":"CEA reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"N","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":3},"text":"CEA is normally found in small amounts in the blood. Most healthy non-smoking people (97%) have values < or =3.0 ng\/mL. Some smokers may have elevated CEA, usually <5.0 ng\/mL.","conditions":[]},{"flag":"borderline","label":{"short":"E","long":"Elevated","orientation":"horizontal"},"values":{"min":3,"max":5},"text":"Most healthy non-smoking people (97%) have values < or =3.0 ng\/mL. Some smokers may have elevated CEA, usually <5.0 ng\/mL.","conditions":[]},{"flag":"abnormal","label":{"short":"H","long":"High","orientation":"horizontal"},"values":{"min":5,"max":20},"text":"A high CEA level in a person recently treated for certain cancers may mean the cancer has returned.","conditions":["Colorectal cancer"]},{"flag":"abnormal","label":{"short":"VH","long":"Very high","orientation":"horizontal"},"values":{"min":20,"max":40},"text":"Highly elevated CEA concentrations (>20 ng\/mL) in a patient with compatible symptoms are strongly suggestive of the presence of cancer and also suggest metastasis.","conditions":["Colorectal cancer"]}],"units":[{"printSymbol":"ng\/mL","code":"ng\/mL","name":"nanogram per milliliter"}],"value":1.5,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"normal":0},{"borderline":0},{"abnormal":0},{"abnormal":1}]
Use the slider below to see how your results affect your
health.
ng/mL
3
5
20
Your result is Normal.
Related conditions
CEA stands for carcinoembryonic antigen. CEA is a protein that is a type of "tumor marker." Tumor markers are substances that are often made by cancer cells or by normal cells in response to cancer.
High levels of CEA are normal in healthy, unborn babies. After birth, CEA levels become very low or disappear completely. So, healthy adults should have little or no CEA in their bodies.
Cancers that may cause high levels of CEA include cancers of the:
Colon and rectum (colorectal or bowel cancer)
Prostate
Ovary
Lung
Thyroid
Liver
Pancreas
Breast
If you've been diagnosed with a cancer that can cause high CEA levels, CEA testing may help your health care provider learn more about your cancer and chance of recovery. The test is often used with other tests to check if cancer treatment is working.
CEA tests are not used to screen for or diagnose cancer. That's because:
Cancers that often cause high CEA levels don't always cause high levels. You can have normal CEA test results even though you have one of these cancers.
Many other health problems that aren't cancer can make CEA levels rise, including certain conditions that affect your liver, digestion, or breathing.
Most CEA tests use a sample of your blood to measure your CEA level. Sometimes the test uses a sample of fluid from your spine, chest, or abdomen (belly), but this is less common.
A CEA test is mostly used in people who have been diagnosed with cancers that often increase CEA levels. It's most commonly used in colorectal cancer. A provider may order a CEA test along with other tests to:
Learn more about a cancer soon after it has been diagnosed. CEA levels can help predict the likelihood of recovery and/or the chance that cancer will come back after treatment.
Check how well cancer treatment is working.
See if cancer has returned after treatment.
If you've been diagnosed with a type of cancer that can cause high CEA levels, you may need CEA testing:
Before treatment to:
Help understand how serious your cancer is.
Help guide treatment decisions.
Get a measurement of your CEA level before treatment to compare with CEA levels after treatment.
During cancer treatment to see if the treatment working.
After treatment to check whether cancer has come back. You may need to have tests on a regular schedule.
CEA is usually measured with a blood sample. During a CEA blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
Sometimes, CEA is tested in other body fluids. For these tests, your provider will remove a small sample of fluid using a thin needle.
For a CEA blood test, you usually don't need to prepare. If you smoke, you may need to stop for a while before your test. That's because smoking increases CEA levels.
A CEA blood test has very little risk. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
To understand your CEA test results, your provider will consider the results of other tests and exams. Ask your provider to explain what your test results mean for your health and treatment.
If you had a test before starting cancer treatment, in general:
A low level of CEAmay mean your tumor is small and the cancer has not spread to other parts of your body. But some cancers don't make much CEA, so your provider may use other tests to learn more about how much cancer you have and if it's spread.
A high level of CEAmay mean you have a larger tumor and/or your cancer has spread. You'll need other tests to confirm how serious your cancer is.
If you had a test to monitor your cancer during or after treatment, your provider will compare your current CEA test results with your past test results. In general:
Decreases in CEA over time often mean that treatment is working.
Increases in CEA or high levels that stay highmay mean that treatment isn't working. For example, if you had surgery for colorectal cancer, these levels may mean that the entire tumor wasn't removed or the cancer is growing back.
Decreases in CEA after treatment followed by increasesmay mean cancer has come back.
CEA levels that remain high or increase after treatment don't always mean that treatment isn't working, or cancer is growing. So, if your CEA levels don't come down, your provider will likely order other tests to find out why.
If you have questions about your results, talk with your provider.
Labs use different methods to measure CEA. The test method can affect your results. So, its best to have your tests done the same way, and usually in the same lab. This allows your provider to compare your results over time. If you have questions about how your tests are done, ask your provider.
CEA Test: MedlinePlus Medical Test [accessed on Mar 09, 2023]
https://www.cancer.gov/about-cancer/diagnosis-staging/diagnosis/tumor-markers-fact-sheet [accessed on Mar 13, 2019]
https://www.labcorp.com/test-menu/21906/carcinoembryonic-antigen-cea [accessed on Oct 03, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (20)
Carcinoembryonic Antigen (CEA): CEA in Colorectal Cancer Staging and Treatment
CEA tests are not used to screen for colorectal cancer, but they're frequently performed after the cancer has been diagnosed. CEA is useful in staging--performing tests to determine if the cancer has spread within the intestine or to distant parts of the body. CEA may also be used for treatment planning, as elevated levels may indicate a poorer prognosis. After surgery, CEA levels may be measured periodically to see if the cancer has spread. It is important to note that CEA is not a perfect predictor of how a patient will respond to treatment, nor is it conclusive in determining if cancer has spread. The American Society of Clinical Oncologists (ASCO) states that CEA should not be used as the sole basis for decision-making in colorectal cancer.
