Research in testicular cancer

We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better practices that will help prevent, find and treat testicular cancer. They are also looking for ways to improve the quality of life of people with testicular cancer.

The following is a selection of research showing promise for testicular cancer. We’ve included information from PubMed, which is the research database of the National Library of Medicine. Each research article in PubMed has an identity number (called a PMID) that links to a brief overview (called an abstract). We have also included links to abstracts of the research presented at meetings of the American Society of Clinical Oncology (ASCO), which are held throughout the year. You can find information about ongoing clinical trials in Canada from CanadianCancerTrials.ca and ClinicalTrials.gov. Clinical trials are given an identifier called a national clinical trial (NCT) number. The NCT number links to information about the clinical trial.

Treatment

Researchers are looking for new ways to improve treatment for testicular cancer. Advances in cancer treatment and new ways to manage the side effects from treatment have improved the outlook and quality of life for many people with cancer. The following is noteworthy research into treatment for testicular cancer.

Surgery

Researchers are studying new surgical techniques to reduce side effects from surgery for testicular cancer.

Testicle-sparing surgery (TSS) tries to spare most of a testicle. It may be an alternative to the standard treatment for testicular cancer, which involves removing the testicle with cancer. For men who have cancer in both testicles or in one remaining testicle, having the standard treatment would mean that they could no longer father children. Researchers are studying testicle-sparing surgery as a possible treatment to prevent infertility (Actas Urologicas Espanolas, PMID 27890492; Journal of Surgical Oncology, PMID 25195665).

Nerve-sparing surgical techniques may help prevent damage to the nerves during retroperitoneal lymph node dissection (RPLND) to help protect ejaculation. One of the risks of doing RPLND is damaging the nerves that control ejaculation, which can affect fertility. Researchers are studying nerve-sparing techniques with both open RPLND and laparoscopic RPLND (BJU International, PMID 27353395; International Journal of Clinical Oncology, PMID 26701172; Clinical Genitourinary Cancer, PMID 25682512).

Robot-assisted retroperitoneal lymph node dissection is a newer procedure that allows the surgeon to use a computer to move surgical instruments connected to robotic arms. The operation is done through several small surgical cuts (incisions), much like laparoscopic surgery. Some surgeons are studying robot-assisted RPLND to remove lymph nodes in men with testicular cancer. Both laparoscopic and robotic-assisted RPLND are linked with shorter hospital stays and fewer side effects compared to open RPLND. More studies are needed to confirm the role that this technique may have in staging and treating testicular cancer (European Urology, PMID 27234998, PMID 27068395; Current Urology Reports, PMID 26968421).

Chemotherapy

Researchers are studying new chemotherapy drugs to treat testicular cancer. They are testing these drugs alone and with other chemotherapy drugs typically used to treat testicular cancer. New chemotherapy drugs that are showing promise include:

Targeted Therapy

Researchers are studying brentuximab vedotin (Adcetris) in clinical trials to see if it can be used to treat relapsed testicular cancer. It is a targeted therapy drug used to treat Hodgkin lymphoma (ClinicalTrials.gov, NCT02689219).

Supportive care

Living with cancer can be challenging in many different ways. Supportive care can help people cope with cancer, its treatment and possible side effects. The following is noteworthy research into supportive care for testicular cancer.

Testicular sperm extraction (TESE) is a technique used to collect sperm. TESE removes tiny pieces of tissue from the testicle. Any sperm cells found can be used right away for IVF or they can be frozen for future use. TESE may be useful in preserving fertility for men who have very low sperm counts or no sperm in their semen (called azoospermia) (Journal of Medical Case Reports, PMID 28511670; International Journal of Clinical Oncology, PMID 27306218; Actas Urologicas Espanolas, PMID 26296279).

Metabolic syndrome is a group of conditions that put someone at risk for heart disease and diabetes. These conditions include high blood pressure, high blood sugar levels, large waist size and abnormal cholesterol and triglyceride levels. Metabolic syndrome is often linked with changes in hormone levels, such as a low testosterone level. It tends to develop much earlier in men treated for testicular cancer than other men and occurs in 20% to 30% of long-term testicular cancer survivors. This syndrome is a long-term problem, but conditions such as high blood pressure and abnormal cholesterol levels can be managed with healthy lifestyle habits and medicines (ASCO, Abstract 102).

High-intensity interval training (HIIT) is a type of intense physical activity that may help lower the risk of heart problems in testicular cancer survivors. These men have a much higher risk of cardiovascular disease, heart attack and congestive heart failure. The risk for heart problems is particularly high in men who are treated at a young age with chemotherapy. Some research shows that HIIT may lower the risk for these heart problems after testicular cancer treatment (Cancer, PMID 28708930). But it’s important to note that a recent study found that there is a risk of blood clots and heart attack in men with testicular cancer who were doing HIIT workouts while having treatment with cisplatin-based chemotherapy (ASCO, Abstract 4551). People with cancer should talk to their doctors before participating in physical activity during treatment.

Problems with cognitive function, such as memory loss and trouble concentrating, can affect men with testicular cancer. Some studies suggest that cognitive problems may be related to emotional distress and fatigue. Other studies suggest these problems may be a side effect of chemotherapy (Brain Imaging and Behavior, PMID 27240852; Journal of Pain and Symptom Management, PMID 26344551; Supportive Care in Cancer, PMID 25716340).

Learn more about cancer research

Researchers continue to try to find out more about testicular cancer. Clinical trials are research studies that test new ways to prevent, detect, treat or manage testicular cancer. Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for testicular cancer were first shown to be effective through clinical trials.

Find out more about clinical trials.

Expert review and references

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  • Berookhim BM & Mulhall JP . Outcomes of operative sperm retrieval strategies for fertility preservation among males scheduled to undergo cancer treatment. Fertility and Sterility. 2014.
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