Cancer Markers: What is the Value

There has been a continual flow of markers for proposed use in cancer identification and management. For example:

1. The recent prognostic blood borne markers for prostate cancer prognostication.

2. BRAF V600 marker for certain types of melanoma

and many others.

It usually works as follows:

1. Some group publishes a paper announcing a new marker or markers. This is all too often devoid of any discussion of why they are good markers such as describing pathway issues. BRAF is a clear exception.

2. The trade press then blasts this "discovery" across its pages and it all too often includes comments by some of the authors all too often making illusions to great things to come.

3. Then the popular press gets a hold on it and generally having o idea what they are saying explode it to a level never anticipated.

Thus the issue is what value and at what cost.

Take the prostate markers, all it tells one is that you will die soon or sooner. Is that valuable? Possible to estate planning but any good clinical physician could come close to the same answer.

Then BRAF V600, we can now extend life 6 months at the cost of $100,000. The same end point, but at significant costs, not to mention 6 months of physician care etc. Is this worth the cost?

Perhaps it is all in the eye of the beholder. Perhaps the researchers should temper their enthusiasm.