Image by TheVisualMD
Carcinoembryonic Antigen (CEA): CEA Testing During Chemotherapy
Whether CEA is tested during systemic treatment for colorectal cancer depends on the stage of the cancer. After surgery, the American Society of Clinical Oncologists (ASCO) recommends that patients with stage II or stage III cancer have a CEA test every 3 months, for a minimum of 3 years. However, if the patient is receiving chemotherapy, CEA testing should be delayed until after chemotherapy is completed. On the other hand, CEA is the marker of choice for monitoring stage IV (metastatic) colorectal cancer during systemic treatment. Patients with metastatic cancer, in which the cancer has spread to distant parts of the body, should have a CEA test every 1-3 months during chemotherapy to see if the treatment is working and whether the cancer is still spreading. ASCO recommends other tests be done in conjunction with the CEA tests.
Image by TheVisualMD
The Importance of Good Bowel Preparation During Colonoscopy
Video by Johns Hopkins Medicine/YouTube
Colon cancer: Essential facts
Video by Institute for Cancer Genetics and Informatics/YouTube
The Colon and Colon Cancer
Video by Armando Hasudungan/YouTube
Colon Cancer: Don't Ignore Your Symptoms
Video by American Cancer Society/YouTube
Colorectal Cancer Screening
Video by Mechanisms in Medicine/YouTube
This browser does not support the video element.
Treating Colon Cancer
This animation explains how colon cancer forms and how it can be treated through chemotherapy and surgery.
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Screening
Colorectal cancer is one of the few preventable forms of cancer thanks to effective screening. For many people, screening for colorectal cancer is an unpleasant thought, but knowing your options and taking a pro-active approach especially if you're over 50 can save your life. In this video, you can learn the "ins and outs" of colonoscopy, as well as learn about a new technique called virtual colonoscopy, which uses high-tech CT scans to screen the colon.
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 6
Colorectal Cancer Clip 6
Video by TheVisualMD
This browser does not support the video element.
Dr. O'Kieffe and patient on preparing for a colonoscopy
A recent colonoscopy patient and gastroenterologist Dr. Donald O'Kieffe of Metro Gastroenterology, Chevy Chase, MD, explain what's involved in the preparation for your screening.
Video by TheVisualMD
This browser does not support the video element.
Dr. Klein on who should be screened
Dr. Mark Klein, a radiologist and colorectal cancer screening specialist at Washington Radiology Associates in Washington, DC, discusses who should be screened for colorectal cancer, and when.
Video by TheVisualMD
Colon cancer staging
Colon cancer staging : After colon cancer has been diagnosed, the next step is to perform tests to determine if the cancer has spread within the intestine or to distant parts of the body. This is called staging. Staging helps the doctor to decide the most appropriate treatment for the cancer at its current stage.
Image by TheVisualMD
Colorectal Cancer Types of Surgery
Surgery is the main treatment for colorectal cancer. Polyps and very early stage cancers (Stage 0 and some early Stage I tumors) can be removed during a colonoscopy, using a variety of techniques. In late Stage I and in Stage II and III cancer, the cancerous part of the colon is removed surgically. The surgeon may perform a resection, consisting of a partial colectomy (removing the cancer and a small amount of healthy tissue around it) and an anastomosis (sewing the parts of the colon back together). Nearby lymph nodes may also be removed and biopsied. If it isn't possible to perform a resection (for instance, if the cancer is at the outlet of the rectum), a colostomy may be performed. In a colostomy, a portion of the large intestine is brought through the abdominal wall to carry stool out of the body, where it empties into a special bag. The colostomy may be temporary in order to allow the colon or rectum time to heal after surgery, or it may be permanent.
Image by TheVisualMD
Colon Anatomy & Function
Image by TheVisualMD
Colostomy
Colostomy Illustration
Image by Blausen.com staff. \"Blausen gallery 2014\". Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762
Colorectal Cancer
Colorectal cancer refers to cancer of the colon and cancer of the rectum. The colon is the longest part of the large intestine, and the rectum is the last several inches of the large intestine, closest to the anus.
Image by TheVisualMD
What Is Colorectal Cancer?
The process of cell growth in the body is normally an orderly one. Cells grow and divide as necessary to produce more cells as they are needed. Cells that are old or damaged die, and are replaced with new cells.
Image by TheVisualMD
Treating Colorectal Cancer
There are three main treatment options for colorectal cancer:
Image by TheVisualMD
Colorectal Cancer Spread to Body Stage 4
Cancer spreads in three ways: by invading surrounding tissue, by invading the lymph system and traveling through lymph vessels to other places in the body, and by invading veins and capillaries and traveling through the bloodstream to other places in the body. Stage IV: Cancer may have spread to nearby lymph nodes and has spread to other parts of the body, such as the liver or lungs. Stage IV colorectal cancer is not considered curable. Image 5 of 5.
