A tumour marker is a biomarker found in blood, urine, or body tissues that can be elevated by the presence of one or more types of cancer. There are many different tumor markers, each indicative of a particular disease process, and they are used in oncology to help detect the presence of cancer. Tumour Markers help in clarifying whether or not a given ovarian mass is more or less likely to be a cancer, but by themselves are NOT diagnostic of cancer.
The most common gynaecological tumour markers are
- alpha-fetoprotein (AFP)
- cancer antigen 125 (CA125)
- cancer antigen 15-3 (CA15-3)
- carbohydrate antigen 19-9 (CA19-9)
- carcinoembryonic antigen (CEA)
- human chorionic gonadotropin (HCG or b-HCG)
- Inhibin
- Alphafetaprotein (AFP)
CA125 is elevated in 85-90% of ovarian cancers but is also elevated in 1% of the normal population and in many other benign conditions such as endometriosis, fibroids diverticulitis, pregnancy, irritable bowel syndrome, appendicitis, liver disease, stomach disease, and more. No one should get this test done unless they actually have a mass, or their doctor has some reason to get it such as suspicion of cancer due to ongoing symptoms. It is therefore said to be sensitive but not specific and unfortunately is only elevated in 50% of early ovarian cancers and at this point is NOT a reliable screening tool to detect ovarian cancer by itself. Because of the large number of confounding benign causes for elevating CA125, its interpretation in premenopausal women needs to be viewed cautiously.
CA15.3 – typically associated with breast cancer
CA19.9 – also typically associated with mucinous tumours of ovary or bowel, and also pancreatic tumours
CEA – is typically associated with mucinous tumours of the ovaries and bowel cancers (smoking can also elevate this marker)
BetaHCG – this is the hormone elevated normally in pregnancy but also some germ cell tumours and also in molar pregnancy (a condition which is a tumour of the placental tissue)
Inhibin – associated with granulosa cell tumours of the ovary – a very reliable marker
AFP – typically associated with yolk sac tumours of the ovary (germ cell tumour), but can be raised in other cancers such as liver cancer.
If you have any concerns regarding results of elevated tumour markers and or family history of ovarian, breast or other gynaecological cancers, Dr Farrell can advise the most appropriate course of action.
