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The rate at which these markers fall after surgery or chemotherapy, even if they are high at the outset, is becoming recognized as a prognostic factor.
Surgery alone can also cure some testicular and ovarian malignant germ cell tumors. For testicular germ cell tumors, successful surgery may make chemotherapy unnecessary. If the disease has not spread to the lymph nodes, and if the levels of tumor marker proteins decrease to normal after surgery, there may be no need for chemotherapy.
The drugs carboplatin and ifosafamide are sometimes also used.
Boys who have had testicular tumors removed completely by surgery may be monitored without chemotherapy. If tumor marker levels fail to return to normal or rise after surgery during the follow-up period, chemotherapy is then used with good results. This is sometimes called "salvage chemotherapy" because it can get rid of tumor cells that were not completely removed by surgery.
Researchers design various studies to improve treatment and advance the understanding of cancer and its causes. Clinical trials are carefully reviewed and must be approved through a formal scientific process before anyone can be enrolled. If there is a research study “open” that your child is “eligible for,” you may be asked to allow your child to participate. It is also possible that your child will be asked to participate in more than one study.
Whether an individual is eligible for a particular study may depend on age, location of the cancer, the extent of the disease and other information. Researchers usually must limit their study to some of these characteristics to have a scientifically valid study. Further, researchers must follow exactly the same restrictions throughout the study.
If your child is eligible to participate in one or more study, your doctor will discuss these with you during an initial treatment conference (also called informed consent conference). The doctor will describe the study, potential risks of participation, and other information you need to decide whether or not you would like your child to participate in the study. You always have the choice to participate or not in research studies.
If you do choose to have your child participate in a study, you doctor will explain what type of information you will receive about the results of the study. The overall results of the research study will be published to inform the public and other researchers. No study will publish any information that identifies an individual.
Visit the Clinical Trials section of this website to learn more about the various kinds of research studies.
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