Image by TheVisualMD
Carcinoembryonic Antigen (CEA): CEA in Colorectal Cancer Staging and Treatment
TheVisualMD
Carcinoembryonic Antigen (CEA): CEA Testing During Chemotherapy
TheVisualMD
1:23
The Importance of Good Bowel Preparation During Colonoscopy
Johns Hopkins Medicine/YouTube
2:49
Colon cancer: Essential facts
Institute for Cancer Genetics and Informatics/YouTube
10:05
The Colon and Colon Cancer
Armando Hasudungan/YouTube
6:06
Colon Cancer: Don't Ignore Your Symptoms
American Cancer Society/YouTube
2:42
Colorectal Cancer Screening
Mechanisms in Medicine/YouTube
3:45
Treating Colon Cancer
TheVisualMD
4:13
Colorectal Cancer Screening
TheVisualMD
0:05
Colorectal Cancer Clip 6
TheVisualMD
0:48
Dr. O'Kieffe and patient on preparing for a colonoscopy
Also called: PSA, Prostate-Specific Antigen, Total PSA
Prostate-specific antigen (PSA) test is a blood test that checks the level of PSA in the blood. PSA is a protein made by the prostate gland. The amount of PSA may be higher in men who have prostate cancer, benign prostatic hyperplasia (BPH), or infection or inflammation of the prostate.
Prostate-Specific Antigen (PSA) Test
Also called: PSA, Prostate-Specific Antigen, Total PSA
Prostate-specific antigen (PSA) test is a blood test that checks the level of PSA in the blood. PSA is a protein made by the prostate gland. The amount of PSA may be higher in men who have prostate cancer, benign prostatic hyperplasia (BPH), or infection or inflammation of the prostate.
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Use the slider below to see how your results affect your
health.
ng/mL
4
10
Your result is Normal.
PSA is always present in low concentrations in the blood of adult males. However, there is no specific normal or abnormal level of PSA in the blood, and levels may vary over time in the same man. Various factors can cause a man’s PSA level to fluctuate, such as inflammation, infections and medications among other factors.
Related conditions
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Use the slider below to see how your results affect your
health.
%
10
25
Your result is Lower risk.
When total PSA is in the range of 4.0-10.0 ng/mL and free PSA is above 25% it indicates a 9% to 16% risk of prostate cancer, depending on age. Studies have shown that men with a total PSA in this "gray area" and a free PSA greater than 25% are more likely to have a benign condition than to have cancer, making a biopsy unnecessary.
Related conditions
A prostate-specific antigen (PSA) test is a blood test that measures the level of PSA in a sample of your blood. PSA is a protein made by your prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes the fluid part of semen.
It's normal to have a low level of PSA in your blood. A high PSA level may be caused by:
Prostate cancer
An enlarged prostate (BPH) (benign prostatic hyperplasia)
Other common prostate problems
Taking certain medicines
A PSA test can't show what is causing abnormal PSA levels. So, if your level is high, you may need other tests.
Other names: total PSA free PSA
A PSA test is used to screen for prostate cancer. Cancer screening means looking for signs of cancer before it causes symptoms. But screening tests can't diagnose cancer. If a screening test finds signs of cancer, you'll need other tests to find out if you have cancer and how serious it may be.
Most types of prostate cancer grow very slowly. They don't spread beyond the prostate and may never cause health problems. In fact, you can live a long life with prostate cancer and never know you have it. The goal of prostate cancer screening is to help find cancers that may be more likely to spread so they can be treated early. But there are challenges and possible harms from using a PSA test to screen for prostate cancer:
A PSA test can't tell the different between abnormal PSA levels from prostate cancer and noncancerous conditions. If your PSA level is high, a prostate biopsy is the only way to find out if the cause is cancer. And prostate biopsies have possible harms.
A PSA test may lead to finding and treating prostate cancer that would never have affected your health. If prostate cancer is found:
It can be difficult to tell the difference between slow-growing cancers and those that are likely to grow faster and spread in your body.
You could have prostate cancer treatment that you never really needed. And cancer treatment may cause serious harms, such as:
Erectile dysfunction
Urinary incontinence
Problems controlling your bowels (poop)
To decide whether a PSA test to screen for prostate cancer is right for you, talk with your health care provider about:
Your risk for developing a serious type of prostate cancer. If your risk is high, the possible benefits of finding cancer early may outweigh the possible harms.
Your general health. Are you well enough to have treatment for prostate cancer if it's found?
Your preferences. How do you feel about the possible benefits and harms of screening, diagnosis, and treatment?
PSA testing may also be used to:
Help diagnose the cause of prostate conditions that aren't cancer
Monitor treatment for a prostate condition, including cancer
It's your choice whether to have a PSA test to screen for cancer. You and your prover may consider your risk for developing a serious cancer that could spread if you don't catch it early. Your risk for serious prostate cancer may be higher depending on your:
Age. The risk of prostate cancer increases after age 50.
Your family health history. If members of your family have had prostate cancer, your risk may be higher.
Your race. Prostate cancer is more common in African Americans. They also have a higher risk of developing prostate cancer at a younger age and having more serious disease.
You may also have a PSA test if:
You have symptoms of a prostate condition, such as:
Painful or frequent urination (peeing)
Blood in urine or semen
Pelvic and/or back pain
You have prostate cancer. Your provider may use PSA testing to monitor your condition or to see how well treatment is working.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You will need to avoid having sex or masturbating for 24 hours before your PSA test. That's because releasing semen can increase your PSA levels, which may make your results less accurate. Also, certain medicines may affect your test results, so tell your provider about any medicines you take.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
There is no specific normal or abnormal level for PSA in blood. In general, the higher your PSA level, the more likely it is that you have cancer. But it's possible to have a high PSA without prostate cancer, or a low PSA with prostate cancer.
If you had a PSA test for a prostate cancer screening or because you have prostate symptoms:
High PSA levels can mean you have prostate cancer or a prostate condition that's not cancer, such as an infection (prostatitis) or an enlarged prostate. If your PSA levels are higher than normal, your provider may talk with you about having more tests to diagnose the cause. These tests may include:
Another PSA test, more commonly if you don't have any symptoms. PSA levels can go up and down, so it helpful to see if your PSA levels change over time.
