Tumor Markers: Role in Cancer
Care
Presented by: Dr Atiya Siddique
Learning Objectives
• Define what tumor markers are.
• Understand how tumor markers are used in
cancer diagnosis and monitoring.
• Recognize examples of common tumor
markers and their associated cancers.
• Identify the limitations and challenges of using
tumor markers.
What Are Tumor Markers?
• Substances (usually proteins) produced
by:
• - Cancer cells
• - Body in response to cancer
• Found in: Blood, urine, tissues, or body
fluids
• Used as indicators in cancer care.
Uses of Tumor Markers
• 1. Screening – Limited use (e.g., PSA)
• 2. Diagnosis – Supportive role with imaging &
biopsy
• 3. Prognosis – High levels may indicate
advanced disease
• 4. Monitoring treatment – Falling levels =
treatment working
• 5. Detecting recurrence – Rising levels may
signal relapse
Common Tumor Markers
• | Tumor Marker : Cancer Type |
• PSA Prostate cancer
• CEA Colorectal, breast, lung
• CA-125 Ovarian cancer
• CA 19-9 Pancreatic cancer
• AFP Liver, testicular cancer
Prostatic Acid Phosphatase (PAP)
• Prostatic acid phosphatase (PAP) originates in the
prostate and is normally present in small amounts
in the blood.
• In addition to prostate cancer, elevated levels of
PAP may indicate testicular cancer, leukemia, and
non-Hodgkin's lymphoma, as well as some
noncancerous conditions
CA-125
• Ovarian cancer is the most common cause of
elevated CA-125, but cancers of the uterus, cervix,
pancreas, liver, colon, breast, lung, and digestive
tract can also raise CA 125 levels.
• Several noncancerous conditions can also elevate CA
125.
• CA 125 is mainly used to monitor the treatment of
ovarian cancer.
Carcinoembryonic Antigen (CEA)
• Carcinoembryonic antigen (CEA) is
normally found in small amounts in the
blood.
• Colorectal cancer is the most common
cancer that raises this tumor marker.
Alpha-Fetoprotein (AFP)
• Alpha-fetoprotein (AFP) is normally
elevated in pregnant women since it is
produced by the fetus. However, AFP is
not usually found in the blood of
adults.
• In men, and in women who are not
pregnant, an elevated level of AFP may
indicate liver cancer or cancer of the
ovary or testicle.
• It is specific for yolk sac tumor.
Human Chorionic Gonadotropin (HCG)
• Human chorionic gonadotropin (HCG) is
another substance that appears normally in
pregnancy and is produced by the placenta.
• If pregnancy is ruled out, HCG may indicate
cancer in the testis, ovary, liver, stomach,
pancreas, and lung.
• It is specific for choriocarcinoma.
CA 19-9
• The CA 19-9 marker is associated with cancers in
the colon, stomach, and bile duct.
• Elevated levels of CA 19-9 may indicate
advanced cancer in the pancreas, but it is also
associated with noncancerous conditions,
including gallstones, pancreatitis, cirrhosis of
the liver, and cholecystitis.
Lactate Dehydrogenase (LDH)
• Lactate dehydrogenase (LDH) LDH is a protein that
normally appears throughout the body in small
amounts.
• Many cancers can raise LDH levels, so it is not
useful in identifying a specific kind of cancer.
• Measuring LDH levels can be helpful in monitoring
treatment for cancer.
• Noncancerous conditions that can raise LDH levels
include heart failure, hypothyroidism, anemia, and
lung or liver disease.
Limitations of Tumor Markers
• Not cancer-specific (e.g., PSA increase in
BPH)
• False positives & false negatives
• Not all cancers produce markers
• Cannot be used alone for diagnosis
Summary
• Tumor markers are supportive tools, not
definitive tests.
• Useful for tracking cancer progress and
recurrence.
• Must be interpreted alongside clinical and
imaging findings.
• Research is ongoing to improve their reliability
and accuracy.
Questions & Discussion
• Any questions?
