Caring4Cancer

WASHINGTON (Reuters) - A chemical that comes from the pesticide DDT may raise a man's risk of developing testicular cancer, U.S. researchers said on Tuesday.

NEW YORK (Reuters Health) - Patients who are being treated for advanced colorectal, ovarian or testicular cancer are living longer than they have in the past, a research team from the National Cancer Institute, Bethesda, Maryland, reports in the May 15th issue of the journal Cancer, published online today.

NEW YORK (Reuters Health) - In a recent study, sons born to women who drank the equivalent of three cups of coffee a day during pregnancy were more likely to have undescended testes at age 2 years.

BARCELONA (Reuters) - The risk of divorce increases if one partner suffers from testicular or cervical cancer, but other types have no effect on whether a couple stays together, Norwegian researchers said on Thursday.

NEW YORK (Reuters Health) - Findings from a new study suggest that both high and low birth weights increase the risk of testicular cancer in men. The reason for this finding is unclear.

NEW YORK (Reuters Health) - Men who survive testicular cancer are just as likely to survive a second cancer as men who never had testicular cancer, according to a report in the Journal of the National Cancer Institute.

According to an article recently published in the New England Journal of Medicine, metastatic testicular cancer that has recurred following standard therapy can potentially be cured with high-dose therapy and an autologous stem cell transplant.

According to an article recently published in the New England Journal of Medicine, surgery before the age of 13 for the treatment of undescended testis reduces the risk of testicular cancer compared with surgery later in life.

NEW YORK (Reuters Health) - Mother Nature has always ensured that male births outnumber female ones, but the gap has been gradually narrowing over the past three decades in the U.S. and Japan, according to a new study.

NEW YORK (Reuters Health) - While men with testicular cancer have a good chance of being cured, they may still not be out of danger, Norwegian researchers report.

According to an article recently published in the Journal of the National Cancer Institute, men who have survived testicular cancer for at least one year are at a higher risk than the general population for death from all causes, particularly infection and circulatory and digestive diseases.

NEW YORK (Reuters Health) - The decline in deaths due to testicular cancer seen in the US and Canada over the last three decades has not reached all countries in the Americas and deaths from this relatively rare cancer remain unacceptably high in most Latin American countries, according to a report.

WASHINGTON (Reuters) - A painstaking scan of the DNA of tumor cells shows hundreds of previously unsuspected genes are involved in cancer, researchers said on Wednesday in a finding that offers new ways to fight the disease.

 

According to the results of a study published in the Journal of Occupational and Environmental Medicine, firefighters have an increased risk of developing certain types of cancer.

Patients who experience a cancer relapse more than two years after treatment for metastatic nonseminomatous testicular cancer can achieve good survival rates if the cancer relapse can be treated surgically. These results were published in the journal BJU International.

In an article published in the Journal of the American Medical Association, researchers have suggested that the responsiveness of testicular cancer cells to chemotherapy may be explained by the sensitivity of these cells to heat. If this proves to be the case, it may be possible to use heat to improve response to cancer treatment in patients with other types of cancer as well.

According to results presented at the American Association for Cancer Research (AACR), first-degree relative of patients who had never smoked but had been diagnosed with lung cancer have an increased risk of developing cancer within their lifetime, particularly cancers that occur before the age of 50.

According to a recent article published in the Journal of Clinical Oncology, men who have survived testicular cancer may be at an increased risk of developing subsequent cardiovascular (heart) disease. These individuals should undergo cardiac monitoring as part of their follow-up medical care.

According to a study published in the Journal of the National Cancer Institute, men treated for unilateral testicular cancer between 1980 and 1994 were often able to father children after treatment. However, the specific type of treatment influenced the probability of success.

According to results recently published in the Journal of Clinical Oncology, the chemotherapy combination of ifosfamide (Ifex®), paclitaxel (Taxol®), and cisplatin (Platinol®) appears highly effective for treatment of patients with recurrent testicular cancer.

According to a study published in the International Journal of Cancer, boys born to higher-weight mothers may be more likely to develop testicular cancer.

A study in the British Journal of Cancer reports that although treatment for testicular cancer may affect hormone levels and quality of life, many men are able to father a child after treatment.

Men with stage I seminoma (a type of testicular cancer) who are treated with one injection of carboplatin have the same low risk of relapse as men treated with radiation, according to a study in the Lancet.   Finding effective alternatives to radiation therapy may help men avoid some of the associated long-term side effects.

