Testicular cancer screening hope

The majority of testicular cancer patients are cured

Scientists have found a way to detect early signs of testicular cancer before it has started to spread.

They hope their work could lead to a simple screening test for men at risk of the disease.

Using a technique to analyse a semen sample, the researchers diagnosed the early stages of cancer in a 23-year-old man who had been thought to be healthy.

The study, by the Rigshospitalet in Copenhagen, is published in the journal Human Reproduction.

The real advantage would be that young men could be diagnosed at the pre-invasive stage of testicular cancer, when only surgery would be required Professor Niels Skakkebæk

There are about 13,200 new cases of testicular cancer each year in Europe.

It is now the most common form of cancer in men between the ages of 20 and 39.

More than 90% of cases can be cured, especially if the disease is picked up at an early stage.

However, it is often difficult to detect the cancer before it has started to spread.

This means that surgery is usually accompanied by chemotherapy or radiotherapy, both of which may cause infertility.

Key protein

Previous studies have shown that cells showing the early stages of testicular cancer - pre-invasive testicular carcinoma in situ (CIS) - could be detected in semen samples of patients with the disease.

However, detection was difficult, time-consuming and unreliable.

The new work is based on detecting a protein called AP-2gamma which is produced by CIS cells, but not healthy cells.

The researchers compared semen samples from 12 patients with known testicular cancer with those from apparently health men, and others with different types of cancer and fertility problems.

The key protein was found not only in the known testicular cancer patients, but also in the man who had been thought healthy.

Further evaluation, including a biopsy, confirmed that in fact he had CIS in his left testicle.

Researcher Professor Niels Skakkebæk said: "To our knowledge, this is the first report of the diagnosis of testicular cancer at the pre-invasive CIS stage in a semen sample from a young patient with suspected infertility, who - if not for the inclusion in our study ­ would most probably have been diagnosed much later, perhaps only after an overt tumour had developed."

More work needed

Professor Skakkebæk said more work was needed before a screening test could be perfected.

In the first study it detected testicular cancer in only five out of 12 people with known disease, but nobody was incorrectly identified as having the disease.

He said: "The real advantage would be that young men could be diagnosed at the pre-invasive stage of testicular cancer, when only surgery would be required.

"With this more gentle treatment, fertility is usually unaffected."

Simon Davies, of the Teenage Cancer Trust, said: "Whilst many teenage and young adult patients now survive testicular cancer, it is not uncommon for them to experience fertility problems as a result of their treatment.

"The finding, that very early stages of testicular cancer can now be detected from semen samples before the cancer starts to spread, is incredibly good news and we are calling for the test to be extended widely, as soon as possible."

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