The big news this morning was
the latest survival figures that show that almost all men diagnosed with testicular cancer survive the disease, where once it would have killed most of its victims. The figures, compiled and analysed by our University of London colleagues at the London School of Hygiene and Tropical Medicine’s Cancer Research UK Survival Group, showed that if the cancer is detected at its earliest stage — as most cases now are — five-year survival rates for patients are at least as good as for the general population. Even for more advanced forms of the disease, the outlook is much better than for most cancers.
One of the many reasons why testicular cancer has gone from a disease that killed 94% of its victims to the poster child for curable cancer is the drug carboplatin, developed here at the Institute of Cancer Research in London.
Carboplatin was developed here in the 1980s as an improvement on a classic chemotherapeutic -- cisplatin. That compound was discovered in 1845, and has been one of the most widely-used of traditional chemotherapies. The platinum-containing chemical interferes with the links in the DNA double helix, and so has a toxic effect on dividing cells -- like cancer cells -- which have to produce new copies of their DNA.
Cisplatin, like many first-generation chemotherapeutics that indiscriminately target any dividing cells, often has severe side-effects, because as well as cancer cells, other dividing cells -- including those that produce blood cells and immune cells -- are killed. But the chemistry of cisplatin also means that it can damage other tissues -- especially nerves and the kidneys -- creating further problems for patients. And it is not just short term side-effects that can be a problem for testicular cancer patients. As survival rates are so high, the toxic effects of treatment can reveal themselves years down the line in increased susceptibility to ill-health -- especially from cardiovascular disease and from other forms of cancer.
But carboplatin provides a much less toxic alternative to cisplatin, improving the quality of life of patients and their long-term good health as survivors. It has also helped to reduce the need for radiotherapy in testicular cancer treatment. All of this is very important: with testicular cancer now an effectively curable disease, survivors have decades of life ahead of them, and so we must make sure that those are good and healthy decades.
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