From the Guidelines
Tumor Markers for Testicular Cancer
Testicular cancer markers include alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH), as indicated by 1. These markers are typically elevated in certain types of testicular cancer, such as non-seminomatous germ cell tumors (NSGCT) and choriocarcinoma.
Marker Levels
In patients with testicular cancer, the following marker levels are typically monitored:
- AFP: normally less than 10 ng/mL, but can be elevated in NSGCT 1
- hCG: normally less than 5 IU/L, but can be elevated in choriocarcinoma and other types of testicular cancer 1
- LDH: normally less than 200 U/L, but can be elevated in various types of testicular cancer, including seminoma 1
Diagnostic and Monitoring Tools
It is essential to note that these markers are not definitive diagnostic tools and should be used in conjunction with physical examination, imaging studies, and histopathological examination to diagnose and monitor testicular cancer, as recommended by 1.
Monitoring Frequency
In terms of monitoring, patients with testicular cancer typically undergo regular blood tests to check for these markers, with the frequency of testing depending on the individual case and the specific type of cancer. For example, patients with stage I NSGCT may undergo blood tests every 2-3 months for the first year, then every 6 months for the next 2 years, as suggested by 1.
Treatment
Medications such as bleomycin, etoposide, and cisplatin may be used to treat testicular cancer, with dosages and treatment durations varying depending on the specific type and stage of cancer, as well as individual patient factors, as indicated by 1. For instance, a common chemotherapy regimen for testicular cancer is BEP (bleomycin, etoposide, and cisplatin), which typically consists of 3-4 cycles of treatment, with each cycle lasting 21 days.
From the Research
Tumor Markers for Testicular Cancer
The following tumor markers are used in the diagnosis, staging, and surveillance of testicular cancer:
- Human chorionic gonadotropin (hCG) 2, 3, 4, 5, 6
- Alpha-fetoprotein (AFP) 2, 3, 4, 5, 6
- Lactate dehydrogenase (LDH) 2, 3, 4, 5, 6
- Human placental alkaline phosphatase (hPLAP) 4
Limitations of Current Tumor Markers
The current tumor markers have limitations, including:
- Low sensitivity and specificity for certain subtypes of testicular cancer 6
- False-positive marker elevations 5
- Limited positive predictive value (PPV) of the markers 5
- Nonspecific biomarkers, such as LDH 6
Novel Biomarkers
Research is ongoing to identify novel biomarkers for testicular cancer, including:
- MicroRNAs, such as miR-371-373 and miR-302-367, which show promise as universal biomarkers for malignant germ cell tumors 6