Germ cell cancer of the testes

New insights into the etiology and specifically the role of atrophy in generating increased gonadotropin drive have come from a case-control study of 794 patients. This study demonstrated possible evidence for trauma and infection-related atrophy, although of most interest from the point of view of the gonadotropin drive hypothesis is the observation that, as with breast cancer, exercise may reduce the risk and early onset of puberty may increase the risk. The value of self-examination education as a way of reducing delay in diagnosis was debated from the viewpoint of general practice. This provided a timely reminder that, in a rare tumor with a more than 95% cure rate, such education might generate more anxiety about the disease than it would early diagnoses. The total absence of carcinoma in situ at the time of orchidectomy in a series of cryptorchidic patients who subsequently developed testis cancer after orchidopexy provides a good reason for not performing a biopsy. The late nongerm cancers at 15 to 20 years after radiation therapy have provoked reexamination of priorities for stage I seminoma. New data from two centers that have used a single course of carboplatin as adjuvant therapy with no relapses in 104 patients are of considerable interest in providing an alternative to radiation therapy.