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BTCS Professionals
Information for healthcare professionals, including doctors, nurses and allied healthcare professionals.
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Non-Seminoma

Non-Seminoma Germ Cell Tumours (Teratoma and mixed tumours)

If the CT scan does not show any spread of the cancer in other organs and the tumour markers are normal, the doctor could recommend a choice of treatment/follow up as follows, however this depends on if the tumour cells had started to spread in the blood or lymphatic vessels.

If the cancer cells have not spread to the blood/lymphatic vessels (PT1) you will be offered:

  • Active surveillance - very regular follow-up.

  • Monthly appointments for the first year, with Tumour Marker blood tests every month and Chest X-Rays alternate months. You will have a CT Scan of your chest, abdomen and pelvis 3 months and 12 months after diagnosis. After a year these appointments become less frequent. NSGCT Active Surveillance

If the cancer cells have spread to the blood/lymphatic vessels (PT2) you will be offered:

  • Active surveillance - very regular follow-up

  • Monthly appointments for the first year, with Tumour Marker blood tests every month and chest X-Rays alternate months. You will have a CT Scan of your chest, abdomen and pelvis 3 months and 12 months after diagnosis. After a year these appointments become less frequent. NSGCT Active Surveillance
  • One course of BEP (Bleomycin, Etoposide, Cisplatin) chemotherapy: NSGCT add on Chemotherapy

Sometimes the CT scan shows the cancer has spread to other organs or the tumour markers remain high. Then the team would recommend: 

  • To have more intense chemotherapy called BEP or EP (Etoposide and Cisplatin)

  • BEP is given as an inpatient for day one, two and three staying in hospital two nights, for three days, but sometimes five days depending on how many cycles you need. On day 9 and 16 having a shorter treatment in chemotherapy day unit which takes around one to two hours. This is a cycle you may have three or four cycles.
  • EP is given as an inpatient for day one, two and three staying in hospital two nights, for three days, but sometimes five days depending on how many cycles you need. This is a cycle you will have four cycles.

This is also recommended if during surveillance the tumour markers rise or a CT scan shows the cancer has spread to other organs of the body.

After the chemotherapy we arrange a CT scan to see if the tumour has gone. Sometimes the scan shows there is something still there - this is likely to be a dead tumour. However, because of the very small possibility there are dormant cells which could start growing again, we would recommend an operation to remove them. This operation is referred to as a RPLND Retroperitoneal Lymph Node Disection.

After Treatment

Once your treatment has been completed there is a programme of surveillance. This is a little more intensive in the first two years and if your disease and treatment was uncomplicated, we would look to discharge you 5 years after the the end of treatment. 

Free Prescriptions

All patients who have had a diagnosis of cancer are entitled to FREE prescriptions for five years, ask your key worker for details.

It's in the Bag Travel Grant and Macmillan Grants

We also have travel grants for those who are only receiving Statutory Sick Pay/Employment & Support Allowance, with no savings who live more than 10 miles from the BHOC. For those who are struggling financially through treatment Macmillan provide grants to help, ask your key worker details.

Unfortunately, in a very small group of men the tumour does not respond as quickly as expected or comes back after the planned treatment.

The team may suggest the following:

  • TIP (Paclitaxol, Ifosphamide, Cisplatin) chemotherapy

  • Paclitaxol, Ifosphamide & Cisplatin are given as an inpatient over five days, once every 21 days. This is a cycle you will have four cycles.

  • Surgery

  • Depending on the type of additional surgery you require, this will be arranged soon after the completion of chemotherapy.

During TIP chemotherapy some men are offered an opportunity to harvest stem cells. This allows for the administration of high dose chemotherapy should your tumour/s not respond as expected.,

Consultation