January 01, 2017
The great news about testicular cancer is that “cure rates are exceptional, approaching 95 percent,” says Phillip Pierorazio, M.D., Director of the Division of Testis Cancer. However, “treatment can require timely, complex, multimodal strategies that most commonly include chemotherapy and surgery. One of the scariest things about testicular cancer is that it can grow very quickly, but that is also why it responds so well to most of our treatments.”
Although there are detailed treatment guidelines by the National Comprehensive Cancer Network and other groups, “outcomes for testicular cancer patients can vary dramatically among institutions,” Pierorazio adds. “The men who do best are at high-volume centers with experience treating the disease.” But even high-volume centers don’t get it right all the time. Pierorazio recently teamed up with colleagues from the University of Chicago and University of Southern California to evaluate inappropriate, or non-guideline directed care, in their testicular cancer patients. “We found that 30 percent of their patients received treatment that differed from the recommendations.”
Most common were unneeded PET scans and “overtreatment in the form of too many chemotherapy cycles, or multiple drugs when one drug would have sufficed. Fortunately, few men were undertreated or received inappropriate treatments. It is difficult to expect every doctor to know the most appropriate and up-to-date treatments for a complex and rare disease. Therefore, testicular cancer should be treated at experienced centers of excellence.” These findings were published in the Journal of Urology.