Seminoma medical therapy: Difference between revisions

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{{Seminoma}}
{{Seminoma}}
{{CMG}}
{{CMG}}{{AE}}{{S.G.}}
 
==Overview==
==Overview==
*Treatments of patients with seminoma depends on stage of seminoma, risk of recurrence, [[Fertility]] and [[Preferences]] of the individual. The majority of patients with seminoma are treated [[Chemotherapy]]. [[Chemotherapy]] is helpful for all stages of seminoma. [[Chemotherapy]] is used in patients who have done [[orchiectomy]]. A combination of [[chemotherapy]] drugs is usually given. Seminoma is a radiosensitive [[tumor]]. [[radiotherapy|Radiation therapy]] may be helpful to treat stage I or II seminomas after [[orchiectomy]]. Active surveillance is the preferred treatment for stege I seminoma after a [[Orchiectomy|radical inguinal orchiectomy]]. There are no standard active surveillance schedules for seminoma. There are no standard active surveillance schedules for seminoma.
==Medical Therapy==
==Medical Therapy==
In recent years, these tumors have been shown to have dramatic sensitivity to both [[radiotherapy]] and [[cytotoxic]] [[chemotherapy]]. The management of childhood seminoma is similar to that of adult seminoma. [[Orchiectomy]] is required in almost all cases.
*Treatments of patients with seminoma depends on:<ref name="Cullen2012">{{cite journal|last1=Cullen|first1=M.|title=Surveillance or adjuvant treatments in stage 1 testis germ-cell tumours|journal=Annals of Oncology|volume=23|issue=suppl 10|year=2012|pages=x342–x348|issn=0923-7534|doi=10.1093/annonc/mds306}}</ref><ref name="pmid16389345">{{cite journal |vauthors=Sagalowsky AI |title=Treatment options for clinical stage 1 testis cancer |journal=Proc (Bayl Univ Med Cent) |volume=13 |issue=4 |pages=372–5 |date=October 2000 |pmid=16389345 |pmc=1312235 |doi= |url=}}</ref><ref name="pmid21819630">{{cite journal |vauthors=Boujelbene N, Cosinschi A, Boujelbene N, Khanfir K, Bhagwati S, Herrmann E, Mirimanoff RO, Ozsahin M, Zouhair A |title=Pure seminoma: a review and update |journal=Radiat Oncol |volume=6 |issue= |pages=90 |date=August 2011 |pmid=21819630 |pmc=3163197 |doi=10.1186/1748-717X-6-90 |url=}}</ref><ref name="pmid25928512">{{cite journal |vauthors=Ahmed KA, Wilder RB |title=Stage IIA and IIB testicular seminoma treated postorchiectomy with radiation therapy versus other approaches: a population-based analysis of 241 patients |journal=Int Braz J Urol |volume=41 |issue=1 |pages=78–85 |date=2015 |pmid=25928512 |pmc=4752059 |doi=10.1590/S1677-5538.IBJU.2015.01.11 |url=}}</ref><ref name="pmid29381453">{{cite journal |vauthors=Lieng H, Warde P, Bedard P, Hamilton RJ, Hansen AR, Jewett MAS, O'malley M, Sweet J, Chung P |title=Recommendations for followup of stage I and II seminoma: The Princess Margaret Cancer Centre approach |journal=Can Urol Assoc J |volume=12 |issue=2 |pages=59–66 |date=February 2018 |pmid=29381453 |pmc=5937398 |doi=10.5489/cuaj.4531 |url=}}</ref><ref name="pmid21241480">{{cite journal |vauthors=Lodi D, Iannitti T, Palmieri B |title=Stem cells in clinical practice: applications and warnings |journal=J. Exp. Clin. Cancer Res. |volume=30 |issue= |pages=9 |date=January 2011 |pmid=21241480 |pmc=3033847 |doi=10.1186/1756-9966-30-9 |url=}}</ref>
:*Stage of seminoma
:*Risk of recurrence
:*[[Fertility]]
:*[[Preferences]] of the individual
<br>
{{familytree/start |summary=Treatment of Seminoma}}
{{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | | | | | | | A01 | | |A01=<div style="width: 9em; padding:0.2em;">'''Treatment of Seminoma'''</div>}}
{{familytree |boxstyle=background: #DCDCDC;| | | | | | | |,|-|-|-|-|-|v|-|-|-|^|-|-|-|v|-|-|-|-|-|.| |}}
{{familytree |boxstyle=background: #DCDCDC;| | | | | | | B01 | | | | B02 | | | | | | B03 | | | | B04 | |B01=<div style="width: 9em; padding:0.2em;">'''Stage I''' </div>|B02=<div style="width: 9em; padding:0.2em;">'''Stage II'''</div>|B03=<div style="width: 9em; padding:0.2em;">'''Stage III'''</div>|B04=<div style="width: 9em; padding:0.2em;">'''Recurrent'''</div>}}
{{familytree |boxstyle=background: #DCDCDC;| | | | | | | |!| | | | | |!| | | | | | | |!| | | | | |!| | | | | |}}
{{familytree |boxstyle=background: #DCDCDC;| | | | | | | C01 | | | | C02 | | | | | | C03 | | | | C04 | | | | |C01=<div style="width: 10em; padding:0.2em;">❑ [[Surgery]]<br>❑ Active surveillance<br>❑ [[Radiotherapy]]<br>❑ [[Chemotherapy]]</div>|C02=<div style="width: 10em; padding:0.2em;">❑ [[Surgery]]<br>❑ [[Radiotherapy]]<br>❑ [[Chemotherapy]]</div>|C03=<div style="width: 10m; padding:0.2em;">❑ [[Surgery]]<br>❑ [[Chemotherapy]]</div>|C04=<div style="width: 10em; padding:0.2em;">❑ [[Chemotherapy|Standard-Dose Chemotherapy]]<br>❑ [[chemotherapy|High-Dose Chemotherapy]] with [[Hematopoietic stem cell transplantation|Stem Cell Transplant]]<br>❑ [[Surgery]]</div>}}
{{familytree/end}}
 
