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Germ Cell Tumor - Childhood - Overview

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Childhood Germ Cell Tumor. To see other pages, use the menu on the side of your screen. Think of that menu as a roadmap to this full guide.

Germ cells are special cells in a developing embryo—also called the fetus or unborn baby—that become the eggs in girls’ ovaries or the sperm in boys’ testicles. Rarely, during development of the embryo, these cells may also travel to other areas of the body and form a tumor. A tumor is a mass that forms when normal cells change and grow uncontrollably. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can spread to other parts of the body. A benign tumor means the tumor will not spread.

Types of Germ Cell Tumors

Germ cells may travel to the chest, abdomen, or brain. Germ cell tumors that form in the brain are called intracranial germ cell tumors. For information on a germ cell tumor in the brain, read about childhood central nervous system tumors. Extracranial germ cell tumors are found outside of the brain.

There are two different categories of germ cell tumors that start in the testicles or ovaries: seminomas and non-seminomas. Generally, non-seminomas tend to grow and spread more quickly than seminomas, but prompt diagnosis and treatment are important for both types of tumor.

Germ cell tumors outside of the brain can be divided into gonadal and extragonadal.

Gonadal germ cell tumors. Gonadal germ cell tumors start and stay in a child’s reproductive organs, which are the testicles or ovaries. For more information on a germ cell tumor in the reproductive organs, read about ovarian and testicular cancer.

Extragonadal germ cell tumors. Extragonadal germ cell tumors start in a child’s reproductive system but travel to different parts of the body. Germ cells that occur outside the gonads (reproductive organs) and outside the brain are called extragonadal and extracranial. These occur in early childhood generally and commonly begin in the sacrum and the coccyx, which are the lowest parts of the spinal column. Extracranial, extragonadal germ cell tumors found in teenagers and young adults are often located in the mediastinum, which is the center of the chest.       

This summary covers extracranial, extragonadal germ cell tumors.

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If you would like additional introductory information, explore this related item. Please note this link takes you to another section on Cancer.Net:

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Germ Cell Tumor - Childhood - Statistics

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find information about how many children have this type of tumor each year and some general survival information. Remember, survival rates depend on several factors. To see other pages, use the menu on the side of your screen.

Extracranial, extragonadal germ cell tumors are rare.

Extracranial germ cell tumors, including those that occur in the reproductive organs, account for about 3% of all tumors in children younger than 20 and about 14% in adolescents age 15 to 19.

Extragonadal germ cell tumors most commonly occur in the sacrum and coccyx in the lower spine, chest, and abdomen.

The overall five-year survival rate is the percentage of people who survive at least five years after the tumor is detected, excluding those who die from other diseases. The overall five-year survival rate for children younger than age 15 with extragonadal germ cell tumors is 83%.

Statistics should be interpreted with caution. It is not possible to tell a person how long he or she will live with a germ cell tumor. Because survival statistics are measured in five-year intervals, they may not represent advances made in the treatment or diagnosis of this tumor. Learn more about understanding statistics.

Statistics adapted from the National Cancer Institute (NCI).

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Germ Cell Tumor - Childhood - Risk Factors

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find out more about the factors that increase the chance of developing this type of tumor. To see other pages, use the menu on the side of your screen.

A risk factor is anything that increases a person’s chance of developing a tumor. Although risk factors often influence the development of a tumor, most do not directly cause a tumor. Some children with several risk factors never develop a tumor, while others with no known risk factors do.

The following factors may raise a child’s risk of developing an extracranial germ cell tumor:

Cryptorchidism. If a boy has an undescended testicle, he has a higher risk of developing a testicular seminoma tumor. To learn more, see the full guide to testicular cancer on another part of Cancer.Net.

Turner syndrome. Turner syndrome is a genetic condition in which a girl is born with a missing X chromosome. Girls with this condition have a higher risk of developing a gonadoblastoma, a benign tumor that can eventually turn into cancer.

Androgen insensitivity syndrome. Androgen insensitivity syndrome is when a person who is genetically male, with one X and one Y chromosome, is resistant to male hormones called androgens. A person with this syndrome has a higher risk of developing a gonadoblastoma or other germ cell tumors.

The following factor may raise a person’s risk of developing an extracranial, extragonadal germ cell tumor:

Klinefelter’s syndrome. Men with this genetic condition are born with an extra X chromosome. Klinefelter’s syndrome is connected to a higher risk of a germ cell tumor in the chest.

