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    Testicular Cancer: A Second Chance

    New Treatment Strategy Uses Stem Cells Combined With High-Dose Chemo After Preferred Treatment Fails

    Testicular Cancer 'Eminently Curable'

    Kohli, who was not involved in the study, notes that while some 7,200 American men get testicular cancer each year, only 380 die. The overall cure rate is 90% -- and even when testicular cancer has spread, some 70% of patients are cured.

    "This is an eminently curable cancer, so losing those 380 patients a year pinches us," Kohli says. "It has been a dilemma how to treat these patients. They are typically very young men in their late 30s or early 40s. Much life is ahead of them, and we want them to live as long as possible."

    Abonour says that this dilemma is resolved, unless patients have other conditions that make it impossible for them to tolerate intensive chemotherapy. He suggests that all testicular cancer patients who fail preferred treatment are candidates for the new technique.

    That's true, agrees Edmund K. Waller, MD, PhD, director of the bone marrow and transplant center at Emory Winship Cancer Institute in Atlanta.

    "The potential to cure patients after they fail standard therapy without transplant is somewhat limited," Waller tells WebMD. "If they have second-line therapy that is not curative, the chances for third-line success is less."

    Kohli, Waller, and Abonour say the excellent outcomes seen in the Indiana study can only be achieved in cancer centers that can field teams of experts able to provide intensive patient support.

    "High-dose chemotherapy with stem cell support is not done in community hospitals, but typically at a referral center," Waller says.

    "Families really should ask the important question: Is the oncology team familiar with the disease?" Abonour says. "It takes an experienced team to work together to identify the right patients and the right treatment for each of them."

    The study by Einhorn, Abonour, and colleagues appears in the July 26 issue of The New England Journal of Medicine.

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