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Seminoma, even at an advanced stage (stage III), is a highly treatable cancer, with a cure rate of approximately 90%. Treatment usually consists of chemotherapy with bleomycin, etoposide, and cisplatin or, for some, just etoposide and cisplatin. Although these treatments are effective against the cancer, cisplatin and etoposide are associated with some serious side effects. These include kidney damage, hearing loss, and neurologic problems with cisplatin; an increased risk for developing a second cancer with etoposide. Researchers in Texas now say that a new chemotherapy combination may be just as effective as the bleomycin/etoposide/cisplatin regimen, with fewer side effects.

Seminoma is a cancer of the germ cells in the testicle. Most seminomas are of the

typical type, which occurs mainly in men 30 to 50 years of age. Treatment options for testicular cancer include surgery, radiation therapy, chemotherapy, and sometimes high-dose chemotherapy or radiation therapy, used with a stem cell transplantation (to help replace the damaged blood cells in the bone marrow after the high-dose therapy). Treatment of stage III seminoma often consists of surgery to remove the testicle (called orchiectomy), followed by infusion with a combination of chemotherapy drugs.

Researchers at MD Anderson Cancer Center in Houston treated 46 men with advanced seminoma with a chemotherapy combination of carboplatin and cyclophosphamide. After 2 years, 93% of the patients remain in complete remission (free of the signs and symptoms of cancer). With this new chemotherapy regimen, there were no significant side effects, specifically no kidney damage, hearing loss, or neurologic problems. Some patients did have low blood counts: 13 required transfusions with platelets (blood cells that help the blood clot), and 9 needed blood transfusions with red blood cells (carry oxygen to the tissues). However, no patient required hospitalization for low blood counts.

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These findings suggest that the chemotherapy combination of carboplatin and cyclophosphamide may be just as effective as the standard treatment of bleomycin/etoposide/cisplatin or etoposide/cisplatin regimens, but may have fewer side effects. (Clinical Cancer Research, Vol 6, No 1, pp 72-77, 2000).