Testicular Cancer: A Reflection on 50 Years of Discovery
Introduction The advances in the treatment of testicular cancer are among the great achievements in medicine. Cancer researchers from around the globe have asked and answered nearly every fundamental question about the treatment of patients with testicular cancer. The results are astonishing: cure in 95% of all patients; refined surgical techniques that preserve sexual function; minimization of short-term and longterm toxicities of therapy; FDA approval of several agents due entirely or in part from trials in testicular cancer including vinblastine in the 1960’s, bleomycin in 1973, cisplatin in 1978, etoposide in 1983, and ifosfamide in 1988. This article will help the reader understand this journey to a cure, which in many ways mirrors the history of drug development and cancer management during the 20th century. The basic tenets of cancer care were established, reinforced, or challenged during the methodical study of testicular cancer. These tenets include the use of randomized clinical trials to minimize toxicity and maximize outcomes; the rational utilization of combination chemotherapy; and the integration of care involving medical and surgical specialties.