A digital rectal exam (DRE). For this test, your provider inserts a gloved, lubricated finger into your rectum to feel your prostate for lumps or anything unusual.
A urine test. A sample of your urine is tested for infection.
A prostate biopsy. A biopsy is minor surgery. A doctor removes samples of tissue from your prostate so it can be studied under a microscope to look for cancer cells. A biopsy is the only way to diagnose cancer. It may be recommended if your provider thinks you may have prostate cancer.
If you had a PSA test to monitor prostate cancer or treatment, ask your provider what a high PSA level means. Your provider will usually look at several tests results over time to get a fuller understanding of your condition.
If you have questions about your results, talk with your provider.
Prostate-Specific Antigen (PSA) Test: MedlinePlus Lab Test Information [accessed on Feb 29, 2024]
Prostate-specific antigen (PSA) blood test: MedlinePlus Medical Encyclopedia [accessed on Oct 03, 2018]
Prostate-Specific Antigen (PSA) Test - National Cancer Institute [accessed on Oct 03, 2018]
PSA - Clinical: Prostate-Specific Antigen (PSA) Diagnostic, Serum [accessed on Oct 03, 2018]
PSA. Lab Tests Online. [accessed on Oct 03, 2018]
010322: Prostate-specific Antigen (PSA) | LabCorp [accessed on Oct 03, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (29)
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Prostate Gland
Prostate Description Line drawing showing lateral view of the prostate gland, rectum, bladder, penis and testis.
Image by National Cancer Institute
Normal vs enlarged prostate
BPH - Prostate enlargement problems
Image by Akcmdu9
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What Is Prostate Cancer?
Delve into the prostate, understand this complex disease found in men that is challenging to diagnose and witness a cutting edge procedure that may change how prostate cancer is diagnosed in the future.
Video by TheVisualMD
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Prostate Cancer Treatment
Once someone is diagnosed with prostate cancer, the patient and his doctors decide a course of action, and create a treatment plan. Very often with prostate cancer, that means simply keeping an eye on the progression of the disease. Here, top doctors lay out the most common prostate cancer treatment options, explain the tools and methods used as well as the risk factors involved.
Video by TheVisualMD
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Standard Biopsy for Prostate Cancer
National Cancer Institute urologist and surgeon Dr. Peter Pinto explains the process of the standard multi-core or "blind" biopsy of the prostate.
Video by TheVisualMD
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Visualizing the Prostate
Unlike for many other cancers, there are no standardized imaging protocols, apart from the use of transrectal ultrasound (TRUS), for the early detection and diagnosis of prostate cancer. This is a critical need. Prostate cancer is a disease for which it is crucial to detect and diagnose cancers early and accurately, both because early prostate cancer is usually without symptoms and because treatment side effects can be severe. Fortunately, new technologies are currently being developed, and even being used in some medical facilities, with promising results. By providing more specific and accurate detection and diagnosis results, these more sophisticated forms of prostate imaging and analysis will help in detecting early cancers, and in making the decision of whether to treat for prostate cancer when abnormalities are detected.
Video by TheVisualMD
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Moving Forward with Prostate Imaging
Unlike for many other cancers, there are no standardized imaging protocols, apart from the use of transrectal ultrasound (TRUS), for the early detection and diagnosis of prostate cancer. This is a critical need. Prostate cancer is a disease for which it is crucial to detect and diagnose cancers early and accurately, both because early prostate cancer is usually without symptoms and because treatment side effects can be severe. Fortunately, new technologies are currently being developed, and even being used in some medical facilities, with promising results. By providing more specific and accurate detection and diagnosis results, these more sophisticated forms of prostate imaging and analysis will help in detecting early cancers, and in making the decision of whether to treat for prostate cancer when abnormalities are detected.
Video by TheVisualMD
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Prostate Cancer Prognosis
A cancer's stage (how far it has progressed) is a very important factor in deciding on treatment and estimating the patient's prognosis. After biopsy confirms the presence of cancer in the prostate, the cancer is staged, meaning that more tests are done to find out how far the cancer has spread in the prostate and if it has spread outside the gland to adjacent tissues or to other sites in the body.
Video by TheVisualMD
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Risks of Overdiagnosis of Prostate Cancer
University of Chicago Hospital radiologist Dr. Aytekin Oto talks about the challenge that doctors face in treating less aggressive forms of prostate cancer.
Video by TheVisualMD
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Risks of Treatment for Prostate Cancer
Prostate cancer patients are likely to have a number of treatment options to choose from. If you have prostate cancer, you may feel pressured to make a decision quickly. But take the time to learn as much as you can about prostate cancer, your prognosis, and the treatments that are appropriate for your case. Talk to your doctor and, preferably, get a second opinion as well. Bear in mind that a surgeon may tend to recommend surgery and a radiation oncologist to recommend radiation therapy. Consider your own feelings about these treatments and their possible side effects.
Video by TheVisualMD
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Treatment Options for Prostate Cancer
Prostate cancer patients are likely to have a number of treatment options to choose from. If you have prostate cancer, you may feel pressured to make a decision quickly. But take the time to learn as much as you can about prostate cancer, your prognosis, and the treatments that are appropriate for your case. Talk to your doctor and, preferably, get a second opinion as well. Bear in mind that a surgeon may tend to recommend surgery and a radiation oncologist to recommend radiation therapy. Consider your own feelings about these treatments and their possible side effects.
Video by TheVisualMD
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MRI for Prostate Cancer
A cancer's stage (how far it has progressed) is a very important factor in deciding on treatment and estimating the patient's prognosis. After biopsy confirms the presence of cancer in the prostate, the cancer is staged, meaning that more tests are done to find out how far the cancer has spread in the prostate and if it has spread outside the gland to adjacent tissues or to other sites in the body.