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Germ Cell Tumor - Childhood - Symptoms and Signs

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. To see other pages, use the menu on the side of your screen.

A child with an extracranial, extragonadal germ cell tumor may experience the following symptoms and signs. Sometimes, children with this type of tumor do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not a germ cell tumor.

  • Pain in the affected area
  • Constipation, which is infrequent or difficult passage of stool
  • Urinary retention, meaning the inability to urinate
  • Cough and/or difficulty breathing

If you are concerned about one or more of the symptoms or signs on this list, please talk with your child’s doctor. Your doctor will ask how long and how often your child has been experiencing the symptom(s), in addition to other questions. This is to help find out the cause of the problem, called a diagnosis.

If a germ cell tumor is diagnosed, relieving symptoms remains an important part of your child’s medical care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your child’s health care team about symptoms your child experiences, including any new symptoms or a change in symptoms.

The next section helps explain what tests and scans may be needed to learn more about the cause of the symptoms. Use the menu on the side of your screen to select Diagnosis, or you can select another section, to continue reading this guide.  

Germ Cell Tumor - Childhood - Diagnosis

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find a list of the common tests, procedures, and scans that doctors can use to find out what’s wrong and identify the cause of the problem. To see other pages, use the menu on the side of your screen.

Doctors use many tests to diagnose a germ cell tumor and find out if it is cancerous, and if so, whether it has spread to another part of the body, called metastasis. Some tests may also determine which treatments may be the most effective. For most types of tumors, a biopsy is the only way to make a definitive diagnosis. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the tumor has spread. This list describes options for diagnosing this type of tumor, and not all tests listed will be used for every child. Your child’s doctor may consider these factors when choosing a diagnostic test:

  • Age and medical condition
  • Type of tumor suspected
  • Signs and symptoms
  • Previous test results

In addition to a physical examination, the following tests may be used to diagnose a germ cell tumor:

Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that a germ cell tumor is present, but only a biopsy can make a definite diagnosis and determine if the tumor is benign or cancerous. The sample removed during the biopsy is analyzed by a pathologist. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. The pathologist will examine the tissue sample for abnormalities in the cells. This is called a histologic examination. The pathologist will also examine the tissue sample for signs of cancer. This is called a cytologic examination.

Blood tests.

  • Alphafetoprotein (AFP). A germ cell tumor may cause high levels of AFP, which is a protein that increases in the mother’s blood during pregnancy. This protein is produced by the fetal (unborn child’s) liver and yolk sac, a pouch that protects the embryo early in development. It can be detected by amniocentesis, a test used to monitor the health of a fetus by using a needle inserted into the abdomen and uterus of a pregnant woman to collect amniotic fluid. AFP is also a tumor marker in patients with certain germ cell tumors. A tumor marker is a substance found in higher than normal amounts in the blood, urine, or body of people with certain kinds of tumors. The levels of AFP in the blood may be monitored to determine how well a treatment is working.
  • Beta HCG. A germ cell tumor may also cause high levels of beta human chorionic gonadotropin (hCG). Women who are pregnant produce high levels of the hormone beta hCG in their blood. High levels of beta hCG in a woman who is not pregnant could mean that a germ cell tumor is present.

Ultrasound. An ultrasound uses sound waves to create a picture of the internal organs. A tumor produces different echoes of the sound waves than normal tissue. When the sound waves are bounced back to a computer, creating images, the doctor can locate a mass inside the body.

Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. A CT scan can also be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill to swallow.

Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can also be used to measure the tumor’s size.  A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill to swallow.

After diagnostic tests are done, your child’s doctor will review all of the results with you. If a germ cell tumor is diagnosed, these results also help the doctor describe the tumor; this is called staging.

The next section helps explain the different stages for this type of cancer. Use the menu on the side of your screen to select Stages, or you can select another section, to continue reading this guide.  

Germ Cell Tumor - Childhood - Stages

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will learn about how doctors describe a tumor’s growth or spread. This is called the stage. To see other pages, use the menu on the side of your screen.

Staging is a way of describing where a tumor is located, if or where it has spread, and whether it is affecting other parts of the body. Doctors use diagnostic tests to find out the tumor's stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis, which is the chance of recovery. There are different stage descriptions for different types of tumors.

