Testicular Cancer

Professor Gordon Rustin


 

The value of research is particularly well demonstrated by the great progress made in curing testicular cancer.

30 years ago, less than 10% of patients survived once their testicular cancer had spread. Now over 90% are cured.

The majority of these stage 1 patients are managed by close surveillance and avoided the need for chemotherapy or radiotherapy. However about a fifth of all patients on surveillance will relapse, but are then cured by chemotherapy. Thanks to a database managed by funding from the CTRT we can reassure patients with the following data:

Professor Rustin has managed over 1600 patients with stage 1 testicular cancer and only 4 patients have died from that cancer, including two who had refused to attend follow-up appointments.

Patients who present with testicular cancer that has already spread are treated with chemotherapy; which has been progressively improved since the two most important drugs, cisplatin and etoposide were introduced in the 1970s. Cure rates range from 75% to 95% in these patients depending upon how advanced their cancer was when they first present. Relapses are mostly seen in those few patients with very advanced cancer. However, it is still possible to cure them, even when their cancer has spread to the brain. We continue to investigate new therapies for those who relapse and carefully analyse our results.

The CTRT is particularly grateful to all the men who have been cured of testicular cancer and who have then made major contributions to the CTRT especially by running in the London marathon. Some of the money raised by these men supports clinical trials that will hopefully lead to improved care of patients with testicular cancer. One trial is investigating the role of magnetic resonance imaging (MRI) scans in patients on surveillance to see if this could further cut down the dose of radiation. Another is investigating whether the side effects of chemotherapy can be dramatically reduced for patients with metastatic seminoma by using a high dose of the single drug called carboplatin, rather than the standard three-drug regimen called BEP. Most of the money raised by these men is used to support new drug development that could be applied to patients with many tumour types.