SAN FRANCISCO, CA USA (UroToday.com) - Dr. Derek Raghavan gave an update, primarily on testicular cancer, but shared some useful pointers regarding treatment of unusual cancers as well.
For instance, he recommended consultation of expert pathologists and clinical physicians when uncommon diagnoses are made. In particular, determining the number of patients the consulting physician has seen and inquiry regarding follow-up is of utmost importance. He also suggests reviewing radiology and biochemical analyses for the patient, as well as literature regarding the diagnosis.
Dr. Raghavan began the discussion regarding testicular cancer by noting that not much has really changed in the last 10 years. He did stress strategies to avoid “rookie mistakes” when managing germ cell tumor (GCT) patients. This includes assigning the proper risk category, giving appropriate chemotherapy, recognizing and properly evaluating decreased creatinine clearance (and avoiding dose reduction when possible), and carefully reviewing CT scans rather than simply reading the reports. He reviewed clinical trial data showing that 3 cycles of bleomycin, etoposide, cisplatin (BEP) is adequate for good-risk GCT, but that data was equivocal regarding 4 cycles of BEP for intermediate risk. He pointed out that TIP chemotherapy is adequate for poor-risk GCT.
Hopefully the next decade of research will continue to improve the outcomes for patients with these malignancies.
Highlights of a presentation by Derek Raghavan, MD, PhD, FACP at the 2014 Genitourinary Cancers Symposium - January 30 - February 1, 2014 - San Francisco Marriott Marquis - San Francisco, California USA
Levine Cancer Institute, Charlotte, NC USA
Written by Phillip Abbosh, MD, PhD, medical writer for UroToday.com
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