===Chemotherapy===
*[[Chemotherapy]] is a common treatment for all stages of seminoma. It is usually given after an [[orchiectomy]]. A combination of [[chemotherapy]] drugs is usually given.
*BEP is the main [[chemotherapy]] combination used for seminoma. It includes [[bleomycin]], [[etoposide]], and [[cisplatin]].
*Sometimes, physicians just give [[etoposide]] and [[cisplatin]] (called EP). EP is given when [[bleomycin]] affects the [[Lung|lungs]] (called [[pulmonary toxicity]]), or there is a high risk that it will cause [[lung]] damage.
*High-dose [[chemotherapy]] and [[Hematopoietic stem cell transplantation|stem cell transplant]] may be used for recurrent [[testicular cancer]], if the standard-[[dose]] [[chemotherapy]] doesn’t work and the [[cancer]] comes back.  
*High doses of [[carboplatin]] and [[etoposide]] are given. After high-dose [[chemotherapy]], a [[stem cell]] [[transplant]] is done to replace the [[Stem cell|stem cells]] that are damaged or destroyed by high-dose [[chemotherapy]]. The [[stem cell]] [[transplant]] is an [[autologous]] peripheral [[blood]] [[stem cell]] [[transplant]].
 
===Radiotherapy===
*Seminoma is '''a radiosensitive''' [[tumor]] (vs. nonseminomatous [[germ cell tumors]])
*[[radiotherapy|Radiation therapy]] may be used to treat stage I or II seminomas after [[orchiectomy]].
*It is given as [[external beam radiation therapy]].  
*[[Radiation]] is directed at the [[Lymph node|lymph nodes]] in the [[abdomen]] and [[pelvis]].