There are two types of staging for germ cell tumors, based on whether the patient has had surgery yet. First, the clinical stage is based on the results of tests done before surgery, such as a physical examination, CT scans, and MRI tests. Then, the pathologic stage is assigned based on information found during surgery, plus the laboratory results of any tissue removed during surgery. The stage provides a common way of describing the cancer so doctors can work together to plan the best treatments.

According to the Children’s Oncology Group, the following pathologic stages are used for germ cell tumors:

Stage I: The tumor has been entirely removed, and tumor markers are normal, or return to normal after surgery.

Stage II: Microscopic traces of the tumor are still present after surgery; tumor markers do not return to normal following surgery.

Stage III: Visible traces of tumor are left behind after initial treatment, and the lymph nodes are significantly affected.

Stage IV: The tumor has spread from its original site to other, more distant areas of the body.

Recurrent: A recurrent tumor is one that has come back after treatment. It may recur at the original site of the tumor or in another place. If there is a recurrence, the tumor may need to be staged again using the system above, in a process called re-staging.

Information about the tumor’s stage will help the doctor recommend a treatment plan.  The next section helps explain the treatment options for this type of tumor. Use the menu on the side of your screen to select Treatment Options, or you can select another section, to continue reading this guide.  

Germ Cell Tumor - Childhood - Treatment Options

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will learn about the different ways doctors use to treat children with this type of tumor. To see other pages, use the menu on the side of your screen.

In general, a tumor in a child is uncommon, so it can be hard for doctors to plan treatments unless they know what has been most effective in other children. That is why more than 60% of children with cancer are treated as part of a clinical trial. Clinical trials are research studies that compare standard treatments, which are the best proven treatments available, with newer approaches to treatments that may be more effective. Clinical trials may test such approaches as a new drug, a new combination of standard treatments, or new doses of current therapies. Studying new treatments involves careful monitoring using scientific methods, and all participants are followed closely to track their health and progress.

To take advantage of these newer treatments, all children with a germ cell tumor should be treated at a specialized cancer center. Doctors at these centers have extensive experience in treating children and have access to the latest research. A doctor who specializes in treating children with a tumor is called a pediatric oncologist. In many cases, a team of doctors works with a child and the family to provide care; this is called a multidisciplinary team. Pediatric cancer centers often have extra support services for children and their families, such as child life specialists, nutritionists, physical and occupational therapists, social workers, and counselors. Special activities and programs to help your child and family cope may also be available.

Descriptions of the most common treatment options for a germ cell tumor are listed below. Treatment options and recommendations depend on several factors, including the type and stage of tumor, possible side effects, and the patient’s preferences and overall health. Your child’s care plan may also include treatment for symptoms and side effects, an important part of cancer care. Take time to learn about all of your child’s treatment options and be sure to ask questions about things that are unclear. Also, talk about the goal of each treatment with your child’s doctor and what your child can expect while receiving the treatment. Learn more about making treatment decisions.

Surgery

The goal of surgery is to remove the tumor and some surrounding tissue, known as a margin, in an effort to remove all tumor cells. The surgery may be performed by a surgical oncologist, a doctor who specializes in treating tumors using surgery. Some patients with germ cell tumors can be treated with surgery alone, including patients with testicular germ cell tumors that are completely removed by surgery.

Talk with your child’s doctor about the possible side effects of the specific surgery your child is having and how they will be managed. Learn more about cancer surgery.

Chemotherapy

Chemotherapy is the use of drugs to destroy tumor cells, usually by stopping the tumor cells’ ability to grow and divide. Chemotherapy is given by a pediatric or medical oncologist, a doctor who specializes in treating a tumor with medication.

Systemic chemotherapy is delivered through the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed. A chemotherapy regimen, your child’s treatment schedule, usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time. Most patients with a cancerous germ cell tumor will need chemotherapy.

The drugs that are commonly used for treating germ cell tumors include bleomycin (Blenoxane), cisplatin (Platinol), and etoposide (VePesid, Toposar).

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

Learn more about chemotherapy and preparing for treatment. The medications used to treat germ cell tumors are continually being evaluated. Talking with your child’s doctor is often the best way to learn about the medications prescribed for your child, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Getting care for symptoms and side effects

A tumor and its treatment often cause side effects. In addition to treatment to slow, stop, or eliminate the tumor, an important part of care is relieving a child’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.

