Germ Cell Tumors
What are Germ Cell Tumors?
Germ cell tumors start in the reproductive cells (eggs or sperm). They develop when cells that are meant to form sperm in the testicles or eggs in the ovaries travel to other parts of the body. Germ cell tumors are more common among children and young adults. They often are found in the ovaries, testes, or brain.
Ovarian germ cell tumors arise from the germ cells of the ovary. They can be benign (not cancer) or malignant (cancer). They are more common among girls and women ages 10 to 30 years old. Germ cell tumors make up about 20 to 25 percent of all abnormal tissue masses in the ovaries. Only five percent of ovarian cancers are germ cell tumors. The most common benign forms are benign teratomas or dermoids. Cancerous forms include dysgerminomas, yolk sac tumors, mixed germ cell tumors, and non-gestational choriocarcinomas.
Most testicular cancers begin in the germ cells. Learn more about testicular cancer.
Diagnosis & Staging
The following tests and scans are used to diagnose germ cell tumors.
- Physical Exam - A complete exam 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. You may be asked about pains, appetite, and energy level.
- 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 tested to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells. Substances linked to germ cell tumors include:
- 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 given in a vein or orally 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. This forms a picture of body tissues called a sonogram.
- Biopsy - The removal of cells or tissues to look for signs of cancer. This is done in a lab. The type 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 cancerous germ cell tumors are treated with surgery and/or chemotherapy. 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 type of tumor, the stage of the cancer (whether or not it has spread to other areas outside the site of origin), your overall health, and your preferences about treatment.
In all cases, treatment should be individualized for you. More on treatment for ovarian cancer can be found here. 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. People of all educational levels and backgrounds can have a hard time communicating with their health care team. It helps to write down questions in advance and take notes. Bring a trusted friend or family member to help listen and take notes.
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.