Testicular cancer is largely a curable disease.
By assessing just three features of a common kind of testicular cancer, known as non-seminomatous germ cell tumor, scientists believe they can identify those at most at risk of relapse, even where there is no evidence of tumor spread.
Testicular germ cell tumors are the most common solid malignant tumor in young Caucasian men.
Patients diagnosed with disease in the early stages face a choice between monitoring with treatment, if relapse occurs, or moving directly on to chemotherapy with its associated long-term side effects.
Predicting who does or does not need chemotherapy is important in order to minimize treatment, with its undesirable side effects. The new test could be used in clinics to make decisions about which patients should be given chemotherapy.
Scientists at The Institute of Cancer Research in the UK analyzed 177 tumor samples from patients with stage 1 non-seminomatous tumors, enrolled in clinical trials through the Medical Research Council (MRC) Clinical Trials Unit.
94.3% of patients in low-risk group did not relapse
They found that three different features of the tumors were important indicators of relapse risk:
- The levels of a molecule called CXCL12
- The percentage of the tumor with an appearance of cancer stem cells
- Whether or not blood vessels were present in the tumor.
They scored tumors based on these features, and found that by combining scores, they could divide patients up into three different risk groups based on how likely patients were to suffer a relapse of the disease within 2 years. It is rare for a patient to relapse from testicular cancer beyond this time.
- The chance of getting testicular cancer is 1 in 263 in the US
- The average age for developing it is 33 years
- In the US, treatment makes the lifetime risk of dying from testicular cancer 1 in 5,000.
The vast majority of patients were in the low-risk group: 94.3% did not relapse in 2 years. In the moderate-risk group, 65.9% did not relapse. Strikingly, only 30% of patients did not relapse in the high-risk group.
The tests were validated in an additional group of 80 patients at the UK's The Royal Marsden Hospital.
Study leader Prof. Janet Shipley explains that the test will be able to detect who really needs chemotherapy.
Chemotherapy is extremely effective in treating testicular cancer, but can have long-term consequences for a patient's health and well-being. Long-term effects include cardiovascular disease, second malignancies, Reynaud's syndrome, neuropathies, fertility and emotional disorders.
Minimizing exposure to chemotherapy is especially important in testicular cancer, as they can affect young adults for decades.
Now, low-risk patients could simply be monitored and potentially avoid chemotherapy and its side effects.The researchers would now like to test this prognostic index in larger groups of men, with a view to protecting future quality of life in what is, essentially, a curable disease.
Medical News Today reported recently that half of testicular cancer cases are caused by hereditary factors.