Seminoma medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
*In case of seminoma, the healthcare team creates an individualized treatment plan. It is generally based on the patient's needs and may include a combination of different treatments. The factors which help in deciding the treatment plan for seminoma include:<ref name="treatmentsoftesticularcancer">Treatments for testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/treatment/?region=on. Accessed on March 1, 2016</ref><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> | *In case of seminoma, the healthcare team creates an individualized treatment plan. It is generally based on the patient's needs and may include a combination of different treatments. The factors which help in deciding the treatment plan for seminoma include:<ref name="treatmentsoftesticularcancer">Treatments for testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/treatment/?region=on. Accessed on March 1, 2016</ref><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> | ||
:*Stage of seminoma | :*Stage of seminoma | ||
:*Risk of recurrence | :*Risk of recurrence | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
The optimal therapy for seminoma depends on the stage at diagnosis.
Medical Therapy
- In case of seminoma, the healthcare team creates an individualized treatment plan. It is generally based on the patient's needs and may include a combination of different treatments. The factors which help in deciding the treatment plan for seminoma include:[1][2][3][4][5][6]
- Stage of seminoma
- Risk of recurrence
- Fertility
- Preferences of the individual
- The various treatment options depending on the stage and recurrence risk of seminoma are discussed below:[7][8][9][10][11]
Treatment of Seminoma | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Stage I | Stage II | Stage III | Recurrent | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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.[12]
- 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 lungs (called pulmonary toxicity), or there is a high risk that it will cause lung damage.
- High-dose chemotherapy and 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 cells that are damaged or destroyed by high-dose chemotherapy. The stem cell transplant is an autologous peripheral blood stem cell transplant.[12]
Radiotherapy
- Seminoma is a radiosensitive tumor (vs. nonseminomatous germ cell tumors)
- Radiation therapy may be used to treat stage I or II seminomas after orchiectomy.[12]
- It is given as external beam radiation therapy.
- Radiation is directed at the lymph nodes in the abdomen and pelvis.[12]
Active Surveillance
- Active surveillance is the preferred treatment for stage I seminoma after a radical inguinal orchiectomy.[12]
- During active surveillance, the healthcare team watches for any signs and symptoms of recurrence. Treatment is given only if seminoma recurs.[12]
- 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.[13]
- Tests that are often done during a follow-up visit include:[13]
- Physical exam
- Blood tests to check serum tumor marker levels
- Chest x-ray
- CT scan of the abdomen
References
- ↑ Treatments for testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/treatment/?region=on. Accessed on March 1, 2016
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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)
- ↑ Treatment for testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/treatment/?region=on. Accessed on March 1, 2016
- ↑ Treatments for stage I seminoma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/treatment/seminoma/stage-i/?region=on. Accessed on March 1, 2016
- ↑ Treatments for stage II seminoma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/treatment/seminoma/stage-ii/?region=on. Accessed on March 1, 2016
- ↑ Treatments for stage III seminoma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/treatment/seminoma/stage-iii/?region=on. Accessed on March 1, 2016
- ↑ Treatments for recurrent seminoma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/treatment/seminoma/recurrent/?region=on. Accessed on March 1, 2016
- ↑ 12.0 12.1 12.2 12.3 12.4 12.5 Treatments for testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/treatment/?region=on. Accessed on March 2, 2016
- ↑ 13.0 13.1 Active surveillance for testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/treatment/active-surveillance/?region=on. Accessed on March 2, 2016