Tumor markers are substances that are produced by cancer or by other cells of
the body in response
To cancer or certain benign (non cancerous) conditions.
Most of the tumor marker are made by normal cells as well as by cancer cells
however, they are produced at much higher levels in cancerous conditioners
These substances can be found in blood ,urine,stool,tumor tissue or other tissue or
body fluids of some patient with cancer
Most of tumor markers are protein in nature.
Recently , pattern of gene expression and changes to DNA also begin to be used as
20 Different type of tumor markers are in clinical use.
Some are associated with one type of cancer while other are associated with
different types of cancer
i.e 1 or 2 type of cancer.
No universal tumor marker that can detect any type of cancer.
There are some limitations to tumor markers.Sometimes non-cancerous
conditioners can cause the level of certain tumor markers to increase.
In addition,not every with a particular type of tumor cancer will have increaselevel
of a tumor marker associated with that cancer.
Tumor marker have not been identified for each type of cancer.
Examples of TUMOR MARKERS
2. HER2 (or HER2/neu, erbB-2, or EGFR2) in breast cancer
Lactate dehydrogenase (LDH)
S-100 (in mylenomas)
Prostate-specific antigen (PSA)
Application of Tumor Markers
Screening:-To identify patients with early cancer
Staging/Prognosis:- To assess the risk and predict the outcomes
Surveillance:-To detect recurrence duringfollow up
Monitoring:-To evaluate the response treatment
Measurement of tumor markers are usuallycombined with biopsies,to diagnose
Tumor markers tells about stage i.e prognosis , So before treatment level of
tumor markers must be checked.
Tumor markers are checked during after the therapy of cancer to determine
determine either cancer is responding or not.
Increase Level tumor marke>>>>>>>> No response
Decrease Level of tumor markers>>>>> Responding
Dr take sample of tumor tissue or body fluid and measure its level
PSA level is determined by Blood analysis
B2-microglubulin B2M level for Mutiplemyelema is determined by Blood urine and
If the tumor markers is being used to determine whether the treatment is working
or whether there is a recurrent, the marker will be measured over time
Serial measurementWhich show whether the level of marker is staying same or
decreasing are more meaningful than a single measurement
Tests for tumor markers.
Pitfalls in immunoassays
Prostate-specific antigen (PSA)
PSA is a tumor marker for prostate cancer.
PSA is a protein made by cells of the prostate gland,which is found only in men.
The level of PSA in the blood can be elevated in prostate cancer, but PSA levels
can be affected by other things, too. Men with benign prostatic hyperplasia (BPH),
a non-cancerous growth of theprostate, often have higher levels. The PSA level
also tends to be higher in older men and thosewith infected or inflamed prostates.
It can also be elevated for a day or 2 after ejaculation.
PSA is measured in nanograms per milliliter (ng/mL).
blood PSA level below 4 ng/mL(cancer is unlikely).
Levels higher than 10 ng/mL ( cancer is likely or also called hitological value).
The area between 4 and 10 is a gray zone.
Men with PSA levels in this borderline range have about a 1 in 4 chance of having
A doctor may recommend a prostate biopsy (getting samples
Of prostate tissue to look for cancer) for a man with a PSA level above 4 ng/mL.
The PSA test is very valuable in monitoring the response to treatment and in the
follow-up of menwith prostate cancer. In men who have been treated with surgery
meant to cure the disease, the
PSA should fall to an undetectable level. The PSA should also go down after
radiation therapy (although it doesn’t go away completely). A rise in the PSA level
may be a sign
the cancer is coming back.
The drawbacks of tumor markers
A simple blood test that could find cancers in their earliest
prevent the deaths of millions of people. But very few tumor markers are useful
for finding cancer at a very early stage.
There are a few reasons for this:
Almost everyone has a small amount of these markers in their blood, so it’s very
hard to spot early cancers by using these tests.
The levels of these markers tend to get higher than normal only when there’s a
large amount of cancer present.
Some people with cancer never have high tumor marker levels.
Even when levels of these markers are high, it doesn’t always mean cancer is