Testis cancer: the way forward

The past decade has been an exciting time in the evolution of management of testicular cancer. A disease that once ranked as one of the major causes of cancer deaths in young men has now been transformed into one of the curable cancers. Having achieved this happy situation, clinicians have turned their attention to the reduction of the side effects of treatment. Surgical protocols have been simplified, with less extensive dissection, and schedules of chemotherapy have been attenuated. In our haste to achieve further benefits for the patients with testicular cancer, we must not sacrifice their chance of cure by poorly conceived or unevaluated clinical programmes. In the 1990s, the greatest cause of deaths from testicular cancer could be the well-intentioned, but inadequately trained or insufficiently cautious clinician. Testicular cancer should be treated in specialist centres with the best facilities by clinicians with a specific interest in the biology and management of the disease.