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. |
