Screening that works
The interpretation is more subtle than “norm 4”: age thresholds, density (PSA/gland volume according to TRUS) and growth rate are important. Prostatitis and adenoma give moderate increases - therefore, decisions about a biopsy are made by the urologist after examination, the ratio of the free fraction and MRI. After radical prostatectomy, PSA should be undetectable—the most sensitive control for relapse. The entire route is in the clinic.
When is it appointed?
- observation after tumor treatment is the main role of markers;
- assessment of formations (ovaries - CA-125+HE4/ROMA; liver - AFP);
- prostate cancer screening - PSA by age and risk;
- monitoring the effectiveness of therapy over time;
- differential diagnosis in combination with visualization.
How to understand tumor markers correctly
Markers are a dynamic tool, not a “cancer test”: most grow in benign conditions, but early tumors may not produce them. The strength of markers is in observation after treatment (growth outstrips images by months) and in the assessment of specific formations in conjunction with ultrasound/CT. The exception is PSA: an established screening for prostate cancer. Prescription and interpretation - with a doctor; “a preventive panel of all markers” without indications creates anxiety, not benefit.
