Clinical applications of serum tumor markers

Article Abstract:

Some cancers produce elevated blood levels of substances known as tumor markers. Measurement of tumor markers has been applied to several situations. Some markers are used as screening tools. In other words, levels of a particular tumor marker are measured in persons felt to be at risk for a certain cancer; those persons whose levels are elevated receive further evaluation. One problem with using markers as screening agents is that when a large population is screened, a number of false positives, or people with high levels of the marker and no cancer, will be found. Conversely, some false negatives will also occur, that is, some persons with the cancer will have normal levels of the marker. Some tumor markers are useful in confirming a clinical suspicion of a given cancer, and aid in diagnosis. Others can be useful for prognosis and monitoring, because the level of a given tumor marker in the blood of a person who has been successfully treated for a particular cancer should fall into the normal range. When the level of that tumor marker rises in a person who has been treated, recurrence must be suspected. Among the tumor markers currently known is CA 125, which is elevated in certain cases of ovarian cancer. CA 125 levels will be elevated in 80 percent of women who have ovarian cancer and in only one percent of normal women. Because the incidence of ovarian cancer is only 30 cases per 100,000 women, in large screening programs, the vast majority of women with elevated CA 125 levels will not have ovarian cancer. When the test is limited to women who have known tumors in the pelvic region, its predictive value as a diagnostic test is improved. Other tumor markers currently being studied include alpha-fetoprotein in liver cancer, human chorionic gonadotropin (HCG) in cancers of the reproductive tract, carcinoembryonic antigen in colon cancer, and prostate-specific antigen in prostate cancer. Of all these, the latter is seemingly the most useful screening tool, because it is found only in prostate tissue, and above certain levels is nearly certainly diagnostic of prostate cancer. The true utility of tumor markers in the diagnosis of cancer is yet to be determined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Measurement, Physiological aspects, Cancer, Chorionic gonadotropin, Chorionic gonadotropins, Prostate specific antigen, Cancer diagnosis, Tumor markers, Alpha fetoproteins, CEA (Oncology), Carcinoembryonic antigen

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The adverse effect dilemma: quest for accessible information

Article Abstract:

Enalapril is an antihypertensive agent that is reported by its manufacturer as having the potential to induce pancreatitis, a painful inflammation of the pancreas. A 23-year-old woman with hypertension was treated with enalapril, and one month later, developed abdominal pain. Her serum amylase, an enzyme released by the pancreas, was normal, but her lipase level, also reflective of pancreatic activity, was elevated. Her symptoms resolved within a few days of discontinuing enalapril, and her blood tests were normal within several weeks. A computer search of the medical literature revealed five previously reported cases of pancreatitis induced by enalapril. The Food and Drug Administration, queried under the Freedom of Information Act, listed three cases of enalapril-induced pancreatitis. Merck Sharp and Dohme, the manufacturer of enalapril, had received about 50 reports of enalapril-induced pancreatitis. The discrepancies highlight the fact that adverse drug effect reporting is voluntary, and thus the numbers of cases found in the medical literature or known by the Food and Drug Administration may be an underrepresentation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drugs, Medicine, Laws, regulations and rules, Causes of, Complications and side effects, Information services, Adverse drug reactions, Pancreatitis, Enalapril

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