Stop Interpreting Tumour Marker Readings Like Stock Indices!

What Are Tumour Markers?

Unlike cancer indices, tumour markers are substances produced by an individual's cancer cells or other tissues in response to cancer development. These markers can be detected in a patient’s blood, urine, or tissues and are often used in cancer diagnosis, treatment monitoring, and prognosis evaluation. However, many patients mistakenly treat tumour marker readings like stock indices—constantly checking for fluctuations and panicking over small changes.

Understanding the true role of tumour markers can help patients avoid unnecessary anxiety and make informed decisions about their health.

Common Tumour Markers and Their Associated Cancers

• AFP (Alpha-fetoprotein) – Liver cancer, testicular cancer, ovarian cancer.

• CEA (Carcinoembryonic Antigen) – Colorectal cancer, pancreatic cancer, gastric cancer, lung cancer, breast cancer, ovarian cancer.

• CA 19-9 – Pancreatic cancer, cholangiocarcinoma, gastric cancer, colorectal cancer.

• CA 125 – Ovarian cancer, endometrial cancer, fallopian tube cancer, peritoneal cancer.

• PSA (Prostate-Specific Antigen) – Prostate cancer.

• CA 15-3 – Breast cancer.

  
  

Applications of Tumour Markers

Tumour markers play an essential role in cancer management. Their main applications include:

1. Early Detection

Some markers are useful for screening individuals at high risk for specific cancers (e.g., PSA for prostate cancer screening). However, tumour markers alone are rarely definitive and should always be combined with imaging and clinical evaluation.

2. Diagnosis Assistance

Tumour markers help in diagnosing certain cancers, particularly when imaging results are inconclusive. A rising marker level may suggest malignancy, but further testing is required to confirm a diagnosis.

3. Treatment Monitoring

Measuring tumour marker levels can assess how well treatments like chemotherapy, radiation, or surgery are working. A declining marker level typically indicates a positive response to treatment.

4. Recurrence Monitoring

After treatment, regular monitoring of tumour marker levels can help detect cancer recurrence early. However, fluctuations in marker levels do not always mean cancer is back—other factors can cause temporary elevations.

Limitations of Tumour Markers

Despite their usefulness, tumour markers have several limitations that patients must understand:

1. Low Specificity

Elevated levels can also be seen in benign conditions or non-cancerous diseases. For example, CA 125 can be high in ovarian cancer but also in conditions like endometriosis or pelvic inflammatory disease.

2. Insufficient Sensitivity

Not all cancers produce detectable levels of tumor markers, especially in early stages. A normal marker level does not always mean cancer is absent.

3. Individual Variability

Marker levels can vary significantly between individuals, even among those with the same type of cancer. This makes it essential to interpret results in conjunction with other diagnostic tools.

4. Fluctuations Are Normal

Tumour marker levels can naturally fluctuate due to many factors, including infections, inflammation, or even lab variations. Patients should avoid obsessively tracking every small rise or fall in their marker levels.

Tumour Marker Readings Are Not Stock Indices!

One of the biggest mistakes patients make is treating tumour marker readings like stock indices—checking them frequently, panicking when they rise slightly, and celebrating when they drop. But cancer does not behave like a stock market, and small marker fluctuations are not always meaningful.

Here’s why you should stop interpreting tumour marker readings like stock indices:

• Short-term changes don’t tell the full story 

  A single increase or decrease in marker levels is not enough to diagnose progression or remission. It’s the long-term trend, combined with imaging and clinical evaluation, that matters.

  
  

• Tumour markers alone are not diagnostic 

  Unlike stock prices that directly reflect market performance, tumour markers alone cannot confirm or rule out cancer. Additional tests, such as biopsies and imaging scans, are necessary for an accurate diagnosis.

  
  

• Over-monitoring causes unnecessary stress

  Constantly checking tumour marker levels can lead to unwarranted anxiety, especially when minor fluctuations occur.

  
  

• Context matters

  Just like the economy influences stock market trends, many factors influence tumour marker levels, including infections, medications, and other health conditions.

  
  

How to Approach Tumour Marker Readings

Instead of reacting to every change in tumour marker levels, here’s what patients should do:

• Trust your doctor’s interpretation

  Oncologists assess tumour markers in combination with other clinical findings. A rising marker does not always mean cancer is worsening.

  
  

• Look at trends, not single results 

  A one-time spike is often insignificant. Your doctor will look for sustained patterns over time.

  
  

• Rely on imaging and biopsies 

  These remain the gold standard for diagnosing and monitoring cancer progression.

  
  

• Stay informed, but don’t panic 

  Educate yourself about tumour markers, but don’t let numbers alone dictate your emotions.

  
  

Final Thoughts

Tumour markers are valuable tools in cancer management, but they should never be interpreted in isolation. They are not definitive diagnostic tools, and their levels can fluctuate for various reasons. Stop treating tumour markers like stock indices—cancer does not operate on daily market trends.

If you have concerns about your tumour marker readings, discuss them with your oncologist instead of drawing conclusions from the numbers alone. The most accurate way to monitor cancer is through a comprehensive approach that includes imaging, pathology, and clinical assessments.

Understanding tumour markers correctly can help you navigate your cancer journey with clarity and confidence, rather than unnecessary fear. Always focus on the bigger picture rather than obsessing over every small change in the numbers.

Cancer Awareness & Education Brought To You

By 👨‍⚕️Dr Teo Yin Keong | TEOncology

Clinical Oncologist, Johor, Malaysia

马来西亚新山肿瘤专科医生张引强

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