Palliative care can help a person at any stage of illness. People often receive treatment for the tumor and treatment to ease side effects at the same time. In fact, people who receive both often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, and other therapies. Your child may also receive palliative treatments similar to those meant to eliminate the cancer, such as chemotherapy and surgery. Talk with your child’s doctor about the goals of each treatment in the treatment plan.

Before treatment begins, talk with your child’s health care team about the possible side effects of your child’s specific treatment plan and supportive care options. And during and after treatment, be sure to tell the doctor or another health care team member if your child is experiencing a problem so it is addressed as quickly as possible. Learn more about palliative care.

Remission and chance of recurrence

A remission is when a tumor cannot be detected in the body and there are no symptoms. This may also be called “no evidence of disease” or NED. 

A remission can be temporary or permanent. This uncertainty leads many patients and families to feel worried or anxious that the tumor will come back. While many remissions are permanent, it is important to talk with your child’s doctor about the possibility of the tumor returning. Understanding the risk of recurrence and the treatment options may help you feel more prepared if the tumor does return. Learn more about coping with the fear of recurrence.

If the tumor does return after the original treatment, it is called recurrent tumor. It may come back in the same place, meaning it is a local recurrence, or nearby, which is a regional recurrence. If it comes back in another place, it is a distant recurrence.

When this occurs, a cycle of testing will begin again to learn as much as possible about the recurrence, including whether the tumor’s stage has changed. After testing is done, your child’s doctor will talk with you about treatment options. Often, the treatment plan will include the therapies described above, such as chemotherapy, but may be used in a different combination or given at a different pace. A recurrent tumor may be treated with carboplatin (Paraplat, Paraplatin, Becenum), ifosfamide (Cyfos, Ifex, Ifosfamidum),  and paclitaxel (Taxol). Bone marrow/stem cell transplantation or radiation therapy may also be used. Your child’s doctor may also suggest clinical trials that are studying new ways to treat this type of recurrent tumor.

When a tumor recurs, patients and their families often experience emotions such as disbelief or fear. Families are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with recurrence.

If treatment fails

Although treatment is successful for the majority of children with a germ cell tumor, sometimes it is not. If a child’s tumor cannot be cured or controlled, this is called advanced or terminal cancer. This diagnosis is stressful, and it may be difficult to discuss. However, it is important to have open and honest conversations with your child’s doctor and health care team to express your family’s feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families.

Parents or guardians are encouraged to think about where the child would be most comfortable: at home, in a home-like setting elsewhere, in the hospital, or in a hospice environment. Hospice care is a type of palliative care for people who are expected to live less than six months. It is designed to provide the best possible quality of life for people who are near the end of life. Nursing care and special equipment can make staying at home a workable alternative for many families.

Some children may be happier if they can arrange to attend school part-time or keep up other activities and social connections. The child’s health care team can help parents or guardians decide on an appropriate level of activity. Making sure a child is physically comfortable and free from pain is extremely important as part of end-of-life care. Learn more about caring for a terminally ill child and advanced cancer care planning.

The death of a child is an enormous tragedy, and families may need support to help them cope with the loss. Pediatric cancer centers often have professional staff and support groups to help with the process of grieving. Learn more on grieving the loss of a child.

The next section helps explain clinical trials, which are research studies. Use the menu on the side of your screen to select About Clinical Trials, or you can select another section, to continue reading this guide.  

Germ Cell Tumor - Childhood - About Clinical Trials

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. To see other pages, use the menu on the side of your screen.

Doctors and scientists are always looking for better ways to treat children with a germ cell tumor. To make scientific advances, doctors create research studies involving volunteers, called clinical trials.

Many clinical trials are focused on new treatments, evaluating whether a new treatment is safe, effective, and possibly better than the current (standard) treatment. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. Children who participate in clinical trials are often among the first to receive new treatments before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment.

There are also clinical trials that study new ways to ease symptoms and side effects during treatment and manage the late effects that may occur after treatment. Talk with your child’s doctor about clinical trials regarding side effects. In addition, there are ongoing studies about ways to prevent the disease.

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know these studies are the only way to make progress in treating germ cell tumors. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with a germ cell tumor.

Sometimes people have concerns that, by participating in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” The use of placebos in cancer clinical trials is rare. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials.