Video by TheVisualMD
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PET/CT for Prostate Cancer
A cancer's stage (how far it has progressed) is a very important factor in deciding on treatment and estimating the patient's prognosis. After biopsy confirms the presence of cancer in the prostate, the cancer is staged, meaning that more tests are done to find out how far the cancer has spread in the prostate and if it has spread outside the gland to adjacent tissues or to other sites in the body.
Video by TheVisualMD
Prostate Anatomy by Zones with insets
Prostate cancer usually starts in certain zones of the prostate. Knowledge of these different zones helps the doctor to decide where to biopsy tissue and where to look for cancer spread. In this image, the central zone is shown as orange, the transition zone is shown as green, and the peripheral zone is shown as yellow.
Image by TheVisualMD
Prostate Gland Zones
The prostate gland is a small gland that sits below the bladder (the gland lies close to the wall of the rectum, which allows it to be felt in a digital rectal exam). The prostate gland can be divided up in two different ways, by lobes or zones; there are four lobes and five zones. The zone system of classification is used mostly for pathology; the largest zone, the peripheral zone, comprises about three-quarters of the prostate and is where most cancer occurs.
Image by TheVisualMD
Prostate Gland and Seminal Vesicle
Visualization reconstructed from scanned human data of a posterior view of the prostate gland, seminal vesicles, ductus deferens and Cowper's glands. The ductus deferens joins with the seminal vesicles to form the ejaculatory duct. The seminal vesicles act to secrete a thick alkaline fluid that mixes with the sperm as it passes into the ejaculatory ducts and the urethra. The prostate gland secretes a lubricant that helps to prevent infection in the urethra and protects and energizes sperm. The Cowper's gland produces a lubricating fluid which is secreted into the urethra.
Image by TheVisualMD
Male Reproductive System Showing Prostate Cancer
Three-dimensional visualization reconstructed from scanned human data. Lateral cross-section of an enlarged cancerous prostate, as well as bladder, penis, and testicles. Prostate cancer is the leading cause of cancer death in men over the age of 75 and the third leading cause of cancer death in men of all ages. Prostate enlargement in older men is usually benign but can be monitored for malignancy through the use of a blood test for prostate specific antigen (PSA) as well as through more invasive exams such as transrectal ultrasound and tranperineal biospy. Early cancers are sometimes treated with removal of the prostate while late-stage cancers are often treated with hormone and/or radiation therapy in combination with removal of the testicles (orchidectomy) to lower the level of testosterone and decrease cell growth. 2 of 2.
Image by TheVisualMD
Prostate Gland
Visualization of the prostate gland. The prostate gland is the largest accessory gland of the male reproductive system. Two thirds of the prostate is glandular while the remaining third is fibromuscular. Prostatic secretions help to prevent infection in the urethra, energizes sperm and keep the urethral lining moist.
Image by TheVisualMD
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Male Reproductive System
Three-dimensional visualization reconstructed from scanned human data. Lateral cross-section of a healthy, normal prostate, as well as bladder, penis, and testicles. Prostate cancer is the leading cause of cancer death in men over the age of 75 and the third leading cause of cancer death in men of all ages. Prostate enlargement in older men is usually benign (noncancerous) but can be monitored for malignancy through the use of a blood test for prostate specific antigen (PSA) as well as through more invasive exams such as transrectal ultrasound and tranperineal biospy. Early cancers are sometimes treated with removal of the prostate while late-stage cancers are often treated by hormone and/or radiation therapy in combination with removal of the testicles (orchidectomy) to lower the level of testosterone and decrease cell growth. 1 of 2.
Image by TheVisualMD
What Is Prostate Cancer?
Image by TheVisualMD
Prostate Cancer Symptoms
Image by TheVisualMD
Prostate Function
Image by TheVisualMD
Prostate Cancer Grading with Gleason Scale
After biopsy, cancer cells are graded
Image by TheVisualMD
Risk Factors for Prostate Cancer
Some risk factors for prostate cancer are controllable, some aren't. Knowing what the risk factors are can help you to lower your chances of getting prostate cancer and to make decisions about beginning screening. Every man should talk with his general practitioner or urologist and discuss the benefits and shortcomings of PSA screening and whether to have it. Risk factors for prostate cancer include: AGE Risk increases dramatically after age 50. RACE Men of African descent are at higher risk. LIFESTYLE Men in North America and northwestern Europe have an increased risk. FAMILY HISTORY Having a brother or father who has the disease raises risk. GENETICS Some genes have been linked to prostate cancer. DIET High-fat diet increases the chances of getting prostate cancer. HORMONES High levels of testosterone can cause or accelerate the disease.
Image by TheVisualMD
Prostate Cancer Symptoms
Prostate cancer usually causes no symptoms in its early stages. Often there are no symptoms until the disease has spread beyond the prostate gland. Symptoms of advanced prostate cancer can include: 1) blood in the urine or semen, 2) difficulty, pain, or frequency in urinating, 3) pain in the lower back, pelvis, hips, or thigh bones, 4) compression of the spine, 5) pain with ejaculation, and 6) anemia and fatigue.
Image by TheVisualMD
Prostate Gland
Prostate and Seminal Vesicles sagittal and axial slices : Derived from magnetic resonance imaging (MRI) data, the axial and sagittal slices (cross sections) through the prostate reveal the glandular tissue of the prostate as well as the ejaculatory ducts and the urethra. The inner coils of the seminal vesicles are also visible within the slices. Seminal fluid from the seminal vesicles mixes with sperm from the testes, via the ductus deferens, within the ejaculatory duct. The contents of the ejaculatory duct are then deposited into the urethra. There prostatic fluid is added to the mix along with contributions from the bulbourethral glands, forming semen. The prostatic urethra most often carries urine from the bladder and through the prostate.
