A 24-year-old man presented to the emergency department with worsening dyspnea and fever of 1 day’s duration. About 3 years earlier, he had been treated for testicular cancer (leiomyosarcoma) with orchidectomy, chemotherapy, and radiation. He had no significant social or family history. Temperature was 38.6°C (101.4°F); blood pressure, 119/80 mm Hg;... More »

The first randomized trial to evaluate the long-term outcome of treatment with a single dose of chemotherapy for early-stage testicular tumors has found that the approach is safe, effective, and less toxic compared to radiation therapy, the current standard of care. The study, the largest ever in testicular cancer, also showed that after 5 years, patients receiving chemotherapy had a decreased risk of developing a second tumor in the other testicle, though longer follow-up is needed. The data... More »

MILAN—Some men with nonseminoma germ cell tumor (NSGCT) testicular cancer have a normalization of tumor markers and minimal or no residual masses in the retroperitoneum after chemotherapy. What then? Should all of them undergo retroperitoneal lymph node dissection (RPLND) to be on the safe side, or should the procedure be reserved for selected cases? Leading researchers in urology debated this topic at the 23rd Annual Congress of the European Association of Urology (plenary session 1). More »

High-dose combination chemotherapy followed by autologous peripheral-blood stem cell transplant produced durable remissions in metastatic testicular cancer patients who relapsed or failed to respond to traditional therapy More »

INDIANAPOLIS -- When metastatic testicular cancer progresses despite initial chemotherapy, including a cisplatin-based combination, a high-dose salvage regimen with stem-cell rescue can lead to relapse-free complete responses. More »

Most testicular tumors are malignant and of germ-cell origin. They constitute only 1% of cancers in males overall but are the most common malignant neoplasm in men aged 15 to 35 years. Testicular cancers frequently present at an early stage, are very sensitive to chemotherapy, and are variably sensitive to radiotherapy. More »

Testicular cancer, although an uncommon malignancy, is the most frequently occurring cancer in young men. In the year 2005, an estimated 8,010 cases of testicular cancer will be diagnosed in the United States. For unknown reasons, the incidence of this cancer has increased since the turn of the century, from 2 cases per 100,000 population in the 1930s, to 3.7 cases per 100,000 population from 1969 to 1971, to 5.4 cases per 100,000 population from 1995-1999. This trend seems greatest for the... More »

The management of germ cell tumors has advanced dramatically, with cure rates approaching 90% to 95%. Treatment of stage I/A seminomas generally includes orchiectomy and adjuvant radiotherapy. Treatment of stage I/A nonseminomatous germ cell tumors involves orchiectomy followed by retroperitoneal lymph node dissection or active surveillance. One of the major advances has been the introduction of cisplatin-based chemotherapy for metastatic disease and the development of a system of risk... More »

Dr. Raghavan is to be commended for a concise and comprehensive overview of the management of germ cell tumors. As he suggests, given the demographics of this relatively uncommon disease and the high cure rate that can be achieved with proper treatment and follow-up, it behooves us to maintain these excellent results, even while striving to reduce the toxicity of treatment. We will highlight a few additional points to complement this superb review. More »

As Dr. Raghavan has emphasized in his excellent overview of the current therapy for testis cancer, it is critical that the success of therapy for this disease not be compromised by a desire to avoid the complications of therapy. We would wholeheartedly agree with his assertion that modifications in therapy must be introduced with a thoughtful and structured approach to minimize the risk to efficacy. More »