A physical examination revealed elevated "tumor markers". How far is it from cancer?

During the physical examination, I believe many friends have paid attention to an indicator: tumor marker . This name easily makes people think of whether they have cancer, and makes many friends anxious when they see it.

Blood samples for general tumor marker testing. Copyrighted images from the gallery, reprinting and using may cause copyright disputes

So what exactly are tumor markers? How to correctly interpret tumor markers? Let's talk about it today~

Tumor markers

Special "signal molecules" in the body

Tumor markers are some special "signal molecules" in our body. These signal molecules may be proteins, enzymes, hormones, or even certain gene fragments.

Abnormal content or structure of these markers in the body may indicate that something is wrong with our body, and in some cases they are associated with cancer . Common tumor markers, such as alpha-fetoprotein (AFP), are often used to detect liver cancer, and prostate-specific antigen (PSA) is often used to detect prostate cancer.

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Tumor markers have many applications in actual clinical practice. First, they play an important role in the auxiliary diagnosis of cancer. Second, they help doctors evaluate the effectiveness of treatment, such as whether chemotherapy is effective and whether the tumor is shrinking. Finally, tumor markers can also act as "police" in the follow-up of patients after treatment to monitor whether there are signs of cancer recurrence.

However, it is worth noting that although tumor markers are powerful, they are not perfect. Sometimes they give out "false positives" - false positive or false negative results . Therefore, doctors usually do not make a diagnosis based on the test results of tumor markers alone, but will combine imaging examinations, pathological examinations and other information for a comprehensive assessment.

Tumor markers

It's not necessarily cancer.

When you see an elevated tumor marker on your medical report, you may be shocked and think, "Oh no, do I have cancer?" In fact, there is no need to be so nervous. There are many reasons for an elevated tumor marker, and it is not necessarily cancer.

First, inflammation and infection can also cause tumor markers to temporarily increase, and even some normal conditions may cause them to increase. A common cold, chronic bronchitis, or even gingivitis can cause these markers to "jump high." For example, an increase in alpha-fetoprotein (AFP) may mean hepatitis rather than liver cancer.

For example, lifestyle habits can also affect the level of tumor markers. Long-term smokers usually have higher levels of carcinoembryonic antigen (CEA) than non-smokers. People who drink too much alcohol will also have elevated levels of ferritin (SF). For premenopausal women, drinking coffee may lead to elevated CA125.

There are also some special situations that can cause tumor markers to increase. For example, AFP may also increase during pregnancy and in infants, and CA125 may also increase during menstruation in some premenopausal women as they age.

Ovarian cancer tumor markers. Copyright image from the library. Reproduction and use may lead to copyright disputes.

Therefore, an increase in tumor markers does not mean cancer. An increase in tumor markers is just a signal sent by the body . At this time, the correct response method is very important.

Elevated tumor markers

What should I do?

First of all, if you see elevated tumor markers on your physical examination report, don’t be nervous or anxious, and don’t blindly check or take medication without authorization , especially some “miracle drugs” that claim to “reduce the risk of cancer.”

If it is only slightly elevated, you can adjust your own condition, quit smoking and drinking, maintain a regular schedule and avoid staying up late, and have a recheck every 1 to 2 weeks as appropriate. If the recheck results are normal, it can basically be considered that the elevation is most likely caused by non-medical reasons such as bad habits and lifestyle.

If the re-examination results do not change much compared to the previous ones (small fluctuations are allowed), you can continue to monitor and re-examine regularly (every 2 to 6 months or so, and then gradually extend it to annual re-examination) to dynamically observe the changes.

If the re-examination result is significantly higher than the previous one, or if the results of subsequent re-examinations show a progressive increase, or if a single re-examination shows a significant increase, reaching several times the normal value, it is recommended to see a specialist and arrange further examination according to the doctor's advice.

We need to know that tumor markers alone cannot establish a diagnosis of cancer. We should not scare ourselves. Maintaining a good mental state is an important part of health . Excessive stress can affect the body's immune function, thus leading to fluctuations in tumor markers.

We must face the physical examination results rationally and better maintain our own health.

References

[1]Hanif H, Ali MJ, Susheela AT, et al. Update on the applications and limitations of alpha-fetoprotein for hepatocellular carcinoma. World J Gastroenterol. 2022;28(2):216-229.

[2]Fukuda I, Yamakado M, Kiyose H. Influence of smoking on serum carcinoembryonic antigen levels in subjects who underwent multiphasic health testing and services. J Med Syst. 1998;22(2):89-93.

[3]Whitfield JB, Zhu G, Heath AC, et al. Effects of alcohol consumption on indices of iron stores and of iron stores on alcohol intake markers. Alcohol Clin Exp Res. 2001 Jul;25(7):1037-45.

[4]Balachandran A, Nayak SR. An Observational Study of Factors affecting CA125 Levels in Premenopausal Women. Adv Biomed Res. 2023;12:235.

[5]Grover S, Koh H, Weideman P, et al. The effect of the menstrual cycle on serum CA 125 levels: a population study. Am J Obstet Gynecol. 1992;167(5):1379-81.

Planning and production

Author: Jiang Yongyuan, Master of Internal Medicine, Third Military Medical University

Review | Pan Zhanhe, Chief Physician, Master Supervisor, Department of Oncology, Zhongshan Hospital, Xiamen University

Planning丨He Tong

Editor: Yinuo

Proofread by Xu Lai and Lin Lin

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