Ask a doctor on the topic of Oncology

M2-PK in the blood CANCER??

April 28, 2012 | 30,00 EUR | answered by Dr. med. Ralf Berg

Dear Sir or Madam,

last December, I had abdominal pain. As a result, I had my blood tested for tumor markers. The following values were found:

CEA 0.6 normal less than 5
CA 19-9 5.2 normal less than 37
CA 72-4 less than 0.3 normal less than 3.5
CA 125 7.4 normal less than 35
SCC 0.2 normal less than 2
NSE 12.5 normal less than 18.3
Cyfra 0.35 normal less than 2.9
Pro-GRP 11.00 normal less than 46
LDH 146
CRP less than 0.03

HOWEVER, the M2-PK is at 22.4 (normal less than 15).

A gastroenterologist then performed an endoscopy, colonoscopy, ultrasound (pancreas, liver, kidneys), and an MRI. All without any findings.

In January, the value was tested again and it was at 21.4 (normal less than 15). So it had only slightly decreased if at all.

Now, 4 months later, the value is at 24.1, indicating an increase. All other values such as CEA, CA 19-9, Cyfra, NSE, LDA, CA 72-4, TPA, and erythropoietin are within normal range.

I also had my Pro-GRP tested again. It used to be between 11-15, but now it's at 33. However, still within the normal range up to 65.

I had an ultrasound of the liver and kidneys last week again, which showed no abnormalities.

Could the doctors have missed cancer in the December examinations? The lungs were never examined except for the markers. Now the Pro-GRP has also increased (though within normal range) and the M2-PK as well.

I have also read about Cushing's syndrome in lung cancer. Therefore, I had my ACTH and cortisol tested.

ACTH was elevated at 56 (normal less than 46)
Cortisol was at the upper end of the normal range at 24 (normal less than 25).

Putting two and two together, it seems like I have lung cancer. Is that correct?

Dr. med. Ralf Berg

Good day dear inquirer,

No, that is not correct. To assess whether you may have a risk for lung cancer, the medical history is more informative than tumor markers. ACTH and cortisol levels are variable and can also be elevated due to stress, infections, lack of sleep, etc. Even in cases where tumors are present, the tumor markers may not show up or only appear later. In many cases where they show borderline or weakly negative results, no tumor is found clinically.

Especially in the case of lung cancer, the tumor markers are not so "specific" and can also be elevated in infections. If you still suspect that you may be suffering from a lung tumor, you should consult a pulmonologist. In addition to the medical history (nicotine, dust, etc.), a chest X-ray should be taken. Only then can your risk be assessed. Tumor markers are not sufficient for this.

It is especially the case with lung tumors that, unfortunately, due to the minimal symptoms they cause, they are often only discovered when they have formed metastases, which then become noticeable. At least this could be ruled out in your recent follow-up findings. When it comes to lung cancer, prevention (quitting smoking) must be given more importance. If you want more precise data on the prevalence and pre-test risk for lung cancer, you can contact the German Cancer Research Center in Heidelberg by phone or in writing.

There, all data on cancer research is collected and linked to prediction methods. Unfortunately, there has been no breakthrough regarding lung tumors, allowing tumor markers to provide reliable predictions.

Warm regards,
Dr. R. Berg