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Release: July 24, 2000

UI participates in multi-national study of testicular cancer

IOWA CITY, Iowa -- Researchers in the University of Iowa College of Public Health were part of a multi-national team of investigators that found that the curative potential of treating testicular cancer with radiation or chemotherapy far exceeds the small risk of leukemia associated with these treatments.

The study results are reported in the July 19 issue of the Journal of the National Cancer Institute by Lois Travis, M.D., Sc.D., of the National Cancer Institute, and colleagues including Charles F. Lynch, M.D., Ph.D., UI professor of epidemiology and medical director of the Iowa Cancer Registry.

In a large majority of cases, testicular cancer is curable using surgery, radiation, and/or chemotherapy, often in combination. However, clinicians have been concerned that radiation and chemotherapy may contribute to the development of secondary leukemia, which has a high mortality rate.

An investigation of secondary leukemia was undertaken within a group of 18,567 testicular cancer patients diagnosed between 1970 and 1993 and who survived at least one year. These patients were reported to population-based cancer registries, including the Iowa Cancer Registry, in the United States, Canada, Denmark, the Netherlands, Sweden and Finland. Of this large group of men, 36 developed leukemia.

"Cancer surveillance studies of this type require access to millions of cases in order to be valid," Lynch said. "Because of its high-quality data, the Iowa Cancer Registry is one of a few registries in the world that participate in such studies."

The researchers conclude that while physicians should be mindful of the possible late toxicity of treatment of testicular cancer, the relatively low excess risk of leukemia associated with current treatments is reassuring. Of 10,000 testicular cancer patients treated with standard radiotherapy to the abdomen and pelvis and followed for 15 years, an excess of nine to 11 leukemias might be expected; chemotherapy might result in up to 16 excess leukemias over a comparable period. Thus, they conclude that the substantial improvement in survival resulting from modern treatment far exceeds any small absolute excess risk of leukemia.

NOTE TO EDITORS: The Journal of the National Cancer Institute contributed to this news release.

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