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Our latest blog, by Joachim Stanley, considers new research which bodes well for early diagnosis of testicular cancer.
I was pleased to learn recently that new research has successfully isolated a group of genes implicated in the development of testicular cancer. A cluster of 19 newly discovered genes have been linked to testicular cancer. These 19 are additional to 25 which were previously known.
Testicular cancer typically affects men between the ages of 18 – 45. It is generally treated with chemotherapy. The rates of cure are comparatively high (in 2014, 2,400 testicular tumours were diagnosed in the UK, with 60 deaths from testicular cancer recorded in the same year), but as with any cancer, early diagnosis will increase the chance of a cure. Sadly, some patients will not respond to treatment.
Latest research and what it means
As a result of this new research, clinicians think they can identify the 1% of men most at risk of testicular cancer, which in turn should facilitate more precisely targeted monitoring of the condition.
The nature of this monitoring remains to be determined: in the first instance, it would be necessary to perform some kind of genetic workup, following which patients deemed to be at higher risk might undergo regular biopsies (an extraction of one or more small pieces of tissue for analysis). No biopsy is infallible (it can only give a “snapshot” of what is happening in the area surveyed) but the chances of early diagnosis would be significantly enhanced.
The research is likely to lead to further developments. Scientists at the Institute of Cancer Research in London compared DNA from over 7,000 men with testicular cancer with that derived from 23,000 healthy subjects. It was found that many of the 19 new risk genes affected how chromosomes are kept stable.
The identification of a genetically targeted study group is likely to lead to further positive benefits. Cancer is not a binary state (i.e., you either have it or you don’t). In cancer cases, cells become progressively more abnormal (“dysplastic”) over a period of time. Eventually, dysplasia produces cancerous cells, which will then gradually invade tissue around them and thereafter spread more widely. A study of how cellular dysplasia evolves into cancer in this risk group may well allow insights into this process.
As with any cancer, hereditary factors are only a part of the story. Environmental factors are also important. If, for example, a patient suffers trauma leading to testicular torsion, then the affected testicle will die if not treated promptly. If it is not removed, there would be dead tissue in situ and this could lead to an increase in the risk of testicular cancer.
As a clinical negligence practitioner, I often deal with cancer cases. Almost invariably, these relate to a delay in diagnosis, which in turn has caused harm that might have been avoided with proper treatment. It is always heartening to see new clinical research, but particularly in the setting of such a devastating group of diseases as cancer.