Tumor Markers

What are tumor markers?

A tumor marker is any substance in your body that provides information about a cancer. Traditionally, tumor markers refer to proteins that cancer cells make. Noncancerous cells can also make tumor markers in response to a cancer. But a tumor marker can also refer to mutations (changes) or patterns in your DNA.

Other names for tumor markers include cancer markers and biomarkers.

What do tumor markers tell you?

Tumor markers — in combination with other tests — help healthcare providers diagnose and treat certain types of cancer. Tumor markers can:

• Indicate the presence of certain types of cancer.
• Help your provider plan treatment.
• Check whether current cancer treatment is working.
• Predict your chance of recovery.
• Monitor for recurrence (return) of certain cancers.

Some tumor markers only give information about one specific type of cancer. Other tumor markers give information about more than one type of cancer.

Where are tumor markers typically found?

There are two main types of tumor markers:

• Circulating tumor markers.
• Tumor tissue markers.

Circulating tumor markers are in:

• Blood.
• Urine (pee).
• Stool (poop).
• Bone marrow.
• Saliva (spit).

To get a sample of your blood, a healthcare provider will run a blood test. If they need a urine, saliva or stool sample, they’ll give you instructions on how to obtain it. To get a sample of your bone marrow, you’ll need a bone marrow biopsy.

Tumor tissue markers are in:

• Tumors (in your body tissues).

A healthcare provider will take a biopsy (small sample) of the affected tissue and send it to a pathology lab for analysis.

Do tumor markers detect all cancers?

No, many cancers don’t have known tumor markers. In these cases, tumor marker testing isn’t an option. When this happens, your healthcare provider may recommend other lab tests or imaging tests, like CT (computed tomography) scans or MRI (magnetic resonance imaging).

What are common cancer tumor markers?

There are many different tumor markers that test for many different types of cancer. Here are some of the most common:

• AFP (Alpha-fetoprotein): Using a sample of your blood, healthcare providers may look for this as they consider diagnoses of liver cancer, testicular cancer and other germ cell tumors, and to determine the success of treatment.
• BCL2 gene rearrangement: Using a sample of your blood, bone marrow or tumor, healthcare providers may look for this as they diagnose and plan treatment for cancers like leukemia and lymphoma.
• BRCA1 and BRCA2 gene mutations: Using a sample of your blood, saliva or tumor, healthcare providers may look for this as they diagnose and plan for screening and treatment of breast cancer and ovarian cancer.
• CA 19-9: Using a sample of your blood, healthcare providers may look for this as they diagnose and evaluate the success of treatment for cancer of the pancreas, gallbladder, bile duct and stomach.
• Carcinoembryonic antigen (CEA): Using a sample of your blood, healthcare providers may look for this if you have colon cancer as they determine the success of treatment or whether the cancer has spread or come back.
• Fibrin/fibrinogen: Using a sample of your urine, healthcare providers may look for this to determine the success of treatment for bladder cancer.
• Lactate dehydrogenase (LDH): Using a sample of your blood, healthcare providers may look for this to stage or determine the success of treatment for leukemia, lymphoma, melanoma, neuroblastoma and germ cell tumors.
• Prostate-specific antigen (PSA): Using a sample of your blood, healthcare providers may look to help diagnose prostate cancer, determine the success of treatment or check to look if it’s returned.
• Thyroglobulin: Using a sample of your blood, healthcare providers may look for this if you’ve had thyroid cancer. They use it to determine how successful treatment has been or to check to see if the cancer came back.
• UGT1A1*28 variant homozygosity: Using a sample of your blood or a cheek swab, healthcare providers may look for this if you have colorectal cancer. They use it to predict how sick you’ll get (toxicity) from a chemotherapy drug called irinotecan.

How does a tumor marker test work?

It depends on the type of cancer your healthcare provider tests for. Tumor marker tests typically require one of the following:

• Blood test.
• Saliva (spit) test.
• Urinalysis (pee test).
• Stool (poop) test.
• Biopsy.

Healthcare providers may run these tests to diagnose cancer, to help plan treatment or to see if your current treatment is working. You might need more than one tumor marker test.

When should I know the results of the test?

It depends on several factors, including what type of tumor marker test your provider requests. You could receive blood, urine, stool or saliva test results within a day or two. If you need a biopsy, it could take a week or longer to get your results.

What’s the normal range for cancer markers?

There are many different cancer markers, each with their own normal range. To learn more about tumor marker ranges for a specific type of cancer, talk to your healthcare provider.

What does it mean when your tumor markers are high?

High tumor marker results could suggest the presence of cancer. It may also suggest that cancer has progressed or spread (metastasized). But this test alone isn’t enough to diagnose cancer. If you have high test results, your healthcare provider will explain what the numbers mean. They may also run additional tests.

What does it mean when tumor markers go down?

If tumor markers go down, it could mean treatment is working. Tumor markers can go up and down over time, even over the course of your treatment. For this reason, it can be difficult to measure them consistently. That’s why healthcare providers use tumor marker tests in combination with other diagnostic tests.

What noncancerous conditions cause tumor markers to rise?

Many noncancerous conditions can cause high tumor marker results. Some of the most notable include:

• Anemia.
• Thyroid disease.
• Ovarian cysts (benign).
• Kidney disease.
• Kidney stones.
• Hepatitis.
• Sarcoidosis.

Can stress cause tumor markers to rise?

Research suggests that chronic stress may cause cancer to spread faster or recur (come back) in people who’ve had cancer in the past.

A note from Cleveland Clinic

Tumor markers — in combination with other diagnostic tools — help healthcare providers diagnose, treat and monitor certain types of cancer. There are many different tumor markers for different types of cancer, so be sure to ask your healthcare provider what your test results mean for you.