One dose chemo treatment the best for testicular cancer

Oct 6 2008

New research from the UK has found that one dose of chemotherapy is the best way to cure testicular cancer in many patients.

If testicular cancer is spotted early enough it is highly curable - it is commonly treated with either the drug carboplatin or radiotherapy - carboplatin is also used to treat ovarian and lung cancer.

In a trial funded by the Medical Research Council it has been found that the drug offered a similar relapse rate - but far fewer side effects and experts believe it could in future avoid the need for the testicle to be removed - the trial tested the chemotherapy on men with the early stage of the disease and found it was as successful but with fewer side-effects.

The study, led by Southampton University, followed almost 1,500 patients, 904 were given radiotherapy, and 573 carboplatin.

Most men diagnosed with testicular cancer have "seminomas", which affect the sperm-producing cells in the testicle and almost half of these are spotted at an early stage when the cancer is either confined to the testicle or causes slight enlargement of the lymph nodes in the pelvis or abdomen.

Such patients have their affected testicle removed, and are then offered either a single dose of carboplatin chemotherapy, a longer regime of radiotherapy, or the option to have no extra treatment running the risk of the cancer returning.

The researchers say radiotherapy can have severe side effects, whereas this type of chemotherapy allows people to resume their normal life much more quickly.

Lead researcher Dr. Ben Mead says the results which were "reassuring" showed that carboplatin was the better option as a carboplatin injection is less unpleasant with fewer long-term risks than radiotherapy.

In the study the rate of relapse in both groups was roughly the same, and Dr. Mead says another four years of follow up is needed before it is known for sure that they have been cured.

Dr. Mead says although practice was changing in Europe to include carboplatin, in many other parts of the world, including the U.S., radiotherapy remains standard treatment, and he hopes this would now change.

Experts say in terms of treatment research, testicular cancer had proved to be a "success story" and the trial shows that chemotherapy can cure early stage seminoma and that men diagnosed with the disease can be successfully treated with fewer side-effects.

They suggest another advantage of the carboplatin treatment was that by treating the whole body rather than one area, the small risk of another testicular cancer emerging in the other testicle was also reduced.

The study found just two out of 573 patients on carboplatin experienced this, compared with 15 out of 904 in the radiotherapy group.

The researchers are now seeking funding to to investigate whether testicular cancer can be approached in a 'lumpectomy' strategy in the same way as in breast cancer, rather than automatically removing the whole testicle.

The trial results are to be presented this week at a cancer conference in Birmingham in the UK.