The value of research is particularly well demonstrated by the great progress made in curing testicular cancer. 30 years ago, less that 10% of patients survived once their cancer had spread. Now over 90% are cured. Over half of all patients are found to have stage 1 disease with no evidence of spread from the testicle. The majority of these stage 1 patients are managed by close surveillance and most of these patients avoid 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 testis cancer that has already spread are treated with therapy that has been progressively improved since the two most important drugs, cisplatin and etoposide were introduced in the 1970's. Cure rates range from 75 to 95% in these patients depending upon how advanced their cancer was when they presented. Relapses are mostly seen in those few patients who present with very advanced disease, but 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 testis 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 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.