Responses to Other Students: Respond to at least of your fellow classmates with at least a 200-word reply about their Primary Task Response regarding items you found to be compelling and enlightening. To help you with your discussion, please consider the following questions:
- What did you learn from your classmate’s posting?
- What additional questions do you have after reading the posting?
- What clarification do you need regarding the posting?
- What differences or similarities do you see between your posting and other classmates’ postings?
- post to read and respond
For assistance with your assignment, please use your textbook and all course resources. After reading through the article I learned that tumor markers are substances that occur in the blood, urine, or other body tissues. Tumor markers are caused by cancer cells or the bodys response to cancer cells (NCI, 2021). According to National Cancer Institute, tumor markers are sometimes used to help diagnose cancer and to monitor your response to treatment, but are not used alone to diagnose cancer because they are not specific or reliable enough. Recent research took it a step further stating that tumor biomarkers are produced when tumors develop and progress, and their measurement may provide useful information for diagnosis, prognosis prediction, detection of recurrence, and monitoring treatment response (Zhou et al., 2024) .
Tumor markers are also used for diagnostic purposes. Doctors can order tumor marker tests when they suspect someone has cancer. The tests can help diagnose cancer, but they cant be used alone to determine if you have cancer because many factors can cause levels to rise. For instance, they can also be elevated in someone who has liver disease or an infection. While ovarian cancer is linked to high levels of CA-125, other conditions like endometriosis or pelvic inflammatory disease can cause a rise as well. Therefore tumor markers should only be used with imaging and biopsy whenever possible. Imaging has advanced over time as well as biomarker testing due to advances in molecular biology/genomics, proteomics, and liquid biopsy technologies. But false positives and negatives due to sensitivity and specificity still present issues today (Zhou et al., 2024) .
I also learned that tumor markers can help detect and determine the extent or severity of cancer, as higher-than-normal values may reflect a greater tumor burden. They are also useful in monitoring a patients response to treatment, such as chemotherapy or radiation. After each round of chemotherapy, doctors can retest tumor marker levels to ensure they are decreasing, which can indicate that the treatment is working effectively.
If a certain cancer treatment includes chemotherapy, doctors will often monitor tumor marker levels before treatment starts and during treatment. If treatment is working, tumor marker levels will usually go down. If levels start to go up, it could be a sign that the cancer is not responding to treatment and you may need to try another type of therapy. Zhou et al. (2024) also reported that biomarkers are used to evaluate therapeutic efficacy and guide treatment decisions, especially those involved in personalized medicine or targeted treatment approaches.
Tumor markers can be useful in detecting cancer recurrence, often before symptoms appear. For example, doctors use them to monitor men for the recurrence of prostate cancer, as marker levels may begin to rise even before a patient experiences any noticeable signs of disease. In addition, modern medicine has advanced the understanding of biomarkers by classifying them into three main categories: diagnostic, prognostic, and predictive. Diagnostic biomarkers help determine whether cancer is present, prognostic biomarkers provide information about the likely course or outcome of the disease, and predictive biomarkers help identify which patients are more likely to respond to specific therapies (Zhou et al., 2024).
Routine screening of an asymptomatic population would be ineffective. There would be too many false positives. If a tumor marker test is only 95% accurate, administering the test to millions of healthy people will result in countless false positives. Many normal, non-cancerous conditions can increase certain tumor markers. Some examples include infection, inflammation, menstruation, liver disease, and pregnancy. Even biologically, we understand there will be variability in some peoples levels. PSA can be elevated with BPH, and CA-125 can rise with endometriosis or menstruation. Biomarkers can also be affected by other diseases as well as exogenous factors (Zhou et al., 2024).
False positives would lead to more invasive testing such as additional blood work, imaging, and biopsies. Many of these tests are painful or come with their own risks. Some patients experience anxiety and fear from excessive testing. False positives could also lead to overdiagnosis and subsequent overtreatment. The abnormalities that are found would be treated when some may not have caused any issues down the road because they can grow so slowly. Patients would be monitored rather than treated if tumors were found incidentally from other screening methods.
Billions of dollars and hours of lab processing would be tied up in universal tumor marker screening. There are many other screening tests that have more evidence to support them as reliable screening methods. Finding masses in the breast through mammograms and finding colon polyps with colonoscopies are much more effective and efficient. Many newer technologies that help detect tumor markers are promising for noninvasive methods and detecting cancer earlier. But only a handful of these have made it to our clinics due to the limitations described above (Zhou et al., 2024). Consequently, false negatives can cause patients to feel relief when they may actually have cancer. Universal screening will do more harm than good because of false positives and false negatives.
I think tumor markers should only be used for people who have already been diagnosed with cancer and need to be monitored or people with previous cancer history who need routine follow-up care. Tumor markers can be very useful for these situations and some tumor markers are starting to be used more when it comes to precision medicine and targeted therapies but should not be used for screening.
References
National Cancer Institute. (2021). Tumor markers . Retrieved March 28, 2024, from
Zhou, Y., Tao, L., Qiu, J., Xu, J., Yang, X., Zhang, Y., Tian, X., Guan, X., Cen, X., & Zhao, Y. (2024). Tumor biomarkers for diagnosis, prognosis and targeted therapy . Signal Transduction and Targeted Therapy , 9 , 132.
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