To join a clinical trial, parents and children must participate in a process known as informed consent. During informed consent, the doctor should list all of the patient’s options so that the person understands how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different from the risks of standard treatment. Finally, the doctor must explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

For specific topics being studied for germ cell tumors, learn more in the Latest Research section.

Patients who participate in a clinical trial may stop participating at any time for any personal or medical reason. This may include that the new treatment is not working or there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that patients participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if the patient chooses to leave the clinical trial before it ends. 

Cancer.Net offers a lot of information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

The next section helps explain the areas of research going on today about this type of tumor. Use the menu on the side of your screen to select Latest Research, or you can select another section, to continue reading this guide.  

Germ Cell Tumor - Childhood - Latest Research

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will read about the scientific research being done now to learn more about this type of tumor and how to treat it. To see other pages, use the menu on the side of your screen.

Doctors are working to learn more about germ cell tumors, ways to prevent them, how to best treat them, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your child’s doctor about the diagnostic and treatment options best for your child.

Combination chemotherapy. Clinical trials are underway to investigate new combinations of chemotherapy to treat extracranial, extragonadal germ cell tumors.

Supportive care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current germ cell tumor treatments in order to improve patients’ comfort and quality of life.

Looking for More about Latest Research?

If you would like additional information about the latest areas of research regarding germ cell tumors, explore these related items that take you outside of this guide:

  • To find clinical trials specific to your diagnosis, talk with your child’s doctor or search online clinical trial databases now.
  • Visit ASCO’s CancerProgress.Net website to learn more about the historical pace of research for childhood cancer. Please note this link takes you to a separate ASCO website. 

The next section addresses how to cope with the symptoms of the disease or the side effects of its treatment. Use the menu on the side of your screen to select Coping with Side Effects, or you can select another section, to continue reading this guide.  

Germ Cell Tumor - Childhood - Coping with Side Effects

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find out more about steps to take to help cope with physical, social, and emotional side effects. This page includes several links outside of this guide to other sections of this website. To see other pages, use the menu on the side of your screen.

Fear of treatment side effects is common after a diagnosis of a germ cell tumor, but it may help to know that preventing and controlling side effects is a major focus of your child’s health care team. This is called palliative or supportive care, and it is an important part of the overall treatment plan, regardless of the stage of disease.

Common side effects from each treatment option for a germ cell tumor are described in detail within the Treatment Options section. Learn more about the most common side effects of a tumor and different treatments, along with ways to prevent or control them. Side effects depend on a variety of factors, including the tumor’s stage, the length and dosage of treatment(s), and your child’s overall health.

Before treatment begins, talk with your child’s doctor about possible side effects of each type of treatment your child will be receiving. Ask which side effects are most likely to happen, when they are likely to occur, and what can be done to prevent or relieve them. And, ask about the level of caregiving your child may need during treatment and recovery, as family members and friends often play an important role in the care of a person with a germ cell tumor. Learn more about caregiving.

In addition to physical side effects, there may be emotional and social effects as well. Patients and their families are encouraged to share their feelings with a member of their health care team who can help with coping strategies, including concerns about managing the cost of your child's medical care

During and after treatment, be sure to tell the health care team about the side effects your child experiences, even if you feel they are not serious. Sometimes, side effects can last beyond the treatment period, called a long-term side effect. A side effect that occurs months or years after treatment is called a late effect. Treatment of both types of effects is an important part of survivorship care. Learn more by reading the After Treatment section or talking with your child’s doctor.

The next section helps explain medical tests and check-ups needed after finishing cancer treatment. Use the menu on the side of your screen to select After Treatment, or you can select another section, to continue reading this guide.  

Germ Cell Tumor - Childhood - After Treatment

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will read about your child’s medical care after treatment for a germ cell tumor is finished and why this follow-up care is important. To see other pages, use the menu on the side of your screen.

After treatment for a germ cell tumor ends, talk with your child’s doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your child’s recovery for the coming months and years. All children treated for a germ cell tumor should have life-long, follow-up care.

Generally, children treated for a germ cell tumor are monitored using physical examinations, x-rays, and blood tests for two years after treatment ends to check for possible recurrence. After this time, it is unlikely that the tumor will recur, and the focus of follow-up care changes to watching for possible late side effects of chemotherapy, if given. Because of the effects of the drugs most commonly used to treat a germ cell tumor, regular tests may be needed for kidney function; lung function; fertility, which is the ability to have children; blood cell production; growth and development abnormalities; and the possibility of secondary cancers. Be sure to talk with your child’s doctor about the specific risks based on the specific chemotherapy used to treat your child.

