What are tumor markers?

Tumor markers – substances formed as a result of the vital activity of cancer (sometimes normal) cells. They are detected in blood/urine tests of patients with cancer. They are diverse in structure, but mostly they are proteins or protein derivatives. Some of them are specific – they show one type of tumor, and some show different types of cancer.

Why are tumor markers needed?

  • Tumor markers reveal whether a person is at risk of developing cancer;
  • Tumor markers help find the source of the tumor before in-depth diagnostics begin;
  • Detect cancer recurrence;
  • Tumor markers evaluate the radicality of the surgical treatment – whether the entire tumor was removed or not.

What should pay attention to?

  • Are there any increases in tumor markers?
  • Which marker is elevated?
  • What does this increase mean?
  • Should I change my treatment regimen?
  • Is marker change assessed in treatment?
  • How often to repeat the study and how often is it necessary to consult an oncologist?

Common tumor markers

  • Prostate-specific antigen (PSA) – a marker of the early stages of prostate cancer and other prostate diseases. Negative result – PSA less than 4 ng/ml. benefit for prostate cancer – PSA level above 10 ng/ml. PSA values ​​from 4 to 10 ng/ml are an intermediate result. Patients who have these PSA levels should have a prostate biopsy. In addition to prostate cancer, PSA is higher in older people, with benign prostatic hyperplasia. Then free PSA, not bound to blood proteins, is measured. If its level is more than 25% of total PSA, then the likelihood of prostate cancer is low. PSA is a sensitive test in assessing the quality of treatment. After surgical removal or radiation therapy, the PSA level is zero. An increase in the marker after treatment means a relapse of the disease.
  • S-10, TA-90 – tumor markers for skin cancer (melanoma). As a rule, the level is higher if there are metastases.
  • Beta-2 microglobulin (B2M) – increases in multiple myeloma and some types of tumors of the bone marrow and hematopoietic system. Used to assess the prognosis of survival (levels above 3 ng/ml, the prognosis worsens).
  • CA 15-3, CA 27.29 – initially – markers of breast cancer. In the early stages, the increase is insignificant (less than 10%). When developed, the marker increases by 75%. It is possible that these markers may also be elevated in other tumors.
  • CA 125 – onmarker of ovarian cancer. 90% with this disease have a CA 125 level of more than 30 U/ml. Previously, this marker was used as a screening diagnostic method. But then they discovered that this level was also detected in many healthy women, as well as in women with endometriosis, in people with lung cancer, in people who had previously had cancer.
  • Carcinoidoembryonic antigen (CEA) – a marker of rectal cancer, but is used in the assessment of cancer of the mammary glands, lungs, thyroid gland, liver, bladder, cervix, pancreas. This marker is nonspecific. A value above 5 U/ml is not a normal level.
  • Alpha fetoprotein (AFP) – increased in people with liver cancer (hepatocellular carcinoma). The norm is less than 20 ng/ml (nanograms/ml). AFP levels increase with tumor growth. In addition, AFP may increase in acute and chronic hepatitis (rarely more than 100 ng/ml), some types of ovarian and testicular cancer (about 5%).
  • CA 72-4, LASA-P – markers of ovarian cancer and gastrointestinal tract tumors. Thyroglobulin is a protein that is produced by the thyroid glands and increases in many thyroid diseases. Used as a tumor marker for the management of patients who have undergone surgical removal of the thyroid gland for cancer. An increase in thyroglobulin above 10 ng/ml is a sign of tumor relapse.
  • AC 19-9 – a marker that shows pancreatic cancer, often used to monitor treatment. High level – indicator above 37 U/ml. Also, an increase is possible in case of cancer of the bile ducts and some types of intestinal cancer.
  • Chromogranin A – it is produced by tumors that come from cells of the endocrine and nervous systems. Serum gammaglobulin is often found in bone marrow tumors (macroglobulinemia, multiple myeloma).
  • Serum Her-2/neu – to assess the prognosis of breast cancer. If the level is more than 450 fmol/ml, a worse response to chemotherapy and poor prognosis for survival are expected.
  • Human chorionic gonadotropin (HCG) – can be found in some mediastinal tumors.
  • NMP22 – a specific protein for bladder cancer. Most often, to monitor the effectiveness of treatment, instead of cystoscopy.
  • Neuron-specific enolase (NSE) – in some cases, used in assessing the condition of lung cancer and tumors arising from endocrine and nervous tissue.
  • Tissue polypeptide antigen (TPA) – a marker of lung cancer.
Name Most specific marker Other markers Purpose of the study The need for additional diagnostic methods
bladder cancer BTA, NMP22 CEA, CA 125, CA 19-9 Monitoring treatment, detecting relapses + (cystoscopy, biopsy, cytological examination of urine)
Breast cancer CA15-3, CEA CA 27.29 Treatment control + (mammography, tomography, biopsy)
Rectal cancer CEA, CA 19-9 – Monitoring treatment, detecting relapses, assessing prognosis + (colonoscopy, sigmoidoscopy, feces for occult blood)
Cancer roasted AFP – Diagnostics, treatment control + (biopsy, ultrasound, tomography)
Lungs’ cancer CEA, NSE TPA Monitoring treatment, detecting relapses + (X-ray studies, tomography)
Melanoma TA 90, SU100 – Metastasis, progression + (biopsy)
Ovarian cancer CA 125 CA 72-4, LASA-P, AFP Monitoring treatment, detecting relapses + (ultrasound, biopsy)
Pancreas cancer AC 19-9 PAP, PSMA Monitoring treatment, detecting relapses, confirming the diagnosis + (ultrasound, tomography)
Prostate cancer PSA Early diagnosis, treatment control, detection of relapses –
Stomach cancer – CEA Metastasis + (fibrogastroscopy, biopsy)
testicular cancer HCG AFP Confirmation of diagnosis, control of treatment +

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