Image by TheVisualMD
Side Effects of Treatment for Prostate Cancer
The side effects of prostate cancer treatment can be severe and sometimes permanent. They include impotence, incontinence, bleeding, and nerve damage.
Image by TheVisualMD
Prostate Gland
MRI Slices of the Prostate : Radiologists view different cross-sectional slices of the prostate, including the sagittal and axial slices, in order to detect any abnormalities.
Image by TheVisualMD
Decipher Test for Prostate Cancer Recurrence
Range of scores for the Decipher test showing low, intermediate, and high risk of prostate cancer metastasis. By estimating the future risk of prostate cancer spread and death, the Decipher test could help patients and their doctors make treatment decisions.
Image by National Cancer Institute (NCI)
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Prostate Gland
National Cancer Institute
Normal vs enlarged prostate
Akcmdu9
4:26
What Is Prostate Cancer?
TheVisualMD
2:35
Prostate Cancer Treatment
TheVisualMD
0:51
Standard Biopsy for Prostate Cancer
TheVisualMD
1:00
Visualizing the Prostate
TheVisualMD
0:34
Moving Forward with Prostate Imaging
TheVisualMD
0:39
Prostate Cancer Prognosis
TheVisualMD
0:40
Risks of Overdiagnosis of Prostate Cancer
TheVisualMD
0:42
Risks of Treatment for Prostate Cancer
TheVisualMD
0:33
Treatment Options for Prostate Cancer
TheVisualMD
0:27
MRI for Prostate Cancer
TheVisualMD
0:33
PET/CT for Prostate Cancer
TheVisualMD
Prostate Anatomy by Zones with insets
TheVisualMD
Prostate Gland Zones
TheVisualMD
Prostate Gland and Seminal Vesicle
TheVisualMD
Male Reproductive System Showing Prostate Cancer
TheVisualMD
Prostate Gland
TheVisualMD
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Male Reproductive System
TheVisualMD
What Is Prostate Cancer?
TheVisualMD
Prostate Cancer Symptoms
TheVisualMD
Prostate Function
TheVisualMD
Prostate Cancer Grading with Gleason Scale
TheVisualMD
Risk Factors for Prostate Cancer
TheVisualMD
Prostate Cancer Symptoms
TheVisualMD
Prostate Gland
TheVisualMD
Side Effects of Treatment for Prostate Cancer
TheVisualMD
Prostate Gland
TheVisualMD
Decipher Test for Prostate Cancer Recurrence
National Cancer Institute (NCI)
Staging
Stage 1 - the earliest stage of cancer when the tumor is only in the womb (uterus).
Stage 2 - the tumor has spread outside the womb to genital areas nearby, such as the vagina or ovary. It has not spread outside the pelvis.
Stage 3 - the cancer has spread to the lungs and may or may not be in the local area around the womb.
Stage 4 - the abnormal cells have spread (metastasised) to other parts of the body, such as the liver or brain.
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FIGO Staging System for Persistent Trophoblastic Disease (PTD) and Choriocarcinoma
Interactive by Cancer Research UK
Stage 1 - the earliest stage of cancer when the tumor is only in the womb (uterus).
Stage 2 - the tumor has spread outside the womb to genital areas nearby, such as the vagina or ovary. It has not spread outside the pelvis.
Stage 3 - the cancer has spread to the lungs and may or may not be in the local area around the womb.
Stage 4 - the abnormal cells have spread (metastasised) to other parts of the body, such as the liver or brain.
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FIGO Staging System for Persistent Trophoblastic Disease (PTD) and Choriocarcinoma
The staging system used for persistent trophoblastic disease and choriocarcinoma is called the FIGO staging system. This system looks at the stage of disease. It also scores various risk factors to work out which treatment you need. There are 4 main stages.
Interactive by Cancer Research UK
Stages of Gestational Trophoblastic Tumors and Neoplasia
After gestational trophoblastic neoplasia has been diagnosed, tests are done to find out if cancer has spread from where it started to other parts of the body.
The process used to find out the extent or spread of cancer is called staging. The information gathered from the staging process helps determine the stage of disease. For GTN, stage is one of the factors used to plan treatment.
The following tests and procedures may be done to help find out the stage of the disease:
Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body onto film, making pictures of areas inside the body.
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
MRI (magnetic resonance imaging) with gadolinium: A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, such as brain and spinal cord. A substance called gadolinium is injected into a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).
Lumbar puncture: A procedure used to collect cerebrospinal fluid (CSF) from the spinal column. This is done by placing a needle between two bones in the spine and into the CSF around the spinal cord and removing a sample of the fluid. The sample of CSF is checked under a microscope for signs that the cancer has spread to the brain and spinal cord. This procedure is also called an LP or spinal tap.
There are three ways that cancer spreads in the body.
Cancer can spread through tissue, the lymph system, and the blood:
Tissue. The cancer spreads from where it began by growing into nearby areas.
Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if choriocarcinoma spreads to the lung, the cancer cells in the lung are actually choriocarcinoma cells. The disease is metastatic choriocarcinoma, not lung cancer.
Many cancer deaths are caused when cancer moves from the original tumor and spreads to other tissues and organs. This is called metastatic cancer. This animation shows how cancer cells travel from the place in the body where they first formed to other parts of the body.
There is no staging system for hydatidiform moles.
Hydatidiform moles (HM) are found in the uterus only and do not spread to other parts of the body.
The following stages are used for GTN:
Stage I
In stage I, the tumor is in the uterus only.
Stage II
In stage II, cancer has spread outside of the uterus to the ovary, fallopian tube, vagina, and/or the ligaments that support the uterus.
