Testicular Cancer

Cancer treatments often cause sexual dysfunctions that remain severe long after therapy is over. Nevertheless, sexual counseling is not routinely provided in most oncology treatment settings. Most patients and their partners can benefit from brief counseling that includes education on the impact of cancer treatment on sexual functioning; suggestions on resuming sex comfortably and improving sexual communication; advice on how to mitigate the effects of physical handicaps, such as having an ostomy, on sexuality; and self-help strategies to overcome specific sexual problems, such as pain with intercourse or loss of sexual desire. Brief counseling can be provided by one of the allied health professionals on the oncology treatment team. A minority of patients will need specialized, intensive medical or psychological treatment for a sexual dysfunction. In a large cancer center, such treatment could be provided as part of a reproductive health clinic serving the special needs of cancer patients. In smaller settings, the oncologist should build a referral network of specialists. Not all managed care organizations reimburse for these services, however. [ONCCOLOGY 13(11):1585-1591, 1999]

Often overshadowed by more common genitourinary cancers, such as prostate, testicular, and kidney cancers, penile and urethral cancers nonetheless represent difficult treatment challenges for the clinician. The management of these cancers is slowly evolving. In the past, surgery, often extensive, was the treatment of choice. Recently, however, radiation and chemotherapy have begun to play larger roles as initial therapies, with surgery being reserved for salvage. With these modalities in their treatment armamentarium, oncologists may now be able to spare patients some of the physical and psychological sequelae that often follow surgical intervention without compromising local control and survival. Part 1 of this two-part article, published in last month’s issue, dealt with cancer of the penis. This second part focuses on cancer of the urethra in both females and males. [ONCOLOGY 13(11):1511-1520, 1999]

Cancer treatments often cause sexual dysfunctions that remain severe long after therapy is over. Nevertheless, sexual counseling is not routinely provided in most oncology treatment settings. Most patients and their partners can benefit from brief counseling that includes education on the impact of cancer treatment on sexual functioning; suggestions on resuming sex comfortably and improving sexual communication; advice on how to mitigate the effects of physical handicaps, such as having an ostomy, on sexuality; and self-help strategies to overcome specific sexual problems, such as pain with intercourse or loss of sexual desire. Brief counseling can be provided by one of the allied health professionals on the oncology treatment team. A minority of patients will need specialized, intensive medical or psychological treatment for a sexual dysfunction. In a large cancer center, such treatment could be provided as part of a reproductive health clinic serving the special needs of cancer patients. In smaller settings, the oncologist should build a referral network of specialists. Not all managed care organizations reimburse for these services, however. [ONCCOLOGY 13(11):1585-1591, 1999]

WASHINGTON-The US Postal Service has issued a 33 cent postage stamp designed to encourage the early detection and treatment of prostate cancer. The stamp features a drawing of the male gender symbol against a red background. The words “Prostate Cancer Awareness-Annual Checkups and Tests” appear on the stamp, which was designed by Michael Cronan of San Francisco.

Researchers from Roswell Park Cancer Institute, Buffalo, New York, are part of an international group studying the long-term health effects caused by the 1986 destruction of the nuclear reactor at the power plant in Chernobyl, Ukraine. The

Patients with poor-prognosis testicular cancer have a better chance of surviving if they are treated at an institution that cares for five or more such patients during an approximate 4-year period than if treated at an institution that sees fewer than five

Intracranial germinomas are uncommon tumors. In the past, patients have traditionally been diagnosed with a trial of focal radiotherapy without biopsy. If the tumor was radiosensitive, it was presumed to be a germinoma.

Researchers at The University of Texas M. D. Anderson Cancer Center have received funding to investigate the long-term effects of chemotherapy on men surviving testicular cancer.

Kaposi’s sarcoma (KS) is the most common malignancy associated with human immunodeficiency virus-1 (HIV-1) infection and can result in significant morbidity. The clinical course of KS is quite variable, although for the

Current controversies in the treatment of stage I seminoma center on the relative roles of surveillance, adjuvant radiotherapy (RT), and adjuvant single-agent chemotherapy. Surveillance has been studied in over 800 patients,

MINNEAPOLIS--Living With Cancer: A Message of Hope, a conversation with some of the nearly 10 million US cancer survivors, debuts nationally on PBS, Friday, September 25, at 9:00 pm (check local listings).

