[Rehabilitation of patients with malignant germ cell tumor]

The progress achieved in the treatment of the malignant germ cell tumor of the male is based on the introduction of cisplatin in polychemotherapy and of consistent interdisciplinary cooperation (including surgery). Thus more than 70% of testicular cancer patients are now cured long term. Early diagnosis and consistent therapy increase the chances of survival additionally. The chances of successful therapy are markedly higher in early tumor stages (90%) than in late tumor stages (less than 50%), where intensive therapy modalities are being tried (bone marrow transplantation, cytokines). After reaching complete remission, consistent follow up programmes are important in order to detect a relapse (10-15%), and to enable the patient to return to his profession. Psychosocial care is also an important factor. The patient should under no condition be pensioned off, more than 90% of the mainly very young patients (median age 20-35) can return to work after the phase of intensive therapy (3-6 months). In the case of our 222 patients, only 13 had to be pensioned and 7 received new professional training. A disabled pass should be issued, whereby the extent of the disability is reduced from at first 80%-100% to 20% after a period of 5 years. The entry into civil service and a life insurance policy are also usually possible after 5 years. To aid in the consistent and necessary follow up of this group of hopeful and highly curable patients, we have had good experiences in Bavaria with a follow up calendar.