Tumor Markers Often Not Used

In a review of more than 4,700 testicular cancer cases, a combination of two of these tumor markers were used less than half of the time, while all three tumor markers were measured in just 16 percent of the cases. The authors of the study found that only about 45 percent of cases used the tumor markers alpha fetoprotein (AFP) and human chorionic gonadotrophin (HCG). Those two were used in conjunction with a third tumor marker, lactate dehydrogenase (LDH), 16 percent of the time.

Scott M. Gilbert, M.D., clinical lecturer in the U-M Department of Urology and lead author of the study notes that information obtained from the use of tumor markers impacts the treatment and potentially the outcome in patients with testicular cancer. If markers remain elevated after therapy, it indicates the cancer remains, or if they begin to rise during the surveillance period following successful treatment, the cancer has returned. Gilbert says he and his colleagues regularly check all three tumor markers in their patients.

A majority of the sites in the study failed to show improvement during the study interval, and one experienced a decrease in the use of tumor markers by the end of the study. The authors point out that the low rates of usage don’t necessarily indicate that the tumor markers were being used as infrequently as the numbers would suggest. One explanation could be that the documentation in medical records was poor, and incidents of tumor marker use were not always recorded, says senior author Brent K. Hollenbeck, M.D., M.S., assistant professor in the U-M Department of Urology.

Using the data from the Surveillance, Epidemiology, and End Results (SEER) program, the researchers found substantially more documentation of PSA use in prostate cancer patients compared to the testicular cancer tumor markers. That information supports the notion that recording may not be the problem, but that the use of testicular cancer markers is in fact very low.

MEDICA.de; Source: University of Michigan Health System