Stage III
In stage III, cancer has spread to the lung.
Stage IV
In stage IV, cancer has spread to distant parts of the body other than the lungs.
The treatment of gestational trophoblastic neoplasia is based on the type of disease, stage, or risk group.
Invasive moles and choriocarcinomas are treated based on risk groups. The stage of the invasive mole or choriocarcinoma is one factor used to determine risk group. Other factors include the following:
The age of the patient when the diagnosis is made.
Whether the GTN occurred after a molar pregnancy, miscarriage, or normal pregnancy.
How soon the tumor was diagnosed after the pregnancy began.
The level of beta human chorionic gonadotropin (β-hCG) in the blood.
The size of the largest tumor.
Where the tumor has spread to and the number of tumors in the body.
How many chemotherapy drugs the tumor has been treated with (for recurrent or resistant tumors).
There are two risk groups for invasive moles and choriocarcinomas: low risk and high risk. Patients with low-risk disease usually receive less aggressive treatment than patients with high-risk disease.
Placental-site trophoblastic tumor (PSTT) and epithelioid trophoblastic tumor (ETT) treatments depend on the stage of disease.
Source: National Cancer Institute (NCI)
Additional Materials (3)
Metastasis: How Cancer Spreads
Video by National Cancer Institute/YouTube
The Staging and Grading of Cancer
Video by Learn Oncology/YouTube
What is cancer staging and how does it work?
Video by Cancer Treatment Centers of America - CTCA/YouTube
1:49
Metastasis: How Cancer Spreads
National Cancer Institute/YouTube
5:40
The Staging and Grading of Cancer
Learn Oncology/YouTube
3:59
What is cancer staging and how does it work?
Cancer Treatment Centers of America - CTCA/YouTube
Recurrent and Resistant Gestational Trophoblastic Neoplasia
Establishing New Life
Image by TheVisualMD
Establishing New Life
From conception to birth, the mother-fetal bond is biologically indivisible. The communication between the mother’s body and the genetically distinct fetus begins with a physiological negotiation that prevents the rejection of the embryo as foreign tissue. The biological conversation that ensues for 9 months will be marked by tremendous complexity and subtle coordination.
Image by TheVisualMD
Recurrent and Resistant Gestational Trophoblastic Neoplasia
Recurrent gestational trophoblastic neoplasia (GTN) is cancer that has recurred (come back) after it has been treated. The cancer may come back in the uterus or in other parts of the body.
Gestational trophoblastic neoplasia that does not respond to treatment is called resistant GTN.
Association of Professors of Gynecology and Obstetrics (APGO)/YouTube
Treatment
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How is a hysterectomy performed?
Image by Cancer Research UK / Wikimedia Commons
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How is a hysterectomy performed?
Diagram showing keyhole hysterectomy.
Image by Cancer Research UK / Wikimedia Commons
Treatment Option Overview for Gestational Trophoblastic Disease
There are different types of treatment for patients with gestational trophoblastic disease.
Different types of treatment are available for patients with gestational trophoblastic disease. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI website. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.
Three types of standard treatment are used:
Surgery
The doctor may remove the cancer using one of the following operations:
Dilatation and curettage (D&C) with suction evacuation: A surgical procedure to remove abnormal tissue and parts of the inner lining of the uterus. The cervix is dilated and the material inside the uterus is removed with a small vacuum-like device. The walls of the uterus are then gently scraped with a curette (spoon-shaped instrument) to remove any material that may remain in the uterus. This procedure may be used for molar pregnancies.Dilatation and curettage (D and C). A speculum is inserted into the vagina to widen it in order to look at the cervix (first panel). A dilator is used to widen the cervix (middle panel). A curette is put through the cervix into the uterus to scrape out abnormal tissue (last panel).
Hysterectomy: Surgery to remove the uterus, and sometimes the cervix. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision (cut) in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision (cut) in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.Hysterectomy. The uterus is surgically removed with or without other organs or tissues. In a total hysterectomy, the uterus and cervix are removed. In a total hysterectomy with salpingo-oophorectomy, (a) the uterus plus one (unilateral) ovary and fallopian tube are removed; or (b) the uterus plus both (bilateral) ovaries and fallopian tubes are removed. In a radical hysterectomy, the uterus, cervix, both ovaries, both fallopian tubes, and nearby tissue are removed. These procedures are done using a low transverse incision or a vertical incision.
After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated, or whether the tumor is low-risk or high-risk.
Combination chemotherapy is treatment using more than one anticancer drug.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
External radiation therapy uses a machine outside the body to send radiation toward the cancer.
Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
The way the radiation therapy is given depends on the type of gestational trophoblastic disease being treated. External radiation therapy is used to treat gestational trophoblastic disease.
New types of treatment are being tested in clinical trials.
Information about ongoing clinical trials is available from the NCI website.
Treatment for gestational trophoblastic disease may cause side effects.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Blood levels of beta human chorionic gonadotropin (β-hCG) will be checked for up to 6 months after treatment has ended. This is because a β-hCG level that is higher than normal may mean that the tumor has not responded to treatment or it has become cancer.
Source: National Cancer Institute (NCI)
Additional Materials (7)
Dilation and Curettage D & C Surgery PreOp® Patient Engagement and Education
Video by PreOp.com Patient Engagement - Patient Education/YouTube
Dilation and Curettage (D&C) — AMITA Health Women’s Health Institute
Video by AMITA Health/YouTube
What should I expect after a D & C (Dilation and Curettage)?
