Prostate cancer is a threat to the elderly

Testicular tumors are characteristic of the younger population and mostly occur between the ages of 15 and 40, while prostate cancer occurs almost exclusively in men over 40 years of age.

Although tumor markers for these diseases are not used as screening tests because they can also indicate benign conditions, some of them, such as PSA, could be used for screening purposes for prostate cancer.

"Most tumor markers are not specific to men. However, as men and women have different sex organs, there are some tumor markers that are produced in the male gonads. The prostate is a muscle-glandular organ, located in the small pelvis of a man. Some of the tumor markers that can indicate the development of prostate cancer and on the basis of which we can predict their aggressiveness or spread are PSA (Prostate-specific antigen), free-PSA, PAP (Prostatic acid phosphatase), CA3 mRNA, 17-Gene signature ( Oncotype DX GPS test), 46-Gene signature (Prolaris)", explains the clinical biochemistry specialist Mirjana Zindović.

She points out that some of the tumor markers that can indicate the development of testicular cancer are AFP (Alpha-fetoprotein), BETA-HCG (Beta-human chorionic gonadotropin, LDH (lactate-dehydrogenase).

"In middle and old age, men are more prone to fall ill with colorectal cancer, pancreatic cancer, lung cancer (especially if they are smokers), stomach cancer... Diagnosed diseases are mainly, in terms of response to applied therapy, or as an aid for a more individual choice of therapy , monitor the concentrations of certain tumor markers, such as: CEA, CA 19-9, Gastrin, CA 72-4, CYFRA 21-1, BRAF V600 mutations, EGFR genetic mutation, KRAS genetic mutation, MSI, dMMR and others", explains Dr. Zindović.

When tumor markers are made

Tumor markers, apart from cancers, can be elevated in other diseases and conditions. Dr. Zindović says that they cannot and should not be viewed in isolation.

"These analyzes must be preceded by a doctor's examination, who will suggest further diagnostic procedures and procedures (ultrasound, NMR, CT, PET, biopsy and others) based on the symptoms and signs of the disease. They cannot be used independently to diagnose cancer," she claims.

He says that the determination of tumor markers is the most important in monitoring the success of applied therapeutic procedures for already diagnosed cancer. He claims that they can be used to detect recurrent tumors, after the end of therapy, when there are still no signs and symptoms of the disease.

"They are not used as screening tests (making a diagnosis before symptoms appear). PSA is so far the only tumor marker that could be used for screening purposes for prostate cancer (in terms of specificity and sensitivity)," says Dr. Zindović.

They can be used to detect recurrent tumors, after the end of therapy, when there are still no signs and symptoms.

Symptoms that make men see a doctor

If the patient nevertheless performs the analysis of some tumor markers in the laboratory on his own initiative and their values ​​are elevated, it is necessary to consult a doctor for examination and possible additional diagnostics.

Dr. Zindović says that the patient should consult a doctor if he urinates more often, especially at night, if he feels that the bladder is not completely emptied, if he has pain and burning when urinating.

Symptoms that should be analyzed in relation to prostate and testicular tumors include a feeling of heaviness and changes in the testicles, such as enlargement, swelling, thickening, constant pain in the testicles for more than 14 days... Men should also consult a doctor if have stomach pain, unintentional weight loss, dark urine, gray stools, difficulty swallowing and body itching, indigestion, and a persistent cough that lasts more than three or four weeks.

What are tumor markers?

Tumor markers are mainly proteins, but also other substances (enzymes, hormones, antigens, various receptors), which are produced in larger quantities by cancerous cells or other cells of the body in response to the presence of cancer, as well as certain benign conditions, explains Dr. Zindović.

He says their presence provides information about the cancer, such as how aggressive it is, what therapy it may be sensitive to, and whether the therapy is working.

"They can be detected in blood, urine, other body fluids and tissues. Different tumor markers are used in clinical practice. Some are associated with only one type of cancer while others may be associated with different types of cancer. They are mostly detected by immunochemical techniques or immunophenotyping," she explains.