Testicular cancer gauge often underused

Serum-based tumor markers are not used in more than half of all patients who have testis cancer, report researchers at the University of Michigan Comprehensive Cancer Center, Ann Arbor.

In a review of more than 4,700 testis cancer cases, the research team found that only about 45% of cases used the tumor markers alpha fetoprotein and human chorionic gonadotrophin. Those two were used in conjunction with a third tumor marker, lactate dehydrogenase, just 16% of the time (Urol Oncol 2008; 26:153–7).

“Tumor markers play a central role in showing physicians how a patient is responding to treatment and whether the disease has recurred,” said lead author Scott M. Gilbert, MD. “We were extremely surprised by the low rates of usage.”

Dr. Gilbert said he and his colleagues regularly check all three tumor markers in their patients. A majority of the sites in the study failed to show improvement during the study interval, and one site experienced a decrease in the use of tumor markers by the end of the study. The authors noted that low rates of usage do not necessarily indicate that the tumor markers were being used as infrequently as the numbers suggest, but may be due to poor documentation in medical records.

“Even if it isn’t a problem related to the care of the patients, it is a quality problem at the medical centers that are not recording the data properly. Either way, major improvements need to occur,” said senior author Brent K. Hollenbeck, MD.