Treatment of patients with metastatic testicular cancer who have failed initial chemotherapy remains unsatisfactory with the majority of patients dying of cancer. At Indiana University doctors recently evaluated daily administration of an oral chemotherapy drug, etoposide, in patients who had previously responded to salvage chemotherapy. Most patients in this study had failed 2 prior chemotherapy regimens. Thirty-four patients were treated with chemotherapy, 14 with autologous bone marrow transplantation, and 23 achieved a complete remission. Etoposide was then started and given daily for 21 days a month. Three of 11 patients who achieved a partial response subsequently had a complete response, but all 3 ultimately developed recurrent cancer. Seventeen of the 23 patients (79%) who achieved a complete response before starting etoposide remain in complete remission with a follow-up of 26-49 months. This study suggests that maintenance chemotherapy may prolong complete remissions in patients with advanced metastatic testicular cancer. Such therapy may be evaluated earlier in poor risk patients. ( Journal of Clinical Oncology, Vol 13, No 5, pp 1167-1169, 1995)

Three cycles of bleomycin, etoposide, and cisplatin have been the standard therapy for patients with metastatic good-risk testicular cancer for more than a decade. However, the administration of bleomycin is associated with an approximate 1% mortality and significant toxicity to the lungs. Omission of bleomycin has been evaluated in several clinical trials, which suggest that 4 cycles of etoposide and cisplatin (EP) are adequate therapy for patients with good-risk metastatic testicular cancer.

While the majority of patients with testicular cancer are cured following standard therapy, some patients experience a recurrence of cancer following treatment. The survival rate of patients with recurrent testicular cancer who are treated following a cancer recurrence with standard therapy is approximately 20-25%. Recent clinical trials, however, have demonstrated an improved survival rate for patients with recurrent testicular cancer who are treated with high-dose chemotherapy followed by an autologous stem cell transplant.

Treatment of patients with testicular germ cell cancer or non-gonadal germ cell cancer who have failed initial chemotherapy is unsatisfactory. Approximately 20% of patients treated with conventional dose salvage chemotherapy survive. Very high doses of chemotherapy that require support with bone marrow or blood stem cells have been shown to improve the chance of cure for patients with lymphoma and leukemia. Doctors in Germany have attempted to treat patients with germ cell cancers who have failed chemotherapy with high doses of chemotherapy supported by stem cells (autologous bone marrow or blood stem cell transplantation).

Stage I seminoma is a highly curable cancer, with cure rates in excess of 95%. Treatment usually consists of surgery, followed by radiation therapy to prevent a recurrence, or return, of the cancer. Researchers in Germany now say that another approach to the prevention of recurrences of seminoma after surgery is to administer 2 courses of a chemotherapy drug called carboplatin. They report that this regimen is as effective as the radiation therapy, without the risk of the long-term side effects associated with radiation therapy.

Before effective chemotherapy was developed most patients with localized testicular cancer underwent retroperitoneal lymph node dissection to diagnose unseen cancer and to remove cancerous lymph nodes. This resulted in surgery being performed on three-quarters of patients who don’t need it, as there is no benefit to the removal of lymph nodes uninvolved with cancer. With the development of effective chemotherapy to treat testicular cancer physicians have been evaluating the alternative of surveillance (careful periodic testing and examination) and treating those patients who develop recurrent disease with chemotherapy. In one study from Canada, 105 patients were managed in this fashion. Thirty-seven of the 105 patients relapsed (35%) and required therapy between 2 and 21 months after diagnosis. Thirty-six of the 37 were treated successfully. This study demonstrates the feasibility of this approach in patients who agree to close supervision and comply with the surveillance program. ( Journal of Clinical Oncology, Vol 10, No. 4, pp 564-568, 1992)

Germ cell cancers can occur as 1 of 2 types: seminoma or non-seminoma. Non-seminoma germ cell cancer that occurs in the mediastinum—the space between the breast bone and lungs—is a cancer that has been difficult to study because of its rarity. Now, researchers at Indiana University report the findings from the largest evaluation to date of patients with this type of cancer.

The drug combination of bleomycin, etoposide and cisplatin (BEP) is effective therapy for patients with testicular cancer. One of the controversies is how much therapy is necessary to prevent relapses in patients with a minimal or moderate amount of cancer. Lower risk patients are those with elevated tumor markers and no other evidence of cancer, lung metastases that are not extensive, and non-palpable retroperitoneal lymph nodes. Previously, doctors at several centers had conducted a study which concluded that 4 cycles of BEP was no better than 3 cycles for curing patients with minimal or moderate cancer dissemination at the time of diagnosis. These doctors at Indiana University recently presented longer-term follow-up data on the 118 patients in this study. Patients had been randomized at diagnosis to receive treatment with either 3 or 4 cycles of BEP. Only 4 of 118 patients have relapsed with testicular cancer and are long-term survivors after salvage chemotherapy. An additional 4 patients relapsed with benign teratoma and are also long term survivors after surgery. There have been no differences in outcomes in patients whether they were treated with 3 or 4 cycles of BEP. It was concluded that 3 cycles of BEP should be given to patients with metastatic testicular cancer who did not have advanced disease (advanced pulmonary disease, primary mediastinal germ-cell tumor or involvement of liver, bone or central nervous system). Treatment with 3 cycles can decrease treatment-related side effects and is less expensive. ( Journal of Clinical Oncology, Vol 16, No 2, pp 702-706, 1998)

A chemotherapy regimen consisting of 2 courses of carboplatin may be more effective and cause fewer side effects than standard adjuvant treatment in patients with stage I seminoma, according a recent article published in the Journal of Clinical Oncology.

