Guide To Tumor Markers Used In Cancer
This is a table of the most often used tumor markers, the cancers they can be found with, non-cancerous health issues that can cause them to be high, and the range of normal results.
In cases where the half-life is listed, this should be kept in mind when checking levels. For example, the PSA half-life is 2-3 days, so if the level were checked the day after surgical removal of the prostate, it would still be raised. If the level were checked a week later, the result should be zero, or very close to zero, if no prostate cells remain.
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How Is Prostate Cancer Detected
There is no single test to detect prostate cancer. The two most common tests are the prostate specific antigen blood test and the digital rectal examination .
The PSA test measures the level of PSA in your blood. It does not specifically test for cancer. Virtually all PSA is produced by the prostate gland. The normal range depends on your age. A PSA above the typical range may indicate the possibility of prostate cancer. However, two-thirds of cases of elevated PSA are due to noncancerous conditions such as prostatitis and BPH.
A DRE is generally conducted by a urologist to feel the prostate. While DRE is no longer recommended as a routine test for men who do not have symptoms of prostate cancer, it may be used to check for any changes in the prostate before doing a biopsy.
If either of these tests suggest an abnormality, other tests are necessary to confirm a diagnosis of prostate cancer, usually a magnetic resonance imaging scan and transrectal ultrasound biopsy.
Measuring Your Full Blood Count
The table below is a guide to the levels of red blood cells, platelets and white blood cells usually found in a healthy person.
These numbers can vary in different hospitals. Your doctor or nurse will tell you which levels they use. The levels also vary slightly between people from different ethnic backgrounds.
The numbers may look complicated, but doctors and nurses use them in a simple way. For example, they may say your haemoglobin is 140 or your neutrophils are 4. You can ask your healthcare team to explain in more detail.
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Why Do People Get Triple Negative Breast Cancer
Because these cancers dont respond to standard drugs that target the hormones or HER2 receptors, they are primarily treated with chemotherapy. Triple-negative breast cancers also tend to be more aggressive, occur earlier in life, and pose a greater risk of returning sooner than other types of breast cancer.
Limitations Of Blood Tumor Markers
An abnormal blood tumor marker result does not necessarily mean you have cancer. For example, only about one in four abnormal prostate-specific antigen results is due to cancer, and approximately 15% of prostate cancer is missed.
There are many reasons for abnormal PSA levels. Similarly, carcinoembryonic antigen , a tumor marker used in colon cancer, is only made in 70 to 80% of colon cancers. Therefore, 20 to 30% of people with colon cancer will not have a raised CEA level.
Tumor blood markers aren’t typically able to diagnose cancer independently but can be combined with other tests for diagnosis. Tumor blood markers can also:
- Monitor the progression of cancer to see whether or not treatments are working
- Determine whether or not cancer has recurred after treatment or surgery
- Help determine the cancer stage
- Help determine the best treatment
- See if a tumor is growing or spreading to other parts of the body
Positive test results may be due to a noncancerous condition. Your doctor can help you understand the results of tumor blood markers and what they mean for you.
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Does Nci Have Guidelines For The Use Of Tumor Markers
NCI does not have guidelines for the use of tumor markers. However, some national and international organizations have guidelines for the use of tumor markers for some types of cancer:
- The American Society of Clinical Oncology has developed and published clinical practice guidelines on a variety of topics, including tumor markers for breast cancer, colorectal cancer, lung cancer, and others.
- The National Academy of Clinical Biochemistry publishes laboratory medicine practice guidelines, including Use of Tumor Markers in Clinical Practice: Quality Requirements, which focuses on the appropriate use of tumor markers for specific cancers.
Breast Cancer Tumor Markers Suggested By Healthcare Professionals
The American Society of Clinical Oncology has considered 13 biomarkers that can be used to help in screening, prevention, and treatment of breast cancer. Healthcare professionals might suggest some specific breast cancer tumor markers which are associated with the development of breast cancer. The list includes:
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Cancer Is The Second Leading Cause Of Death In The Us
Cancer kills over a half a million Americans every yearsecond only to heart disease. But cancer can be detected through antigens and other biomarkers in your blood. Your family history of breast cancer, pancreatic cancer, colon cancer, ovarian cancer and even lung cancer can determine whether youre at risk of developing cancer. Worried about cancer? Get a lab test to detect cancer today.
