Although it is a rare type of cancer, representing fewer than two percent of all malignant growths in human beings, cancer of the testis constitutes an important form of malignancy in young adult men between the ages of 20 and 35 years. Most testicular tumors are of germinal cell origin and are classified into at least five cell types. Seminomas are highly responsive to surgery and radiotherapy, particularly in the early stages of the disease. Widespread seminoma and the other types of testicular tumors, the carcinomas, frequently not responsive to these forms of treatment, have been found to benefit from drug therapy.
Results of one study of a group of 41 patients suggested that an effective method of drug treatment of advanced testicular tumors, particularly embryonal cell carcinoma, was high-dose intermittent chemotherapy with nitrogen mustard alternating with methotrexate or dactinomycin.
Another report described the outcome of chemotherapy given 154 patients with metastatic testicular cancer. Of 24 who were freed of their disease by the treatment, 13 (9 percent) were alive and well at the time of reporting, 3 were alive with recurrence, and 8 had died. The survival period following the start of chemotherapy, for those still alive, ranged from 9 months to 10 years. Results of the study suggested that chlorambucil was the best drug for metastatic seminoma and that dactinomycin used alone was the most effective agent for treatment of three types of metastatic carcinoma (embryonal carcinoma, teratocarcinoma, and choriocarcinoma). Further studies of the effects of combination chemotherapy with dactinomycin, chlorambucil, and methotrexate are in progress.