Germ cell cancers are uncommon but have significant implications for an individual as the disease can affect a variety of bodily functions. More than 5% of germ cell cancers were classified as nonseminomatous testicular cancer.
This is the most common childhood cancer in boys. Approximately 13-19% of boys of all ages will be diagnosed with a germ cell cancer. Most germ cell cancers present as a mass, usually in one of the pelvic organs such as the testis or ovary. Rarely, it may present as a retrocecal mass, an epididymal mass or abdominal pain as an abdominal germ cell tumor.
Germ cell tumors should not be treated as if they are benign or pre-malignant, as they can occur at any age from 4 months gestational age. Treatment should be based on stage and grade. Treatment must be tailored to minimize the burden of treatment. Long-term (10 years) cure or control seems to be possible in many patients.
The treatment of germ cell cancers involves surgery, chemotherapy and radiotherapy in order to eradicate cancer cells and improve survival. When complete surgery and chemotherapy are not performed, prognosis will depend on the extent of disease and whether further chemotherapy is necessary.
Germ cell tumors can occur spontaneously or be caused by exposure to toxic substances and/or radiation. They may present as both benign (teratoma) and malignant tumors, with the most common form being diffuse spermatocytic seminoma. Testicular cancer can be treated conservatively depending on the patient's age, with the most recent evidence suggesting cryotherapy and watchful waiting with active surveillance before or after chemotherapy is required in young adult patients. Chemotherapies have been used by more than 50% of patients with seminoma, but the extent and duration of use are variable. If chemotherapy is used, there is high cure rate but high rate of secondary treatments.
About 11,600 cases of germ cell cancer will be diagnosed in the year 2020. (1.4 per 10,000) Germ cell cancers represent about 7% of all malignant neoplasms (both solid and soft tissue) in the United States. (0.5 per 10,000.) This incidence has been steadily increasing since the late 1980s. The annual incidence of germ cell cancer is also higher in men than in women. Of the approximately 300,000 cases of germ cell malignancies (both seminoma, nonseminoma, and testis interstitial cell), approximately 170,000 to 200,000 are malignant teratomas, 25% of which are gonadal teratomas.
These data suggest that, in a population with a low risk of developing germ cell cancer, a history of two or more testicular cancer diagnoses increased the risk more than three-fold. In addition, the incidence of all germ cell cancers continues to increase, with an increase in yolk sac tumors perhaps most notable. These statistics may be useful in assessing germ cell cancer risks in a population at which individuals may be counseled to postpone fertility therapy until the risk of germ cell tumor exposure has passed.
Germ cell tumors are considered to be tumors of gonadal and extra-gonadal origin, although the origin of some tumors may be the [liver(liver). This article summarizes the updated research for germ cell cancers in order to increase the knowledge of the disease and its diagnosis, progression, and treatment. Germ cell tumors may develop out of [germ cells, which are immature germ cells/sperm that can develop into oocytes and sperm in females or gametocytes and spermatocytes in males] The most common germ cell tumour is [epithelial germ cell tumor (yolk sac germ cell tumor)]; <2% are testicular tumors and <0.2% are non-gonadal.
The authors report good local control at the irradiated site and no recurrence of tumors. We recommend proton beam radiation as a standard treatment for the treatment of unresectable metastatic seminoma, preferably in combination with additional chemotherapy.
Germ cell cancer may be appropriately treated with low toxicity levels of chemotherapy drugs. The decision to participate in clinical trials is best made with patient education, as these trials can have significant side-effects. Clinicians should be familiar with these most recent trials to make the best decision for each patient.
There is a very small amount of clinical data regarding proton beam-radiation in treating GCTs. While not as common, metastatic disease, or [locally administered] radiotherapy, proton beam therapy is being investigated for its benefit and toxicity. Further study is needed to better define the effectiveness of the newer techniques.