Patients with high-risk stage I non-seminoma testicular cancer include those with vascular or lymphatic invasion, an increased embryonal component, and an absence of yolk sac elements in the cancer specimen. Patients with greater than 3 of these risk factors have a 50% risk of cancer relapse. Patients with stage I non-seminoma can be successfully treated with surgical orchiectomy and retroperitoneal lymph node dissection or 2 cycles of chemotherapy and no retroperitoneal lymph node dissection with a similar outcome. The risk of cancer recurrence following retroperitoneal lymph node dissection is reported to be 4-10% and about 0-5% when 2 cycles of chemotherapy are used for treatment.

Three cycles of bleomycin, etoposide, and cisplatin have been the standard therapy for patients with metastatic good-risk testicular cancer for more than a decade. However, the administration of bleomycin is associated with an approximate 1% mortality and significant toxicity to the lungs. Omission of bleomycin has been evaluated in several clinical trials, which suggest that 4 cycles of etoposide and cisplatin (EP) are adequate therapy for patients with good risk metastatic testicular cancer. Physicians in France performed a randomized clinical trial in 250 patients with good risk metastatic testicular cancer that directly compared these two chemotherapy regimens and have reported preliminary results. The complete remission rates were the same (92% and 91%). With an average follow-up of two years the overall survival is also the same (97% and 96%). No toxic deaths have occurred in either group. The side effect of neutropenia occurred more frequently in the EP group and skin and nervous system toxicity was more common in the BEP group. This study suggests equivalent results including toxicity between the two regimens and that bleomycin may not be a necessary drug. Longer follow-up will be reported in the future. ( Proceedings of American Society of Clinical Oncology, Vol 18, Abstract 1199, 1999)

Patients with poor risk germ cell cancer (non-testicular germ cell cancer with a mediastinal primary, liver metastasis, markedly elevated tumor markers) have an approximate cure rate of 40-50% with conventional chemotherapy. High-dose chemotherapy with PBSC support has been investigated as salvage therapy for patients with metastatic germ-cell cancer who had failed chemotherapy with the suggestion that this is superior to conventional dose chemotherapy. Recently, physicians in Germany further evaluated HDC with PBSC support as initial therapy for patients with aggressive poor risk germ cell cancer. They compared the results of HDC in 146 patients to conventional-dose therapy in similar patients. They observed a 3 year cancer-free survival of 72% in patients receiving HDC with PBSC support compared to 59% for patients receiving conventional chemotherapy. This analysis provided the basis for a proposed randomized controlled trial that will directly compare HDC with PBSC support to conventional therapy for patients with poor risk metastatic germ cell cancer in the United States. ( Proceedings of American Society of Clinical Oncology, Vol 18, Abstract 1169, 1999)

Metastatic non-seminomatous germ cell (testicular) cancer is a rare but curable cancer. Because of the rarity, some treatment centers are unlikely to encounter many patients with this cancer in a single year and therefore may not have extensive treatment experience. Common standardized treatment protocols have been developed to assure appropriate treatment, but the impact of treatment experience is unknown. Physicians in Europe evaluated the association between the experience of the treating cancer institution and the long-term outcome of patients.

Seminoma, even at an advanced stage (stage III), is a highly treatable cancer, with a cure rate of approximately 90%. Treatment usually consists of chemotherapy with bleomycin, etoposide, and cisplatin or, for some, just etoposide and cisplatin. Although these treatments are effective against the cancer, cisplatin and etoposide are associated with some serious side effects. These include kidney damage, hearing loss, and neurologic problems with cisplatin; an increased risk for developing a second cancer with etoposide. Researchers in Texas now say that a new chemotherapy combination may be just as effective as the bleomycin/etoposide/cisplatin regimen, with fewer side effects.

While the majority of patients with testicular cancer are curable following standard therapy, some "high-risk" patients have a poor prognosis and a cancer-free survival of approximately 50-60%. Previous clinical studies have demonstrated that patients with recurrent testicular cancer can be cured with high-dose chemotherapy and autologous bone marrow or blood stem cell support. Because of the effectiveness of high-dose chemotherapy in patients with recurrent cancer, many physicians believe that the use of high-dose chemotherapy with autologous stem cell support as part of the initial treatment program for patients with "high-risk" testicular cancer will improve cure rates.