Doctor's dilemma: incorporating tumor markers into clinical decision-making.
Physicians are often faced with the dilemma of how to incorporate tumor markers into routine clinical decision-making. Tumor markers may influence clinical decisions at various stages of cancer therapy: screening, diagnosis, prognosis, detection of early relapse, and monitoring of therapy. We use the examples of beta-human chorionic gonadotrophin (beta-HCG) and alpha-fetoprotein (AFP) as markers for germ cell tumors (GCT), and prostate-specific antigen (PSA) as a marker for prostate cancer, to illustrate their use and limitations for these purposes. We then focus on monitoring and choice of treatment by presenting three vignettes; these highlight the potential benefits and problems associated with the use of tumor markers for monitoring and detection of early relapse in asymptomatic patients.
Canil
Christina M
CM
Department of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, University Health Network, Toronto, Ontario, Canada.
Tannock
Ian F
IF
D000328:Adult; D000368:Aged; D001007:Anxiety; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D003110:Colonic Neoplasms / Q000378:metabolism / Q000628:therapy; D003657:Decision Making; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000378:metabolism / Q000523:psychology; D009369:Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000517:prevention & control* / Q000628:therapy; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000378:metabolism / Q000628:therapy; D013736:Testicular Neoplasms / Q000378:metabolism / Q000628:therapy
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D017430:Prostate-Specific Antigen