• Paddington Medical

What are tumour markers and should I do it?

Updated: Apr 12

Have you considered doing a health screening for yourself? Seen the multitude of packages in the market already? You probably have seen some of these packages including the entire spectrum of cancer tumour markers, but do you know if this is really useful?

Does a "normal" tumour marker value indicate that you don't have cancer? Or conversely, does an "elevated" tumour marker value indicate that you have cancer?



This article is written to advise you on what are tumour markers and what are the pros and cons of doing tumour markers. Also, this article touches on what methods of cancer screening are encouraged by the Ministry of Health. Lastly, we will give our perspective on what elements of health screening are most basic and essential for you.


What are Tumour Markers?


Tumor markers are substances found in higher-than-normal levels in the blood, urine, or tissues of some people with cancer. These substances can be made by the tumor. They can also be made by healthy cells in your body. Tumor marker tests check to see if you have these substances in your body and in what amounts. Tumor markers are often proteins.



How do medical professionals use Tumour Markers in the management of cancer?

  • Decide which type of treatment or combination of treatments will work best for a certain type of cancer

  • Figure out how well a treatment is working

  • Predict a person’s chance of recovery

  • Predict how likely it is a cancer will come back after treatment and find it if it does


Can Tumour Markers be used for screening for cancer?


Tumour markers have little value in cancer screening, according to latest scientific evidence. A raised tumour marker value does not necessarily indicate the presence of cancer. For example, AFP (a tumour marker for liver or testicular cancer) can also be raised in the presence of liver cirrhosis or hepatitis. In some cases with raised tumour markers, after extensive investigations (and spending a lot of money), the patient was found to be 100% normal. Not to mention, the amount of mental stress the patient went through.


A "normal" tumour marker value does not necessarily indicate that there is no cancer. There are many cases of patients doing health screening which includes a lot of tumour markers, and these tumour markers were all supposedly normal; a few months later, the patient was diagnosed with cancer.


So, instead of using tumour markers, what can I do to screen for cancer?


Our clinic takes reference from the latest Ministry of Health guidelines for cancer screening and these are the recommendations


For ladies

Cervical Cancer: Regular PAP smears - click here to learn more

Breast Cancer: Mammogram and / or Breast Ultrasound

Colon Cancer: Stool Test above 50 years old and / or colonoscopy


For gentlemen

  1. Colon Cancer: Stool Test above 50 years and / or colonoscopy

  2. Prostate Cancer: Digital Rectal Examination and Prostate Specific Antigen


Do note that these are general guidelines. In certain situations, your requirements for cancer screening may vary and hence do approach us in clinic to discuss more if you are not sure.


Ladies, did you know also, that you can reduce your risk of a certain kind of cancer with vaccination?


Cervical cancer, which is caused by the Human Papilloma Virus (HPV), can be prevented or at least reduced with vaccination. Certain types of HPV can infect the cervix (the lower part of the womb), vagina and vulva. HPV can be transmitted through skin-to-skin contact such as sexual activity, by sharing contaminated sex toys and very rarely, during delivery from an infected mother to her baby. HPV cannot be spread by sitting on toilet seats or touching common surfaces. In most cases, the body's immune system can fight off the infection and clear the virus. However, sometimes the HPV infection can persist and cause abnormal changes to the cells. Some of these abnormal cells may develop into cervical cancer. This usually takes years to develop. Specifically, HPV subtypes 16 and 18 account for about 70 percent of cervical cancer cases.


So apart from cancer screening, what should I be doing to ensure that I am in the best of health?


In a regular person with no known medical condition, no chronic diseases and no family history of any diseases, we recommend you do an annual health screening which includes the following

  1. Cholesterol check

  2. Diabetes

  3. Blood pressure

  4. PAP smear and / or mammogram and / or breast ultrasound for ladies


So as you can see, if you are below 50 years old, and are generally in the pink of health, there aren’t many things that you need to be doing. However, if you are above 50 years old, we would recommend that you see us in clinic to discuss further on what screening modalities are needed for you.



By:

Dr Zhang Huipei (Mdm)

Family Physician and Medical Director

&

Dr Lee Joon Loong

MBBS (Australia), Diploma in Geriatrics Medicine

Medical Director




References

MOH Health Hub

Cancer.net

Channelnewsasia: https://www.channelnewsasia.com/news/singapore/singapore-prostate-cancer-rectal-exam-uncomfortable-painless-13634994

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