Video by IntermountainMoms/YouTube
How abdominal hysterectomy is carried out
Video by Bupa Health UK/YouTube
Laparoscopic Hysterectomy
Video by Lee Health/YouTube
What to Expect During a Hysterectomy - Jeffrey Stearnes, MD, CHI Health
Video by CHI Health/YouTube
Hysterectomy Removal of the Uterus PreOp® Patient Education Feature
Video by PreOp.com Patient Engagement - Patient Education/YouTube
3:12
Dilation and Curettage D & C Surgery PreOp® Patient Engagement and Education
An illustration of the dilation and curettage medical procedure.
Image by Fred the Oyster
How Are Hydatidiform Moles Treated?
Treatment of a hydatidiform mole may include the following:
Surgery (Dilatation and curettage with suction evacuation) to remove the tumor.
After surgery, beta human chorionic gonadotropin (β-hCG) blood tests are done every week until the β-hCG level returns to normal. Patients also have follow-up doctor visits monthly for up to 6 months. If the level of β-hCG does not return to normal or increases, it may mean the hydatidiform mole was not completely removed and it has become cancer. Pregnancy causes β-hCG levels to increase, so your doctor will ask you not to become pregnant until follow-up is finished.
For disease that remains after surgery, treatment is usually chemotherapy.
Source: National Cancer Institute (NCI)
Additional Materials (2)
Dilation and Curettage | D & C Surgery | PreOp® Patient Education
Video by PreOp.com Patient Engagement - Patient Education/YouTube
PreOp® Patient Education: Dilation and Curettage D and C pt2
Video by PreOp.com Patient Engagement - Patient Education/YouTube
2:47
Dilation and Curettage | D & C Surgery | PreOp® Patient Education
How Is Gestational Trophoblastic Neoplasia Treated?
Complete Hydatidiform Mole
Image by euthman
Complete Hydatidiform Mole
A rare hysterectomy specimen with a complete mole. Formalin-fixed. Water immersion gross photograph.
Image by euthman
How Is Gestational Trophoblastic Neoplasia Treated?
Low-risk Gestational Trophoblastic Neoplasia
Treatment of low-risk gestational trophoblastic neoplasia (GTN) (invasive mole or choriocarcinoma) may include the following:
Chemotherapy with one or more anticancer drugs. Treatment is given until the beta human chorionic gonadotropin (β-hCG) level is normal for at least 3 weeks after treatment ends.
If the level of β-hCG in the blood does not return to normal or the tumor spreads to distant parts of the body, chemotherapy regimens used for high-risk metastatic GTN are given.
Treatment of high-risk metastatic gestational trophoblastic neoplasia (invasive mole or choriocarcinoma) may include the following:
Combination chemotherapy.
Intrathecal chemotherapy and radiation therapy to the brain (for cancer that has spread to the lung, to keep it from spreading to the brain).
High-dose chemotherapy or intrathecal chemotherapy and/or radiation therapy to the brain (for cancer that has spread to the brain).
Placental-Site Gestational Trophoblastic Tumors and Epithelioid Trophoblastic Tumors
Treatment of stage I placental-site gestational trophoblastic tumors and epithelioid trophoblastic tumors may include the following:
Surgery to remove the uterus.
Treatment of stage II placental-site gestational trophoblastic tumors and epithelioid trophoblastic tumors may include the following:
Surgery to remove the tumor, which may be followed by combination chemotherapy.
Treatment of stage III and IV placental-site gestational trophoblastic tumors and epithelioid trophoblastic tumors may include following:
Combination chemotherapy.
Surgery to remove cancer that has spread to other places, such as the lung or abdomen.
Recurrent or Resistant Gestational Trophoblastic Neoplasia
Treatment of recurrent or resistant gestational trophoblastic tumor may include the following:
Chemotherapy with one or more anticancer drugs for tumors previously treated with surgery.
Combination chemotherapy for tumors previously treated with chemotherapy.
Surgery for tumors that do not respond to chemotherapy.
Source: National Cancer Institute (NCI)
Additional Materials (4)
What to Expect During Chemotherapy
Video by Maimonides Medical Center/YouTube
Chemotherapy Side Effects
Video by Epworth HealthCare/YouTube
What is Chemotherapy Like? | Cancer Research UK
Video by Cancer Research UK/YouTube
Understanding Chemotherapy - Jumo Health
Video by Jumo Health/YouTube
6:09
What to Expect During Chemotherapy
Maimonides Medical Center/YouTube
16:56
Chemotherapy Side Effects
Epworth HealthCare/YouTube
2:56
What is Chemotherapy Like? | Cancer Research UK
Cancer Research UK/YouTube
13:11
Understanding Chemotherapy - Jumo Health
Jumo Health/YouTube
Prognosis
Germ Layers
Image by CNX Openstax
Germ Layers
Formation of the three primary germ layers occurs during the first 2 weeks of development. The embryo at this stage is only a few millimeters in length.
Image by CNX Openstax
What Affects the Long-Term Outlook for People with Gestational Trophoblastic Disease?
Certain factors affect prognosis (chance of recovery) and treatment options.
Gestational trophoblastic disease usually can be cured. Treatment and prognosis depend on the following:
The type of GTD.
Whether the tumor has spread to the uterus, lymph nodes, or distant parts of the body.
The number of tumors and where they are in the body.
The size of the largest tumor.
The level of β-hCG in the blood.
How soon the tumor was diagnosed after the pregnancy began.
Whether GTD occurred after a molar pregnancy, miscarriage, or normal pregnancy.
Previous treatment for gestational trophoblastic neoplasia.
Treatment options also depend on whether the woman wishes to become pregnant in the future.
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Gestational Trophoblastic Disease
Gestational trophoblastic disease (GTD) is a general term for rare tumors that form from the tissues surrounding fertilized egg. GTD is often found early and usually cured. Hydatidiform mole (HM) is the most common type of GTD. Learn more about GTD risk factors, symptoms and treatment.