Various substances secreted by cancer cells such as cysteine proteases and sialic acid moieties of mucin possess procoagulant properties and activate factor X and factor VII.[34] [35] It is also proposed that cancer cells can directly stimulate factor X.[36] Cancer procoagulant is mainly found in malignant tissue and is a 68 kDa cysteine protease that activates factor X directly: independent of factor VII.[37]. The gene discussed is CTSB; the disease is cancer.