Tumor Markers

Tumors are characterized by specific chemical compounds present in the body of those living with cancer. Diagnosis and treatment of cancer in Israel always includes the study of tumor marker at leading private hospital, Herzliya Medical Center, where biochemical, genetic and molecular testing is provided to patients in order to identify a wide range of tumor markers. It must be emphasized, however, that the diagnosis of cancer is a complex process by which the analysis of tumor markers play a very important, yet not completely decisive role.

What are tumor markers?

Tumor markers are defined as metabolic products of cancerous cells, or, the converse - healthy tissue that is responsive to the growth process of cancer-causing cells. Most tumor markers have been categorized in recent years and referenced by specific proteins present in the membranes of cancerous cells, or grouped by the presence of specific DNA or RNA sequences.

Modern diagnostic techniques allow the blood of the individual patient to be tested for individual protein molecules or fragments of genetic material that provide evidence of the cause or origin of a tumor, as well as information to help predict the body’s response to treatment.

Tumor markers are observed in bodily fluids such as blood and/or urine. Evidence from tumor markers can also be found in fragments of tissue when analyzed. Some tumor markers are more specific than others, which provides significant evidence for particular cancer types. Non-specific markers in the body rise, regardless of the type of cancer.

In theory, increased concentrations of tumor markers could be considered the indication of a cancerous tumor. However, experts in cancer diagnosis and cancer treatment in Israel agree that analysis of tumor markers should be considered along with the results of additional examination and analysis, in order to determine the true indications of evidence gather in the context of all data collected; which may also include evidence gathered by medical imaging technologies (i.e. CT, MRI).

Tumor Marker Tests

Screening and early diagnosis - The main goal of analyzing tumor markers is to screen for early signs of cancer for diagnosis to be determined at a stage when symptoms are absent or not yet specific. Currently, blood tests are widely used to detect cancers, such as prostate cancer by searching for the presence of a prostate specific antigen (PSA) – a tumor marker that when concentrated, reveals an increased threat to patients at risk for prostate cancer.

Please note, that a negative test result, or analysis that yields lacking evidence from tumor markers, cannot reliably exclude the potential presence of a cancerous tumor, just as evidence positive for cancerous tissue as a result of screening is the possible result of non-cancerous causes.

  • Predicting severity. Some aggressive cancer types can be predicted based on tumor marker analysis. For example, tumor markers HCG and AFP present among patients with testicular cancer indicate increased severity of cancer presence and less favorable prognosis. High levels of ovarian cancer marker CA 125 in the pelvic cavity could be an indication of extensive metastases. This information is important in determining a patient’s treatment plan.
  • Selecting the best treatment strategy. Oncology treatment in Israel is often based on the formation of a specific treatment plan developed from the characteristics of tumor markers that are observed. This can help medical professionals make determinations such as assigning therapies that are more aggressive to particular patients based the results. Furthermore, patients with breast or stomach cancer often test positivity for marker HER2, which indicates greater susceptibility to certain therapies and less receptivity to other types of therapy.
  • Evaluating treatment effectiveness. A reduced concentration of tumor markers is (usually) always indicative of a positive trend
  • Diagnosis of relapse. After completion of treatment, the tumor marker levels normalize. A sudden rise could indicate a recurrence of the disease.

Tumor markers for Treatment of Cancer

As previously mentioned, tumor markers are observed in the blood and/or urine. Tumor markers that are established as cancerous are monitored among cancer patients who are in the process of undergoing treatment, though not for purposes of screening for initial diagnosis.

  • Alpha-fetoprotein (AFP) - liver cancer (hepatocellular carcinoma), germ cell tumors, testicular cancer
  • Beta-2-microglobulin (B2M) - multiple myeloma, chronic lymphocytic leukemia, Waldenstrom's macroglobulinemia. Highly concentrated B2M is associated with poorer prognosis
  • Bladder cancer antigen (BTA) - cancer of the bladder. Due to the low specificity marker, clinical indications of this marker is limited and included in other sources of analysis
  • CA 15-3 and 27-29 – detection of breast cancer; used for screening and diagnosis
  • CA 19-9 - Monitoring patients with pancreatic cancer and determining the aggressiveness of bladder and colorectal cancers
  • CA 125 - ovarian cancer: monitoring and evaluation of tumor marker’s characteristics. Screening efficiency not fully proved
  • Calcitonin - medullary thyroid carcinoma. Calcitonin - thyroid hormone - one of the few markers that is used for early diagnosis of cancer
  • Carcinoembryonic antigen (CEA) - a non-specific marker, though it may be a potential indication of colorectal cancer, lung cancer, breast cancer, cancer of the liver, thyroid, pancreas, or stomach cancer. Analysis of CEA is often performed in diagnostic processes
  • Chromogranin A (CgA) - neuroendocrine tumors
  • Human chorionic gonadotropin (hCG) – germ-cell tumors
  • Inhibin - stromal tumors of the ovaries
  • Lactate - testicular cancer, germ cell tumors, lymphoma, melanoma, and neuroblastoma
  • Neuron-specific enolase (NSE) - small cell lung cancer and neuroblastoma
  • NMP22 - bladder cancer
  • Prostate-specific antigen (PSA) - prostate cancer, analyzed for ongoing screening, monitoring, and determinations of prostate cancer recurrence
  • Prostatic acid phosphatase (PAP) - prostate cancer
  • S-100 - melanoma. The marker is present in serum samples or in tumor tissue
  • Soluble mesothelin-related peptides (SMRP) – mesothelioma, a rare type of lung cancer
  • Thyroglobulin - thyroid cancer

Tumor Cell Markers:

  • Mutations in ALK
  • Mutations in BRAF gene
  • Epidermal growth factor (EGFR)
  • HER2
  • Hormone receptors of cell membrane; estrogen and progesterone
  • Mutations in KRAS gene
  • S-100

At Herzliya Medical Center in Israel, medical professionals practice modern methods to provide effective cancer treatments by gathering evidence and analyzing precise abnormalities detected in the genomes of cancerous tumors. Professionals examine cellular tumor markers to aid evaluation of the degree of cancer aggressiveness and maintain the ability to measure susceptibility and/or resistance to particular forms of therapy to best provide treatment to each patient.

 

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