Your child’s doctor can recommend the necessary examinations and tests for these late effects. Follow-up care should also address your child’s quality of life, including any developmental or emotional concerns. Learn more about childhood cancer survivorship.

The child’s family is encouraged to organize and keep a record of the child’s medical information. That way, as the child enters adulthood, he or she has a clear, written history of the diagnosis, the treatment given, and the doctor’s recommendations about the schedule for follow-up care. The doctor’s office can help you create this. This information will be valuable to doctors who care for your child during his or her lifetime. ASCO offers treatment summary forms to help keep track of the treatment your child received and develop a survivorship care plan once treatment is completed.

In addition, the Children’s Oncology Group has information to help children and parents navigate the steps after treatment of a germ cell tumor. Children who have had a germ cell tumor can also enhance the quality of their future by following established guidelines for good health into and through adulthood, including not smoking, maintaining a healthy weight, eating a balanced diet, and participating in regular physical activity. Talk with the doctor about developing a plan that is best for your child’s needs. Learn more about the next steps to take in survivorship.

The next section offers a list of questions you may want to ask. Use the menu on the side of your screen to select Questions to Ask the Doctor, or you can select another section, to continue reading this guide.

Germ Cell Tumor - Childhood - Questions to Ask the Doctor

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find some questions to ask your doctor or other members of your health care team, to help you better understand your child’s diagnosis, treatment plan, and overall care. To see other pages, use the menu on the side of your screen.

Talking often with the doctor is important to make informed decisions about your child’s health care. These suggested questions are a starting point to help you learn more about your child’s care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your child’s next appointment, or download Cancer.Net’s free mobile app for an e-list and other interactive tools to manage your child’s care.

  • What type of tumor does my child have?
  • Where is it located?
  • Is it cancerous?
  • If so, what stage is the cancer?
  • Can you explain my child’s pathology report, or laboratory test results, to me?
  • What are my child’s treatment options?
  • What clinical trials are open to my child? Where are they located, and how do I found out more about them?
  • What treatment plan do you recommend? Why?
  • What is the goal of each treatment? Is it to eliminate the tumor, help my child feel better, or both?
  • What are the possible side effects of this treatment, both in the short term and the long term?
  • How will this treatment affect my child’s daily life? Will my child be able to go to school and perform his or her usual activities?
  • If I am worried about managing the costs related to my child’s medical care, who can help me with these concerns?
  • Could this treatment affect my child’s ability to become pregnant or have a child in the future?
  • Who will be part of my child’s health care team, and what does each member do?
  • Who will be coordinating my child’s overall treatment and follow-up care?
  • What are the chances that the tumor will recur?
  • What follow-up tests will my child need, and how often will he or she need them?
  • What support services are available to my child? To my family?
  • Whom should I call for questions or problems?

The next section offers some more resources that may be helpful to you. Use the menu on the side of your screen to select Additional Resources, or you can select another section, to continue reading this guide.  

Germ Cell Tumor - Childhood - Additional Resources

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2014

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about this type of medical care and treatment. This is the final page of Cancer.Net’s Guide to Childhood Germ Cell Tumor. To go back and review other pages, use the menu on the side of your screen.

Cancer.Net includes many other sections about the medical and emotional aspects of being diagnosed with a tumor, both for the child and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond. Here are a few sections that may get you started in exploring the rest of Cancer.Net:

- Search for a cancer specialist in your local area using this free database of doctors from the American Society of Clinical Oncology.

- Review dictionary articles to help understand medical phrases and terms used in cancer care and treatment.

- Read more about the first steps to take when your child is newly diagnosed with cancer.

- Find out more about clinical trials as a treatment option.

- Learn more about coping with the emotions that cancer can bring, including those within a family or a relationship.

- Find a national, not-for-profit advocacy organization that may offer additional information, services, and support for people with this type of cancer.

- Explore next steps a person can take after active treatment is complete.

This is the end of Cancer.Net’s Guide to Childhood Germ Cell Tumor. Use the menu on the side of your screen to select another section to continue reading this guide.