Current controversies in the treatment of stage I seminoma center on the relative roles of surveillance, adjuvant radiotherapy (RT), and adjuvant single-agent chemotherapy. Surveillance has been studied in over 800 patients,

WASHINGTON--"The March . . . Coming Together to Conquer Cancer" rings of militancy. It has an American war hero, retired US Army General H. Norman Schwarzkopf, as its honorary chairman. Its monthly newsletter is subtitled "A Campaign Bulletin." And when leaders and supporters of The March held a press briefing to talk about the nationwide event scheduled for Sept. 26, the rhetoric matched.

With the increasing success of multimodality anticancer therapy, most men of reproductive age will survive their malignancy. Reproductive function is a principal concern of these men. Health-care providers are shifting the

With the increasing success of multimodality anticancer therapy, most men of reproductive age will survive their malignancy. Reproductive function is a principal concern of these men. Health-care providers are shifting the

Traditionally, cytotoxic drugs have played a limited role in the treatment of brain tumors, but important advances in chemotherapy have occurred during the past decade. Certain central nervous system (CNS) malignancies are

With the increasing success of multimodality anticancer therapy, most men of reproductive age will survive their malignancy. Reproductive function is a principal concern of these men. Health-care providers are shifting the

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative extent of disease evaluation, and role of the surgeon in

This paper is a very nice review of the history of the development of modern urologic surgical procedures for the treatment of testicular germ-cell tumors and their current indications. I agree with virtually everything the authors say. I will emphasize several points that they make and highlight a few small areas of disagreement.

The article by Drs. Steele and Richie is a well-written, extremely important review of the natural history, treatment options, and current role of surgery in the management of nonseminomatous germ cell tumors of the testis. The authors present their rationale for retroperitoneal lymph node dissection (RPLND) in a thoughtful and provocative way. Their philosophy mimics that practiced at the University of Southern California (USC), which is very similar to that espoused by Drs. John Donohue and Larry Einhorn, who pioneered the current management practices that have made germ cell testicular tumors the most curable solid tumor in humans.[1,2]

Carcinoma of the testis is the most common malignancy in males 15 to 35 years of age. Testicular cancer has become one of the most curable solid neoplasms and, as such, serves as a paradigm for the multimodality treatment of malignancies. The cure rate for patients with clinical stage I disease is nearly 100%, and patients with advanced disease now achieve complete remission rates of over 90%. The markedly improved outlook for patients with this cancer over the past 15 years has led to a reassessment of management options, especially in patients with clinical stage I disease. The realization that platinum-based chemotherapy could cure most patients with an advanced nonseminomatous germ cell tumor (NSGCT), especially those with minimal disease, led to the introduction of various strategies to decrease the morbidity associated with surgical management. These strategies include surveillance protocols, chemotherapy for clinical stage II disease, and observation protocols for a subset of patients with advanced disease who have had a partial response to chemotherapy. Retroperitoneal lymph node dissection (RPLND) has an important place in the management of both low- and high-stage testicular cancer. It offers the patient two basic benefits: accurate staging and the possibility of a surgical cure, even in the presence of metastatic disease. [ONCOLOGY 11(5):717-729, 1997]

Progress in managing testicular cancer over the last 2 decades has produced survival rates of well over 90% using a multidisciplinary approach that serves as a model for other tumors. Improved imaging techniques permit more accurate clinical staging, allowing the clinician to select, for each patient, the sequence of surgical and chemotherapeutic modalities that maximizes survival while keeping morbidity within tolerable limits. Current investigators are attempting to refine treatment protocols so as to maintain or improve survival while reducing morbidity and costs.

The National Cancer Act of 1971 was established when then President Nixon declared the "war on cancer." Since that time, no magic bullet has been discovered, and it is apparent that we have not been victors in the war against the nation's second leading killer. Overall cancer rates have continued to rise, with only a slight decrease in mortality from breast and other cancers. Nevertheless, remarkable progress has been made in the cure of childhood cancers, Hodgkin's disease, and testicular cancer.[1,2]

WASHINGTON--Breast cancer mortality continues to drop among white women in the United States, Canada, and Great Britain, and, for the first time, it has dropped in black American women, NCI Director Richard Klausner said in his delivery of the 6th Annual Jo Oberstar Memorial Lecture at the George Washington University School of Medicine.

Here is a true story, one that you won't see on ER or Chicago Hope--A 64-year-old man is referred to me with cancer that started somewhere in his intestines and is now replacing liver and lung. He is bed-bound, losing weight quickly, and has no appetite. He has been treated with two types of chemotherapy, both of which have made him sick, yet the cancer has continued to grow.