Editorial
Open Access
Preventive Medicine using Impedimetric Biosensors:
Early Detection of Cancer
Mustafa Yuksel1, Oguz Hanoglu2 and Mustafa Yavuz3*
1Turgut Ozal University, School of Health, Department of Audiology, Ankara 06800, Turkey
2Istanbul Kemerburgaz University, Computer Engineering, 34217, Istanbul, Turkey
3Waterloo Institute for Nanotechnology (WIN), University of Waterloo, Canada
*Corresponding author: Mustafa Yavuz, Waterloo Institute for Nanotechnology (WIN), University of Waterloo, ON, Canada, Tel: +1-519-888-
4567; email:
@
Received: October 04, 2015; Accepted: October 06, 2015; Published: October 09, 2015
As known, cancer is a highly specific disease, causing genetic
alternations, and resulting in cells to divide without control, and
spreading into other tissues and organs. Despite the vast amount
of on-going research to find a hope, cancer is still a leading cause
of death in today's world. It has been reported that: a total of
1,596,670 new cases of cancer with 571,950 projected deaths
for the year 2011 in the United States alone [1]. Worldwide,
12.5-13 % of the deaths are caused by cancer, more than the
total percentage of deaths from AIDS, malaria and tuberculosis
combined. It has been reported that 7.6 million people died
because of cancer in 2008. Although, the overall number of
cancer patients and those dying from the disease have declined
over the past decade, cancer still continues to be a major threat
with over 11 million projected deaths worldwide in 2030 [2,3].
Unfortunately, current technology on cancer diagnosis and
treatment is unable to help millions of cancer patients who
are looking for a hope [3-5]. According to the World Health
Organization (WHO), existing modalities for cancer management
can prevent only up to one-third of new cancer cases. The rest
two-third needs to be dealt with strategies that integrate early
detection with effective treatment measures [6]. Cancer is an
uncontrolled and abnormal cell growth that leads to the formation
of a tumor mass. This tumor progresses and over time it turns out
to a fatal risk by spreading to the other parts of the body. This is
called metastasis. After metastasis, it is very difficult to remove
cancer cells from the body and cure the cancer patient [4]. This
is the reason why early cancer detection is extremely important
to deal with it. Figure 1.1 illustrates the incidence and mortality
numbers worldwide in the year 2008. The numbers are given for
the five cancer diseases (pancreas, liver, lung, oesophagus and
gallbladder) with the highest mortality/incidence rates. Pancreas
cancer, for example, has the rate of 95.7% which indicates how
helpless we are in treating this cancer.
According to the US National Cancer Institute, nanotechnology
promises to achieve significant breakthroughs in the fields of
cancer diagnosis, treatment and prevention. Nanoscale objects
such as nanoparticles and quantum dots are smaller than the

Figure 1: (A) Incidence and mortality numbers of the five cancer diseases
with highest mortality/incidence rates in 2008 [2].
human cells (5-10 μm in diameter) and can readily interact
with biomolecules on both the cell surface and within the cell.
These molecular level interactions provide useful information
for monitoring complex cellular processes including the onset
of biomolecular transformations leading towards cancer
metastasis. The surface of nanoparticles can be modified with
appropriate ligands to target tumor cells with high specificity and
affinity and are used extensively for delivering therapeutic drugs
and imaging contrast agents to the cancer cells while sparing the
normal healthy cells. Surface modifications render nanoparticles
biocompatible and reduce toxicity levels, which is crucial for in
vivo applications. Applications of nanotechnology for cancer
management involve the use of nanoparticles for detecting cancer
at its earliest stages, precisely locating its position within the
body, delivering anticancer drugs, specifically to malignant cells,
and determining if these drugs are killing the malignant cells.
Figure 1-1 summarizes the cancer nanotechnology applications
through molecular tumor imaging, early detection, molecular
diagnosis, targeted therapy, and bioinformatics [7]. Early
detection can be achieved by monitoring the human body for
certain cancer biomarkers. These biomarkers can be of various
molecular origins depending on the specific cancer. (i.e., proteins,
DNA/RNA) Cancer biomarkers are great tools not only for early
detection ofcancer; but also monitoring the progress of a cancer
treatment [4].
Several biomarkers associated with various cancer diseases
have been discovered so far, some of which are illustrated in
Table 1.1. There is a correlation between the high amount of
cancer biomarkers in the human body with related cancer. For
example, the risk for prostate cancer is indicated by an elevating
levels of Prostate Specific Antigen (PSA) in human blood.
Cancer biomarkers with thresholds in human serum are
shown in Table 1.2. In this table 1.2, some biomarker thresholds
are given in units/liter (U/L). The unit is an arbitrary amount
related to a specific bio-cancer agreed upon by doctors and
scientists. They can be converted to gram/liter using the
conversion factors associated to each biomarker.
The exact mechanisms beyond the cancer and its metastasis
are still not known, however, early detection (before metastasis)
Table 1.1: Biomarkers associated with cancer diseases [8].
Cancer type disease |
Biomarker |
Prostate |
PSA,PAP |
Breast |
CA15-3,CA125,CA27.29,CEA, BRCA1,BRCA2,
MUC-1,CEA,NY-BR-1,ING-1 |
Leukaemia |
Chromosomal abnormalities |
Testicular |
α-Fetoprotein(AFP), β-human chorionic gonadatropin, CAGE-1, ESO-1 |
Ovarian |
CA125, AFP, hCG, p53, CEA |
Any solid tumor |
Circulating tumour cells in biological fluids, expression of targeted growth factor receptors |
Colon and pancreatic |
CEA, CA19-9, CA24-2, p53 |
Lung |
NY-ESO-1, CEA, CA19-9, SCC, CYFRA21-1, NSE |
Melanoma |
Tyrosinase, NY-ESO-1 |
Liver |
AFP, CEA |
Gastric carcinoma |
CA72-4, CEA, CA19-9 |
Esophagus carcinoma |
SCC |
Trophoblastic |
SCC,hCG |
Bladder |
BAT, FDP, NMP22, HA-Hasi, BLCA-4, CYFRA21-1 |
Table 1.2: Cancer biomarkers and their threshold levels in human
serum [8].
Cancer biomarkers |
Thresholds |
Cancer biomarkers |
Thresholds |
NSE |
12.5 mg/L |
CEA |
3 µg/L |
PSA |
4 µg/L |
CA125 |
35 kU/L |
GST |
3.2 U/L |
CA153 |
25 kU/L |
ALP |
~0 |
CA27-29 |
36.4 kU/L |
SCCA |
1.5 µg/L |
CA549 |
11 kU/L |
Ferritin |
250 µg/L |
CA19-9 |
37 kU/L |
AFP |
10 µg/L |
CA50 |
14-20 kU/L |
CA242 |
20 kU/L |
CA72-4 |
6 kU/L |
is very important. Periodically monitoring cancer biomarkers
is a necessity and biosensors are the promising tools that can
enable us to achieve this. What we need is low cost-user friendly,
compact biosensors in liue of huge instruments of astronomic
prices present in medical laboratories with simple and instant
measurement abilities. If the cost and time per a cancer
biomarker check is reduced, these checks can be routinely done
for everybody.
Impedance biosensors are electrical sensors that can be
miniaturized and suited to these kinds of monitoring applications.
Sensitivity and repeatibility is two of the biggest challenges
before their commercialization [9]. Future research in this area is
expected to overcome these challenges and pave the way for low
cost, small size commercial products. These products can help us
to detect cancer and start fighting with it earlier.
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