What are Germ Cell Tumors?
Germ Cell tumors start in the reproductive cells (eggs or sperm). When cells that are meant to form sperm in the testicles or eggs in the ovaries travel to other parts of the body, they may grow into germ cell tumors. These tumors may begin to grow anywhere in the body but usually begin in organs such as the pineal gland in the brain, in the mediastinum, or in the abdomen.
Germ cell tumors can be benign (not cancer) or malignant (cancer). Benign germ cell tumors are called benign teratomas. These are more common than malignant germ cell tumors and often are very large.
Malignant germ cell tumors are divided into two types, nonseminoma and seminoma. Nonseminomas tend to grow and spread more quickly than seminomas. They usually are large and cause symptoms. If untreated, malignant germ cell tumors may spread to the lungs, lymph nodes, bones, liver, or other parts of the body.
Diagnosis & Staging
If a patient has symptoms that could be a germ cell tumor, the doctor will test for fever and high blood pressure and check general signs of health. The patient will likely have one or more of the following tests:
- Physical Exam - An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. In men, the testicles may be checked for lumps, swelling, or pain.
- Chest X-Ray - An x-ray of the organs and bones inside the chest.
- Serum Tumor Marker Test - A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. Certain substances are linked to detect germ cell tumor (Blood levels of the tumor markers help determine if the tumor is a Seminoma or Nonseminoma.):
- Alpha-fetoprotein (AFP)
- Beta-human chorionic gonadotropin (β-hCG)
- Lactate dehydrogenase (LDH)
- CT Scan (CAT scan) - A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly.
- Ultrasound Exam - A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs to form a picture of body tissues called a sonogram.
- Biopsy - The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The type of biopsy used depends on where the germ cell tumor is found.
- Excisional Biopsy: The removal of an entire lump of tissue.
- Incisional Biopsy: The removal of part of a lump or sample of tissue.
- Core Biopsy: The removal of tissue using a wide needle.
- Fine-Needle Aspiration (FNA) Biopsy: The removal of tissue or fluid using a thin needle.
Treatment & Side Effects
Most germ cell tumors are treated with a combination of radiation, chemotherapy, and or surgery. Different types of treatment are available for patients with a germ cell tumor. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. (A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer)
Your treatment options depend on the prognosis, your overall health and your preferences about treatment. In metastatic disease, the location and extent of the cancer is also an important consideration.
In all cases, treatment should be individualized for you. Although cancers are classified into particular stages, each person is unique.
You do not have to rush to make a decision, so consider the options carefully. Ask questions if you do not understand any aspect of treatment or the terms your doctors are using. Research shows that cancer survivors of all educational levels and backgrounds can have a hard time communicating with their health care team. One of the best ways to improve communication with your health care team is to prepare your visits so that you can best make use of the time.
A treatment plan is a way to deal with both the short and long term goals of managing your cancer. There are several treatment options for germ cell tumors. Patients have time for second opinions and to talk through all of their options with their doctors and develop a treatment plan that best fits their needs.