Evaluation and treatment of testicular cancer

Testicular cancer accounts for only 1% to 2% of malignant disease in males, with approximately 5,000 new cases per year in the United States. Yet its low incidence belies its importance: Among males from 15 to 35 years old it is the most common nonhematologic neoplasm. Moreover, it is one of the few solid tumors that are curable in advanced stages. Recent progress in treating the disease can be attributed to a number of factors, including refinements in pathologic diagnosis, development of accurate noninvasive staging procedures, effective use of sophisticated biologic marker determinations, development of effective combination-chemotherapy regimens, and skillful integration of different therapeutic modalities. The strategies developed for treating testicular cancer can probably serve as models for other, more common chemoresponsive tumors. For the individual patient with testicular cancer, optimal management requires methodical and skillful application of the clinical principles that have evolved over the past decade.