===Active Surveillance===
*Active surveillance is the preferred treatment for stage I seminoma after a [[orchiectomy|radical inguinal orchiectomy]].
*During active surveillance, the healthcare team watches for any [[signs]] and [[symptoms]] of recurrence. Treatment is given only if seminoma recurs.
*There are no standard active surveillance schedules for seminoma. Active surveillance may last for 5-10 years. You may have follow-up visits every 2-6 months for the first 3 years.
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Types of cancer]]
[[Category:Needs content]]
[[Category:Oncology]]


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[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Urology]]

Latest revision as of 13:50, 7 May 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [2]

Overview

  • Treatments of patients with seminoma depends on stage of seminoma, risk of recurrence, Fertility and Preferences of the individual. The majority of patients with seminoma are treated Chemotherapy. Chemotherapy is helpful for all stages of seminoma. Chemotherapy is used in patients who have done orchiectomy. A combination of chemotherapy drugs is usually given. Seminoma is a radiosensitive tumor. Radiation therapy may be helpful to treat stage I or II seminomas after orchiectomy. Active surveillance is the preferred treatment for stege I seminoma after a radical inguinal orchiectomy. There are no standard active surveillance schedules for seminoma. There are no standard active surveillance schedules for seminoma.

Medical Therapy


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Treatment of Seminoma
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Stage I
 
 
 
Stage II
 
 
 
 
 
Stage III
 
 
 
Recurrent
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Surgery
❑ Active surveillance
Radiotherapy
Chemotherapy
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Chemotherapy

Radiotherapy

Active Surveillance

  • Active surveillance is the preferred treatment for stage I seminoma after a radical inguinal orchiectomy.
  • During active surveillance, the healthcare team watches for any signs and symptoms of recurrence. Treatment is given only if seminoma recurs.
  • There are no standard active surveillance schedules for seminoma. Active surveillance may last for 5-10 years. You may have follow-up visits every 2-6 months for the first 3 years.

References

  1. Cullen, M. (2012). "Surveillance or adjuvant treatments in stage 1 testis germ-cell tumours". Annals of Oncology. 23 (suppl 10): x342–x348. doi:10.1093/annonc/mds306. ISSN 0923-7534.
  2. Sagalowsky AI (October 2000). "Treatment options for clinical stage 1 testis cancer". Proc (Bayl Univ Med Cent). 13 (4): 372–5. PMC 1312235. PMID 16389345.
  3. Boujelbene N, Cosinschi A, Boujelbene N, Khanfir K, Bhagwati S, Herrmann E, Mirimanoff RO, Ozsahin M, Zouhair A (August 2011). "Pure seminoma: a review and update". Radiat Oncol. 6: 90. doi:10.1186/1748-717X-6-90. PMC 3163197. PMID 21819630.
  4. Ahmed KA, Wilder RB (2015). "Stage IIA and IIB testicular seminoma treated postorchiectomy with radiation therapy versus other approaches: a population-based analysis of 241 patients". Int Braz J Urol. 41 (1): 78–85. doi:10.1590/S1677-5538.IBJU.2015.01.11. PMC 4752059. PMID 25928512.
  5. Lieng H, Warde P, Bedard P, Hamilton RJ, Hansen AR, Jewett M, O'malley M, Sweet J, Chung P (February 2018). "Recommendations for followup of stage I and II seminoma: The Princess Margaret Cancer Centre approach". Can Urol Assoc J. 12 (2): 59–66. doi:10.5489/cuaj.4531. PMC 5937398. PMID 29381453. Vancouver style error: initials (help)
  6. Lodi D, Iannitti T, Palmieri B (January 2011). "Stem cells in clinical practice: applications and warnings". J. Exp. Clin. Cancer Res. 30: 9. doi:10.1186/1756-9966-30-9. PMC 3033847. PMID 21241480.

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