New Prostate Cancer Blood Test
If you have an abnormal PSA score, your doctor may recommend another newertest that gives a better sense of yourprostate cancer risk. The prostate health index is one such test that is a more accurateblood test and measures your risk for having prostate cancer. Its approvedby the FDA for men who have PSA scores between 4 and 10.
What are the benefits of the PHI test?
- Fewer unnecessary biopsies: Some men who have elevated PSA scores are unsure about getting an invasive biopsy. This tool can be used to better determine whether your risk is high enough to warrant a biopsy.
- More accurate: This test is better at detecting prostate cancer. It can also detect whether you have a more aggressive type of cancer. This information can guide doctors to a more targeted treatment plan for you.
If you score low on the PHI test, your doctor may recommend monitoring youover time to see if your levels rise enough to cause concern.
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What If My Psa Is High
PSA screening is just the first step, alerting you and your doctor that more testing may be needed. If PSA is only slightly elevated, your doctor may recommend repeating the test a couple of weeks later. From there, other types of tests can help with the decision on whether you need a biopsy, including:
- Digital rectal exam , if not already done
- PSA velocity, or the rate of rise over time
- PSA density, or the PSA per volume of prostate
- PSA-based markers
- Other markers, a urinary PCA3 or SelectMDx test
- Magnetic resonance imaging of the prostate
Each time you see your doctor for a checkup, have a conversation about prostate health and prostate cancer screening. PCF recommends that you make a about PSA screening with your doctor, starting at age 45, or age 40 if you have a family history of prostate or other cancers or are Black.
Can A Tumor Marker Be Used To Screen For Cancer
Ideally, markers could be used as a screening test for the general public. The goal of a screening test is to find cancer early, when it is the most treatable, and before it has had a chance to grow and spread. So far, the only tumor marker to gain some approval as a screening tool is the Prostate Specific Antigen for prostate cancer, though this has concerns as well.
The main worry with tumor markers is that they are not specific enough they have too many false positives. This means that the level is high when cancer is not present. This leads to costly tests that are not needed and causes the patient to be worried. The other concern is that the marker level is not high in early enough stages of the cancer, so the cancer cannot be found any earlier than when symptoms start to appear. Keep in mind that some substances used as tumor markers are normally made in the body, and a “normal” level is not always zero.
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How Are Tumor Markers Used
Tumor markers may be used for a variety of purposes. However, they are not typically used alone. Depending on the type of cancer, they may be used in conjunction with a tissue biopsy or a bone marrow or blood smear examination, for example, and/or with other tumor markers. They are not definitive but provide additional information that can be used to help:
Examples of tumor markers that are used in each of these ways are provided in the table below.
Tumour Marker Blood Tests
Tumour markers are substances that might be raised if there is a cancer. Theyre usually proteins. They can be found in the blood, urine or body tissues. You might also hear them called biomarkers or molecular markers.
Doctors might use tumour marker tests together with the results of other tests you have to:
- help diagnose a cancer
- monitor how well your cancer treatment is working
- check if the cancer has come back
Some tumour markers are only made by one type of cancer. Others can be made by several types. Some tumour markers are found in non cancerous conditions as well as cancer. And some cancers dont have any tumour markers.
For those cancers that may have raised tumour markers, you can find out more in the tests section for that cancer type.
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Future Scope Of Tumor Markers
The future holds great promise for the field of tumor markers. With the advances in genomic and proteomic technology, human diseases will be classified based on molecular rather than morphological analysis. This will occur through techniques such as laser capture micro-dissection for the procurement of tissues and cells, and by combining genomic and proteomic analysis. Early diagnosis of disease is possible by using unique gene or protein profiles consisting of multiple biomarkers. The analysis of panels of protein biomarkers may be performed by using traditional ELISA or antibody-based protein chips for parallel testing. Furthermore, there will be many more diagnostic tests generated as a result of genomic and proteomic discoveries.
In the future, the development of biochips will grow much faster than rest of the diagnostic industry which will include DNA, RNA, and protein chip. All the types of samples will be analyzed including tissues, cells, and body fluids. Integrated diagnostic tools that combine these methods with molecular imaging technique will be used. Finally, bioinformatics will link to scientific data to clinical information to provide and better more comprehensive care of the patient’s health. We will witness a rapid translation of new discoveries from the laboratory to patient’s bedside. With advances in proteomic, laboratory testing and hence laboratory diagnosis become even more important in the integral health-care delivery system.
