Persistence Pays Off With Testicular Cancer
Cure rate soars after repeat chemotherapy treatments
 (HealthDay News) -- If at first you don't destroy testicular cancer, try, try again seems to be a good approach.
Researchers reported in the New England Journal of Medicine that repeating high-dose chemotherapy, even if it failed the first time, can often successfully cure testicular cancer.
"This was a regimen established by our group over 10 years ago, and now we show that it is applicable to all testicular cancer patients," the study's senior author, Dr. Rafat Abonour, an associate dean for clinical research at Indiana University School of Medicine, told HealthDay .
He said the study was "testimony to the dedication and leadership of Dr. Larry Einhorn," its lead author who Abonour said was instrumental in establishing the role of cisplatin and other chemotherapy agents in the treatment of testicular cancer.
Einhorn is now the Lance Armstrong Foundation Professor of Oncology, a position that was created after bicyclist and Tour de France winner Lance Armstrong was treated and cured of testicular cancer at Indiana University .
As many as 8,000 American men are diagnosed with testicular cancer each year, according to the National Institutes of Health. It's a rare cancer, occurring in only about 1 percent of American men, but it tends to affect young men under 40 more often, the institute reports.
Symptoms include enlargement of a testicle or a change in the way a testicle feels, a lump in either testicle, dull pain in the lower back or abdomen, a feeling of heaviness in the scrotum and the development of male breast tissue.
The cure rate is quite high -- about 90 percent -- from the first round of treatment. But, for those with more stubborn cancer, the study suggests that, even after failure of the first treatment, a cure is still possible during the next round of chemotherapy.
The research involved 184 men undergoing what's known as "salvage chemotherapy" -- high-dose chemotherapy that's given after the cancer has not responded to other treatments. Four years later, the cancer in 116 of the 184 men was considered to be in complete remission, the study found. Before the salvage treatment, 49 of the 116 men had undergone two or more previous rounds of chemotherapy, and almost half of that group -- 22 men -- were found to be cancer-free four years later.
"The take-home message is that continuous effort to provide treatment is effective," Abonour said.
Dr. George Bosl, chairman of the Department of Medicine at Memorial Sloan-Kettering Cancer Center in New York City , said that "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."
He cautioned, though, that the success with testicular cancer won't translate to a boon for treating other types of cancer. Most testicular cancers occur in germ cells, which is where sperm is produced, and germ cells appear to be especially vulnerable to chemotherapy.
"Germ cell tumors are different from other cancers, where curative chemotherapy in the first line of treatment is hard to come by," Bosl said.
On the Web
To learn more about Lance Armstrong's treatment and testicular cancer, visit the American Cancer Society.
SOURCES:
HealthDay News ; Rafat Abonour, M.D., associate dean for clinical research, Indiana University, Indianapolis; George Bosl, M.D., chairman, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York City; July 26, 2007, New England Journal of Medicine ; National Library of Medicine (www.nlm.nih.gov)
Author:
Serena Gordon
Publication Date:
July 31, 2008
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