Dutch doctors hopeful for new screening tool in testicular cancer
ARNHEM, THE NETHERLANDS -- A group of Dutch doctors are expecting to develop in the next few years a new screening test in testicular cancer that may yet eliminate the need for the standard biopsy operation.
"We’re doing research on a new staining technique using the OCT3/4 marker which allows us to find tumour cells in the sperm, and it’s very tumour-cell specific,” says Dr. Gert Dohle , co-chairman of the 5th Meeting of the European Society of Andrological Urology (ESAU) held recently in Amsterdam. “We have to start a screening protocol before we can say that this technique will come into practice. The next couple of years will show that it does work and that it is advantageous to start in men at risk."
Testicular cancer is considered the most common malignancy among men in the reproductive age (20 to 34-year-old males) and the incidence is increasing, according to doctors. Although various studies are still ongoing, doctors believe the rise or risks for testicular cancer are probably due to many factors including increased exposure to maternal hormones during foetal growth, environmental influences or lifestyle at the time of early tumour development.
More than 95% of testicular tumours are of germ cell origin (testicular germ cell tumours or TGCTs) and can be divided into two main types: seminomas and non-seminomas. All TGCTs are believed to originate from the carcinoma in situ (CIS) cell. At present, very few patients are diagnosed with CIS, although CIS almost always leads to testicular cancer.
Dr. Niels van Casteren, who presented the preliminary results obtained by a team from the Erasmus Medical Centre in Rotterdam at the ESAU meeting, says using the new staining technique in the semen samples from a small group of patients yielded positive results. The study, conducted from January to September this year, involved 10 patients with a suspected TGCT, nine post-orchidectomy patients, 11 patients with bilateral testicular microcalcifications, and 15 negative controls.
“In eight out of nine patients with TGCT and in both patients with CIS, OCT3/4 positive cells were detected in the semen samples. This method can be a good first line of defence in the fight against TGCT,” says Van Casteren. According to Van Casteren, OCT3/4, also known as OTF3 and POU5F1, was found to be a highly specific and sensitive marker for CIS, adding that the plan is to increase the number of patients to as many as 100 men.
“Fortunately the OCT3/4 staining procedure is so specific for testicular tumour cells that we believe that it is a good screening tool,” explains Dohle as he notes that other staining techniques often lead to a big number of false positives, or patients who stain positive but actually do not develop the cancer cells.
“Now we still have to do (surgical) biopsy to detect early CIS, which usually does not show any symptoms. But, hopefully, in a few years’ time we will be able to detect the tumour cells in the sperm,” says Dohle.
Despite the high cure rate of testicular cancer, doctors are keen to obtain diagnosis at the pre-invasive CIS stage, as the disease is potentially lethal and treatment has severe side-effects, particularly on reproductive organs. At present there is no satisfactory imaging technique to detect early CIS.
For more information, please contact:
European Association of Urology
Ms. Lindy Brouwer
Communication Officer
T: +31 26 3890139
E: communicationoffice(at)uroweb.org
