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Seminoma is the slower, more radiosensitive half of testicular cancer. After removal of the testicle most men need no further treatment and are simply monitored; those who relapse or present with spread are cured with a short course of chemotherapy.
Seminoma arises from germ cell neoplasia in situ and presents as a painless testicular mass, with modest rises in hCG and LDH but never AFP, which would mark a non-seminomatous element. After radical inguinal orchidectomy, stage I disease is managed by surveillance in most men, since only about one in six relapse and all are salvageable; a single dose of carboplatin (MRC TE19) or, rarely now, para-aortic radiotherapy are alternatives. Stage II disease with small nodes is treated with radiotherapy or chemotherapy, and bulkier or metastatic disease with three cycles of BEP or four of EP, curing more than 90 percent; residual masses after chemotherapy are assessed with PET rather than removed. Long-term follow-up watches for second cancers and cardiovascular effects of treatment.
Just over half of testicular germ cell tumours, peaking in men in their thirties; almost every patient is cured, and the effort now goes into giving the least treatment that keeps it that way.
Germ cell tumours drain along the spermatic cord to the para-aortic nodes high in the abdomen, not to the groin, which is why staging scans look at the retroperitoneum.
Same organ: Retroperitoneal germ cell tumour, Leydig cell tumour of the testis, Sertoli cell tumour of the testis, Spermatocytic tumour of the testis, Germ cell neoplasia in situ (GCNIS), Embryonal carcinoma of the testis, Yolk sac tumour of the testis, postpubertal type, Choriocarcinoma of the testis, Testicular germ cell tumours, Non-seminomatous germ cell tumour, Germ cell tumours of childhood and adolescence (extracranial and CNS)
Orchidectomy then surveillance; single-dose carboplatin as an alternative; radiotherapy now rarely used because of second cancers.
Radiotherapy for small-volume nodes or chemotherapy (BEP or EP) for larger nodes; de-escalation trials of carboplatin with radiotherapy ongoing.
Three cycles of BEP or four of EP for good risk, four cycles of BEP for intermediate risk; PET-directed management of residual masses.
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Single-dose carboplatin is the adjuvant option for stage I seminoma where surveillance is not chosen; radiotherapy is now rarely used because of second cancer risk.
FDG-PET is standard for residual seminoma masses larger than 3 cm after chemotherapy, sparing most men surgery.
Three cycles of BEP for good risk and four for intermediate and poor risk follow directly from this classification, which was updated in 2021 with modern survival figures.
Query for this cancer: (TITLE:"Seminoma" OR ABSTRACT:"Seminoma" OR TITLE:"Classic seminoma" OR ABSTRACT:"Classic seminoma" OR TITLE:"Pure seminoma" OR ABSTRACT:"Pure seminoma" OR TITLE:"Germinoma when in the brain" OR ABSTRACT:"Germinoma when in the brain") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Seminoma, not a curated reading list.
The targets of this cancer's medicines and the ones linked to it directly.
Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes.
One section per setting: the options named, what each is for, the trials behind them, the recorded trade-offs and the questions to ask.
Bleeding that does not stop by itself, bleeding from more than one site, or new bruising in several places or one large area.
Pulmonary toxicity rises with G-CSF, high inspired oxygen, renal impairment and age over 40.
Reduce for CrCl below 50.
Dose by Calvert formula using GFR (see the calculators).
Dose reduce or avoid for CrCl below 60 (carboplatin is the alternative).
Reduce to 75% for CrCl 15-50.
See all on the product pages:BleomycinCarboplatinCisplatinEtoposide·Printable cards in the navigator
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Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record.
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