What to Know: Germ Cell Tumor Markers, with Timothy Gilligan, MD

Last Updated: December 5, 2019

Dr. Timothy Gilligan explains an ASCO guideline on tumor markers for germ cell tumors.

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Read the entire clinical practice guideline at www.asco.org/guidelines/germcelltm.

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Cancer.Net®: Doctor-Approved Patient Information from ASCO®

On-Screen:

2010 ASCO Annual Meeting, Germ Cell Tumor Markers, June 7

Timothy D. Gilligan, MD; Co-Chair; ASCO Germ Cell Tumor Markers Committee

Timothy Gilligan, MD; Member, American Society of Clinical Oncology: Germ cell tumors are cancers of the reproductive cells. They typically occur in the testicles in men. They can occur in the ovaries in women. And they can rarely occur in other locations. Children can get them. But what we're really talking about today is germ cell tumors in males, which is testicular cancer. So it's a cancer of the cells that make sperm. So germ cell tumor markers, or what we call serum tumor markers, which are proteins in the blood, are important for germ cell tumors because they allow us to manage the cancer more accurately, take better care of patients. We can find relapses sooner, we can figure out whether or not the cancer has spread. The fundamental reason we check tumor markers in germ cell tumors is it allows us to take better care of the patient.

Part of the reason that tumor markers may be important in germ cell tumors is that, because tumor markers are related to reproduction and pregnancy, a lot of the blood tests that were developed around pregnancy turned out to be useful in germ cell tumor markers as well. And these tumors, more than most tumors, very predictably make certain proteins that we can detect in the blood. So the new guidelines on the use of serum tumor markers for germ cell tumors that are coming out now from ASCO are mainly designed to help doctors take as good care of patients as possible, to get the best outcomes and to avoid unnecessary treatment or an ineffective treatment where a different treatment should be given instead. So we looked very carefully at the medical literature and all the studies that have been done on testicular cancer that have measured tumor markers, and made assessments as to the situations in which tumor markers were helpful in taking better care of patients, getting better outcomes or choosing a better therapy.

I think the most important take-home message for patients is that, if you have testicular cancer, in most cases you should be having regular blood work done at specific intervals to check for these markers. So if you're a man and you have a lump in your testicle, and you go in and someone thinks it's a testes cancer, the usual treatment-- if the imaging tests suggest you have testes cancer, the initial treatment is usually to remove the testicle. It's important to have these tests done before the testicle is removed. After you've been diagnosed with testicular cancer, it's important to measure these markers on a regular basis, for most patients. For men who have stage I seminoma's, we don't think it's important. But in almost every other situation, we do think it's important that they're regularly checked. So for any reason they're not being checked regularly, it may be worth asking your doctor why not.

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