Types of Tumor Markers & Why It's Important to Identify Them

While cancer can often trigger emotions of depression and fear, now anyone who is fighting against this disease can benefit from the advances in cancer research. One of the milestones is the discovery of tumor markers and the testing procedures that are transforming the understanding of scientists about the disease.

Learn How Tumor Markers Can Aid in the Diagnosis and Treatment of Cancer

Cancer has been causing the loss of millions of lives every year while scientists continue to research the best approach to eradicate it. The most common strategy is early diagnosis and treatment by identifying the tumor markers.

What Is a Tumor Marker?

Patient-Blood-Draw-by-Doctor-ss-body | Types Of Tumor Markers & Why It's Important To Identify Them

A tumor marker is essentially a protein or other substance produced in higher amounts primarily by cancer cells in response to cancer or certain benign (noncancerous) conditions. A tumor marker can be found in the blood, urine, tumors, tissues, or bodily fluids of patients with cancer. It is essential in cancer management since it provides information about the disease, such as how aggressive a tumor is, whether it can be treated with targeted therapy, or whether it responds to treatment.

However, testing for tumor markers must be combined with other tests due to several reasons. In many cases, people with benign conditions may also have elevated tumor markers in their blood. Benign tumors do not lead to cancer. They are mostly harmless as they cannot spread to other parts of your body and can be left alone under medical supervision. In addition, tumor markers are not always present in individuals with a tumor. Another reason is that some tumor markers do not specify tumor type.

2 Main Types of Tumor Markers

Tumor markers can be divided into two main types, including:

Circulating Tumor Markers

Circulating tumor markers can be collected from the blood and other bodily fluids in patients with cancer. These markers are primarily used to determine prognosis or predict the likely outcome or course of the disease, the chance of recovery or recurrence, and how a patient may recover. In other cases, circulating tumor markers can help determine the stage of cancer. If the patient has already started treatment, these cancer markers allow doctors to assess how well a treatment is working or detect cancer that remains after treatment.

Although finding an elevated level of a circulating tumor marker aids in diagnosing cancer, this alone is not sufficient to diagnose cancer. Instead, doctors often combine circulating tumor marker tests with other tests, such as biopsies or imaging. Tumor markers may also be measured periodically to show if they fluctuate over time. A decrease may indicate that cancer responds to treatment and is unlikely to recur. In contrast, an increasing or unchanged level may indicate that the cancer is not improving.

Examples of commonly used circulating tumor markers include:

Calcitonin for medullary thyroid cancer
CA-125 for ovarian cancer
Beta-2-microglobulin for multiple myeloma, leukemia, and lymphoma

Tumor Tissue Markers

Unlike circulating tumor markers found in the blood and body fluids, tumor tissue markers are present in the existing tumors. A biopsy to remove a tumor sample is usually required to measure tumor tissue markers. Tumor tissue markers are primarily used to estimate prognosis, diagnose and classify cancer, and select an appropriate treatment. Tumor tissue markers that indicate whether someone can receive a targeted therapy are biomarkers for cancer treatment. Examples of these biomarkers include:

Estrogen and progesterone receptors for hormone therapy against breast cancer
FGFR3 gene mutation analysis for treatment of bladder cancer
PD-L1 for treatment with an immune checkpoint inhibitor against multiple cancer types (an immune checkpoint inhibitor is a type of drug that facilitates the removal of cancer cells by immune system cells)

How Is a Tumor Marker Blood Test Performed?

Because certain tumors leak cells and genetic materials into the blood, blood samples are helpful to identify cancer. Cells are constantly growing, proliferating, and dying inside a tumor. When cancer cells die, they are broken down into molecules containing tumor DNA. If cancer cells die near a tumor blood supply, these tumor DNA-filled microscopic materials enter the bloodstream. Scientists can collect and isolate tumor DNA from the bloodstream using a blood test. The tumor DNA is then analyzed to provide cancer information.

What Is the Normal Range for Tumor Markers?

Depending on the type of cancer and the tumor marker used in the test, test result values may vary, meaning that there is no specific normal range for all cancers. However, it is most likely that high tumor marker levels can signify cancer. For example, the aforementioned CA-125 tumor marker for ovarian cancer lower than 35 units per milliliter (U/mL) is expected. If this tumor marker is greater than that, it indicates the possible presence of ovarian cancer. The higher the test result, the more likely the tumor has spread to other body parts.

The recommended use of tumor marker tests in clinical practice means that millions of lives could be saved thanks to early cancer detection and treatment. We can be optimistic about the imminent end of a disease once thought incurable and emerge victorious in the battle against it.

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Types of Tumor Markers & Why It’s Important to Identify Them