Published 8 October 2009, doi:10.1136/bmj.b4125
Cite this as: BMJ 2009;339:b4125

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The science and art of medicine

The first 150 words of the full text of this article appear below.

Last week’s BMJ cast yet further doubt on prostate specific antigen as a screening tool for prostate cancer (2009;339:b3572, b3537, b3601), and this week we warm to the theme of tumour markers and their limitations. The Clinical Review (doi:10.1136/bmj.b3527) and the Practice article on rational testing (doi:10.1136/bmj.b3111) make clear that tumour markers are a mixed bag, not to be used in screening, unhelpful for diagnosis in patients with non-specific symptoms, and best reserved for monitoring once a diagnosis has been made. Unfocused requests and inappropriate use of tumour markers cost health services around the world large sums of money. They provide false reassurance in some cases and cause unnecessary anxiety, investigations, and treatment in others.

The authors stress that in the right hands and in some conditions—notably germ cell tumours—tumour markers have an important role. And as options for cancer treatment improve, the next generation of . . . [Full text of this article]

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See everything: overlook a great deal: correct a little.

BM Hegde
bmj.com, 9 Oct 2009 [Full text]

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Richard Bartley
bmj.com, 11 Oct 2009 [Full text]

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