Lab Tests Of Biopsy Samples
Biopsy samples are sent to the lab where they are looked at closely. If cancer is found, other lab tests may also be done on the biopsy samples to help better classify the cancer and possibly find specific treatment options.
Gene tests: If the cancer has spread , doctors will probably look for specific gene changes in the cancer cells that might help determine which drugs will be more helpful in treatment than others. For example, doctors now typically test the cancer cells for changes in the KRAS,NRAS, and BRAF genes. Patients whose cancers have mutations in these genes typically do not benefit from treatment with certain targeted therapy drugs. In the case of tumors that have the BRAF V600E mutation, they are not only less likely to respond to certain targeted drugs, but may need a different type of targeted drug added for treatment to work.
MSI and MMR testing: Colorectal cancer cells are typically tested to see if they show high levels of gene changes called microsatellite instability . Testing might also be done to see if the cancer cells have changes in any of the mismatch repair genes . EPCAM, another gene related to MSH2, is also routinely checked with the 4 MMR genes.
Changes in MSI or in MMR genes are often seen in people with Lynch syndrome . Most colorectal cancers do not have high levels of MSI or changes in MMR genes. But most colorectal cancers that are linked to Lynch syndrome do.
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What Can I Expect During A Blood Test
Collecting a sample for a blood test takes only a few minutes. In an office, clinic, lab or hospital, your healthcare provider will:
Blood Tests For Cancer Markers
Cancer is a term used to describe abnormal cell growth and proliferation in the body. This is a relatively scary word to hear for anybody. The most common thought that comes to a persons mind on hearing the word Cancer is a deadly disease which is potentially fatal.
Well, it is true in most of the cases where a diagnosis of cancer is made considerably late. The reason is that, quite often, cancer of any type or any organ does not show alarming signs and symptoms right from the very beginning. In plenty of cases, cancer is discovered accidentally while having a regular blood check or while investigating for some other cause.
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Use In Men Already Diagnosed With Prostate Cancer
The PSA test can also be useful if you have already been diagnosed with prostate cancer.
- In men just diagnosed with prostate cancer, the PSA level can be used together with physical exam results and tumor grade to help decide if other tests are needed.
- The PSA level is used to help determine the stage of your cancer. This can affect your treatment options, since some treatments are not likely to be helpful if the cancer has spread to other parts of the body.
- PSA tests are often an important part of determining how well treatment is working, as well as in watching for a possible recurrence of the cancer after treatment .
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Getting A Prostate Biopsy
For some men, getting a prostate biopsy might be the best option, especially if the initial PSA level is high. A biopsy is a procedure in which small samples of the prostate are removed and then looked at under a microscope. This test is the only way to know for sure if a man has prostate cancer. If prostate cancer is found on a biopsy, this test can also help tell how likely it is that the cancer will grow and spread quickly.
For more details on the prostate biopsy and how it is done, see Tests to Diagnose and Stage Prostate Cancer.
For more information about the possible results of a prostate biopsy, see the Prostate Pathology section of our website.
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What Is The Psa Test
Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in the blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter of blood.
The blood level of PSA is often elevated in people with prostate cancer, and the PSA test was originally approved by the FDA in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease. In 1994, FDA approved the PSA test to be used in conjunction with a digital rectal exam to aid in the detection of prostate cancer in men 50 years and older. Until about 2008, many doctors and professional organizations had encouraged yearly PSA screening for prostate cancer beginning at age 50.
PSA testing is also often used by health care providers for individuals who report prostate symptoms to help determine the nature of the problem.
In addition to prostate cancer, several benign conditions can cause a persons PSA level to rise, particularly prostatitis and benign prostatic hyperplasia . There is no evidence that either condition leads to prostate cancer, but someone can have one or both of these conditions and develop prostate cancer as well.
Imaging Tests Have Risks And Costs
The biggest risk is that imaging tests expose you to radiation. The effects of radiation add up over your lifetime and can increase your risk of cancer.
Imaging tests can also show a false positive. This means a test shows something unusual, but after more testing, is not a problem. False positives can lead to stress, more tests, and a delay in getting needed treatment.
Imaging tests can also add thousands of dollars to your treatment costs. Not all insurance companies pay for them for early-stage breast cancer.
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