This summary discusses the treatment of extragonadal germ cell tumors.
Germ cell tumors develop from testicular or ovarian cells. Sometimes these cells travel to the chest or abdomen and may turn into a rare type of cancer called extragonadal germ cell tumor.
Extragonadal germ cell tumors can be cancerous or noncancerous. The cancerous tumors are divided into 2 types, seminoma and nonseminoma. Nonseminoma cancers include embryonal carcinoma, malignant teratoma, endodermal sinus tumor, choriocarcinoma, and mixed germ cell tumors. These tumors are more common in males, but also occur in females; they are aggressive tumors and are usually found in young adults. Nonseminomas can develop anywhere, but usually appear in the chest, abdomen, or brain. Diagnosing (finding) the tumor may be difficult; in young people who have masses in the trunk of the body, nonseminoma should be considered.
Noncancerous extragonadal germ cell tumors are often very large. They are treated with surgery (taking out the cancer).
Seminomas are very sensitive to radiation therapy (using x-rays to kill cancer cells). About 60% to 80% of patients who undergo radiation therapy will stay disease-free. Chemotherapy (using drugs to kill cancer cells) is also very effective for seminoma. Patients who have localized (cancer that is still in the organ where the cancer began) small tumors are usually treated first with radiation therapy. Patients who have large tumors, or tumors that are spreading, are treated with chemotherapy that consists of etoposide- and cisplatin-based anticancer drugs. Many patients will still have some tumor left after treatment. Small masses will be closely monitored, but will not be treated until symptoms appear or change. Larger masses may be monitored and/or removed with surgery.
Patients who have nonseminomas will receive chemotherapy when the cancer is diagnosed. Patients with nonseminomas usually have large tumors and have symptoms. Early surgery for nonseminoma is seldom useful, and patients may be treated in a clinical trial. Patients who have tumor remaining after chemotherapy may undergo surgery. Patients with nonseminomatous extragonadal germ cell tumors whose tumor comes back after chemotherapy may be treated on a clinical trial.
Nonseminomas that occur in the chest are more frequent in patients who have Klinefelter’s syndrome. These patients are at risk of also developing cancer of the blood. Treatment is more successful for patients who have small tumors that are not resistant to chemotherapy, and who are not likely to develop other cancers.
Patients with nonseminoma that occurs near the kidneys generally respond well to treatment, depending on the size of the tumor.
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Editorial changes were made to this summary.
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Web sites and Organizations
The NCI's Cancer.gov Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. There are also many other places where people can get materials and information about cancer treatment and services. Local hospitals may have information on local and regional agencies that offer information about finances, getting to and from treatment, receiving care at home, and dealing with problems associated with cancer treatment.
The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
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PDQ is a comprehensive cancer database available on Cancer.gov.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at Cancer.gov, the NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.
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PDQ also contains information on clinical trials.
Before starting treatment, patients may want to think about taking part in a clinical trial. A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about new treatments, the risks involved, and how well they do or do not work. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard."
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