Therapy for Testicular Cancer Recurrence a Success
When first-line chemotherapy for testicular cancer is not enough, intensifying the dose can cure most men with this cancer, according to a report in the New England Journal of Medicine.
This
therapy regimen was established a decade ago, and now
the approach is found to be right for all testicular
cancer patients, says study author Dr. Rafat Abonour,
at Indiana University’s
School of Medicine.
Dr. Larry Einhorn, lead author on the study and a cancer specialist at Indiana University, led the way in establishing the value of medications such as cisplatin in the treatment of testicular cancer and has worked steadily at expanding their use and value.
The testicles are the male sex glands and are part of the male reproductive system. They are located behind the penis in a pouch of skin called the scrotum.
The testicles produce sperm and several male hormones, including testosterone. The hormones control the development of the reproductive organs, as well as other male characteristics - body and facial hair, low voice, and wide shoulders.
The American Cancer Society estimates that, in the year 2007, about 7,920 new cases of testicular cancer will be diagnosed in the US. An estimated 380 men will die of testicular cancer this year.
Common
symptoms for testicular cancer include:
-
lump in either testicle
-
enlargement of a testicle
-
feeling of heaviness in the scrotum
-
dull ache in the lower abdomen or in the groin
-
sudden collection of fluid in the scrotum
-
pain or discomfort in a testicle or in the scrotum
-
enlargement or tenderness of the breasts
The National Cancer Institute (NCI) recommends that a man should see
a physician if any of the above symptoms lasts two
weeks or longer.
The overall cure rate for testicular cancer is 90 percent for the first round of treatment, but there is a subset of more deadly metastatic cases where the cancer has spread to other parts of the body. About 30 percent of those patients suffer relapses and require further treatment.
The
study report describes the results of what it calls "salvage chemotherapy" in
184 such men.
The researchers say that a course of treatment centering on high dosages of anticancer medications led 116 participants to complete cancer remission over an average follow-up of four years.
Even among a subset of 49 men for whom two or more previous rounds of treatment had failed, almost half (22 men) were found to be free of cancer four years later.
Cures are possible because most testicular cancers are unusually sensitive to anticancer medications, explains Dr. George Bosl, at Memorial Sloan-Kettering Cancer Center in New York City.
Most
of those malignancies occur in "germ" cells, where
sperm is produced.
"The major point of this report is that if a young man with a germ cell tumor undergoes chemotherapy and if the disease remains afterward, very high doses of chemotherapy can cure a substantial fraction of those patients," says
Dr. Bosl.
Unfortunately,
the lessons learned from the treatment of testicular
cancer may not extend to other malignancies, he notes, "because
germ cell tumors are different from other cancers,
where curative chemotherapy in the first line of treatment
is hard to come by."
"The take-home message is that continuous effort to provide treatment is effective," says
Dr. Abonour.
Always consult your physician for more information.
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In addition to a complete medical history and physical examination, diagnostic procedures for testicular cancer may include the following:
ultrasound - a diagnostic technique which uses high-frequency sound waves to create an image of the internal organs.
blood tests - assessment of blood samples to check for increased levels of certain proteins and enzymes to determine if cancerous cells are present, or to determine how much cancer is present.
biopsy - a procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope to determine if cancer or other abnormal cells are present.
When testicular tumors are present, the entire tumor, as well as the testicle and spermatic cord, may be removed to prevent the spread of cancerous cells through the blood and lymph systems.
Staging of testicular cancer is the process of determining if and how far the cancer has spread.
Treatment options are based on the results of staging.
Procedures for determining stage include the following:
computed tomography scan (Also called a CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
lymphangiography - images of the lymph system in which dye is injected into a lymph vessel to improve images.
magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
Positron emission tomography (PET) -
a nuclear medicine procedure in which radioactive glucose
(sugar) is injected into the patient’s vein.
Because cancers use sugar much faster than normal tissues,
the cancerous tissue takes up the radioactive material.
A scanner can spot the radioactive deposits. This test
has turned out to be very useful for spotting cancer
that has spread beyond the testes.
Always consult your physician for more information.
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