What are tumour markers?

Background:

CA125 is a high molecular weight glycoprotein, which is expressed by a large proportion of epithelial ovarian cancers. The sensitivity and specificity of CA125 are poor and there are no guidelines produced by the Royal College of Pathologists or the Association of Clinical Biochemists to aid clinicians and laboratories in its most appropriate use.

Aim:

To identify the patient population having a CA125 measurement and to determine its contribution to individual patient management.

Methods:

A retrospective case note audit looking at patients who had a CA125 measurement performed between April 2000 and April 2002.

Results:

The study comprised 799 patients; 751 (94%) were female and 48 (6%) male; 221 (29%) females and 22 (46%) males had an abnormal result. CA125 was mainly used to investigate a wide range of signs and symptoms, and few tests were for follow up or screening of ovarian cancer. In female patients having a CA125 for suspicion of malignancy/ovarian cancer, only 39 (20%) of the abnormal results were caused by ovarian cancer. False positive results were largely caused by another malignancy (48 cases; 26%), benign ovarian disease (26 cases; 14%), and benign gynaecological conditions, particularly leiomyomas (18 cases; 9%). The specificity of CA125 for ovarian cancer increased with concentrations >1000 kU/litre.

Conclusions:

These results confirm the high false positive rate and poor sensitivity and specificity associated with CA125. The substantial inappropriate usage of CA125 has led to results that are useless to the clinician, have cost implications, and ato patient anxiety and clinical uncertainty.

Please click on the required question.

• 1 What is cancer (malignancy)
• 2 What is meant by cancer staging?
• 3 How prevalent is cancer?
• 4 How prevalent are womens' cancers?
• 5 What causes cancer?
• 6 Is cancer a hereditary condition?
• 7 How can gynaecological cancer present?
• 8 How can we reduce the risks of the womens' cancers?

   

  Reducing the Risks of Womens' Cancers.

• 9 What are screening tests?
• 10 What are the reactions to a diagnosis of cancer?
• 11 Is there a place for counselling when cancer is diagnosed?
• 12 Can personality alter the prognosis?
• 13 Is the incidence of deaths from the female cancers changing?
• 14 Is there a place for a holistic approach to cancer?

   

  Cancer of the Cervix.

• 15 How prevalent is cervical cancer?
• 16 What causes cervical cancer?
• 17 How long an interval should there be between cervical screening (smear) (PAP) tests?
• 18 Is there any evidence that cervical screening can reduce the incidence of cervical cancer?
• 19 Will pre-malignant changes of the cervix invariably lead to cancer?

   

  Endometrial Cancer (Uterus)

• 20 What causes endometrial cancer?
• 21 Are there screening tests for endometrial cancer?
• 22 How does endometrial cancer present?
• 22a How can endometrial cancer be prevented?
• 22b How can endometrial cancer be treated?

  Cancer of the Ovary.

• 23 How does ovarian cancer present?
• 24 How prevalent is ovarian cancer?
• 25 What are tumour markers?
• 26 Can we screen for ovarian cancer?
• 27 What is the relationship between infertility and ovarian cancer?
• 28 Can treatment of infertility increase the risk of ovarian cancer?
• 29 What is the relationship between oral contraception and cancer?
• 30 Can ovarian cancer be prevented?
• 31 I use talcum power. Could this increase my risk of developing ovarian cancer?

   

  The Treatment Of Womens' Cancers

• 32 Can we predict the course of a cancer?
• 33 What treatment options are available for gynaecological cancer?
• Q32.33c What treatment options are available for ovarian cancer?

  Cancer of the Vulva, Vagina and Fallopian Tube

• 34 How prevalent are malignant conditions of the vulva, vagina and Fallopian tubes?

  Breast Cancer

• 35 What is the incidence of breast cancer?
• 35 ?What is the cause of breast cancer?
• 35a What are the advantages of breast cancer screening - mammography - mammograms?
• 36 How often should breast screening be carried out?
• 37 Are there any problems having a mammogram?
• 38 Should I check myself for breast lumps?
• 39 One of my family developed cancer of the breast. Am I at increased risk?
• 40 We have a family tendency towards developing breast / ovarian cancer. Are there any genetic tests to find out if I am at increased risk?
• 41 What happens if a mammogram shows an abnormality?
• 42 What are the advantages and disadvantages of tamoxifen in the management of breast cancer?
• 42a Breast Cancer Treatment - What is available?
• 43 What is the relationship between breast cancer and the pill?

  Web sites and Support Groups

• 44 Are there any support groups?
• 44 Are there any support groups?
• 45 Support Groups.
• 46 Breast Cancer Support Groups
• 47 Ovarian Cancer Support Groups
• 48 Endometrial Cancer Support Groups
• 49 Cervical Cancer Support Groups
  
  
  

  
  
  

  Thank you for choosing to visit us.

  
  

  This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

  I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.