Description

What is childhood extracranial germ cell tumor? Testicular germ cell tumors of early childhood Testicular germ cell tumors of adolescence and young adulthood Extragonadal, extracranial germ cell tumors of early childhood Extragonadal, extracranial germ cell tumors of adolescence and young adulthood Ovarian germ cell tumors

Stage Explanation

Extracranial Germ Cell Tumors         Stage I         Stage II         Stage III         Stage IV         Recurrent Ovarian Germ Cell Tumor         Stage I         Stage II         Stage III         Stage IV         Recurrent

Treatment Option Overview

Treatment in a clinical trial

Childhood Mature and Immature Teratomas
Childhood Malignant Testicular Germ Cell Tumor
Childhood Malignant Ovarian Germ Cell Tumor
Childhood Extragonadal Malignant Germ Cell Tumor
Recurrent Childhood Malignant Germ Cell Tumor
To Learn More About Childhood Cancer
Get More Information From NCI
Changes to This Summary (06/26/2008)
About PDQ

Description

What is childhood extracranial germ cell tumor?

Germ cells are reproductive cells that develop into testicles in males and ovaries in females. Sometimes these cells travel to other areas of the body, such as the chest, abdomen, or brain, and may turn into a rare type of cancer called germ cell tumor. This summary covers germ cell tumors that occur extracranially (everywhere but in the brain).

Extracranial germ cell tumors can be benign (not cancerous) or malignant (cancerous). Most germ cell tumors are benign and are very rare in children younger than age 15. Germ cell tumors of early childhood have biological characteristics which are different than those that occur in adolescents and young adults. The location of the tumor and the age of the child make a difference in the prognosis (chance of recovery) and in how the tumor is treated. The major types of germ cell tumors by location and age are:

This type of germ cell tumor forms within the testis of young boys. The treatment for this type of germ cell tumor is covered later in this summary.

This type of germ cell tumor forms within the testes of older boys. Testicular germ cell tumors are classified as either seminoma or nonseminoma. This classification is important for planning treatment because seminomas are more sensitive to radiation therapy. (Refer to the PDQ summary on Testicular Cancer ¹ for more information.)

This includes any type of germ cell tumor that is not located in the reproductive organs (testicles or ovaries) or in the brain. These germ cell tumors are usually located in the sacrum (a triangular-shaped section of fused bone located between the hip bones at the base of the spine) and the coccyx (the fused bones located on the end of the sacrum; also called the tailbone). The treatment for this type of germ cell tumor is covered later in this summary.

This type of germ cell tumor is usually located within the chest. The treatment for this type of germ cell tumor is covered later in this summary.

Ovarian germ cell tumor, a rare type of cancer that affects teenage girls and young women, is a disease in which cancer (malignant) cells are found in egg-making cells in an ovary. An ovary is a small organ that holds the eggs that can develop into a baby. There are 2 ovaries: one located on the left side of the uterus (the hollow, pear-shaped organ where a baby grows) and one located on the right. The treatment for this type of germ cell tumor is covered later in this summary (refer to the PDQ summary on Ovarian Germ Cell Tumors ² for more information).

Germ cell tumors form in developing cells and usually contain tissues that are foreign to the location of the tumor. Germ cell tumors can further be classified as teratomas or malignant germ cell tumors. Teratomas can be either mature (well differentiated tissue that forms a tumor that is less likely to become cancer) or immature (undifferentiated tissue that can spread and become cancer). Most teratomas are mature and develop into benign tumors.

Stage Explanation

Once a germ cell tumor is found (diagnosed), tests will be done to find out if the germ cell tumor is benign or malignant. If the tumor is malignant, more tests will be done to find out if the cancer cells have spread to other parts of the body (staging). In order to stage a germ cell tumor, the patient may undergo a surgical procedure. Knowing the stage of the disease will assist the doctor in effectively planning further treatment.

The following stages are used for all extracranial germ cell tumors:

Cancer has not spread from the tumor to surrounding tissues or lymph nodes and can be surgically removed with no cancer cells remaining.

Cancer has spread to surrounding tissues or lymph nodes, and surgery cannot remove all cancer cells from the surrounding tissues.

Cancer has spread to surrounding tissues, has affected several lymph nodes, is found in fluid in the abdomen, and surgery cannot remove the entire tumor from the surrounding tissues.

Cancer has spread to other organs in the body.

Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the original site of the tumor or in another place.

The following stages are used for ovarian germ cell tumor:

Cancer is found in either one or both of the ovaries; it has not spread to the surrounding tissue. Tumor cells may be present in peritoneal (abdominal) fluid.

Cancer is found in one or both ovaries and has spread to the uterus, and/or the fallopian tubes (the pathway used by egg cells moving from the ovary to the uterus), and/or other body parts within the pelvis (bladder, rectum, vagina). Tumor cells may be present in abdominal fluid.

Cancer is found in one or both ovaries and has spread to lymph nodes or to other body parts inside the abdomen (outside of the pelvis), such as the surface of the liver or intestine.

Cancer is found in one or both ovaries and has spread outside the abdomen or has spread to the inside of the liver.

Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the ovary or in another place.

Treatment Option Overview

Different types of treatment are available for children with extracranial germ cell tumors. 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. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Because cancer in children is rare, taking part in a clinical trial should be considered. Some clinical trials are open only to patients who have not started treatment.

Experienced doctors working together may provide the best treatment for children with extracranial germ cell tumors. Your child’s treatment will often be coordinated by a pediatric oncologist, a doctor who specializes in cancer in children. The pediatric oncologist may refer your child to other specialists, such as a pediatric surgeon, a psychologist, a radiation oncologist, and other doctors who specialize in the type of treatment your child requires.

Treatment for extracranial germ cell tumor depends upon the location of the tumor, the stage of the tumor, and the type of tumor. The types of treatment used for extracranial germ cell tumor are:

• Surgery (cutting the tumor out of the body)



• Chemotherapy (using drugs to kill tumor cells)

More than one method of treatment may be used, depending on the type of extracranial germ cell tumor and how much cancer the patient has in his or her body. Complete or near complete surgical removal of the tumor is often possible. If the tumor cannot be completely removed, chemotherapy may also be given.

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy drugs may be taken by mouth or injected into a vein (intravenous) or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body.

For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

Clinical trials are taking place in many parts of the country. In the following lists of treatments for the different types of childhood extracranial germ cell tumors, a link to search results for current clinical trials is included for each section. These have been retrieved from NCI's clinical trials database. For some types of tumors, there may not be any trials listed. Check with your child's doctor for clinical trials that are not listed here but that may be right for your child.

Childhood Mature and Immature Teratomas

Treatment will depend on whether the tumor is a mature or immature teratoma. If the tumor is a mature teratoma, the treatment will be surgery to remove the tumor and possibly some of the surrounding tissues or structures. If the tumor is an immature teratoma, treatment will be surgery with or without chemotherapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with childhood teratoma ³.

Childhood Malignant Testicular Germ Cell Tumor

Treatment will depend on the age of the child. The majority of childhood malignant testicular germ cell tumors occur in boys younger than 4 years of age. Surgery is the most common form of treatment for testicular germ cell tumor. A doctor may take out the tumor by removing one or both testicles through an incision (cut) in the groin. This is called a radical inguinal orchiectomy. Treatment for boys younger than 5 years of age will be radical inguinal orchiectomy with or without chemotherapy.

The treatment for adolescents and young adults with testicular germ cell tumor is the same as the treatment for adults. (Refer to the PDQ summary on Testicular Cancer ¹ for more information.)

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with childhood malignant testicular germ cell tumor ⁴.

Childhood Malignant Ovarian Germ Cell Tumor

Treatment will depend on the age of the child and the specific tumor type. Surgery is the most common form of treatment for ovarian germ cell tumor. A doctor may take out the cancer using one of the following operations:

• Unilateral salpingo-oophorectomy: taking out the ovary with the cancer and the fallopian tube on the same side



• Tumor debulking: taking out as much of the cancer as possible

Treatment for young girls with early stage ovarian germ cell tumor will be unilateral salpingo-oophorectomy. Treatment for young girls with advanced stage ovarian germ cell tumor will be unilateral salpingo-oophorectomy with or without chemotherapy.

The treatment for adolescents and young adults with ovarian germ cell tumor is similar to the treatment for adults. (Refer to the PDQ summary on Ovarian Germ Cell Tumors ² for more information.)

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with childhood malignant ovarian germ cell tumor ⁵.

Childhood Extragonadal Malignant Germ Cell Tumor

Treatment for childhood extragonadal malignant germ cell tumor depends on the size and location of the tumor. Treatment for smaller tumors will be surgery to remove the tumor followed by chemotherapy. Treatment for larger tumors will be a biopsy (a surgical procedure to remove a small portion of the tumor) followed by chemotherapy to reduce the size of the tumor, possibly followed by surgery to remove any remaining tumor.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with childhood extragonadal germ cell tumor ⁶.

Recurrent Childhood Malignant Germ Cell Tumor

Due to the small number of childhood extracranial germ cell tumors and the effectiveness of treatment, the number of patients who have tumors that return is small. Treatment for patients with recurrent germ cell tumor will usually be chemotherapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent childhood malignant germ cell tumor ⁷.

To Learn More About Childhood Cancer

For more childhood cancer information and other general cancer resources from the National Cancer Institute, see the following:

• What You Need to Know About™ Cancer - An Overview ⁸
• Childhood Cancers ⁹
• CureSearch - National Childhood Cancer Foundation Children’s Oncology Group ¹⁰
• Late Effects of Treatment for Childhood Cancer ¹¹
• Young People with Cancer: A Handbook for Parents ¹²
• Care for Children and Adolescents with Cancer: Questions and Answers ¹³
• Understanding Cancer Series: Cancer ¹⁴
• Staging: Questions and Answers ¹⁵
• Coping with Cancer ¹⁶
• Support and Resources ¹⁷
• Cancer Library ¹⁸
• Information for Survivors/Caregivers/Advocates ¹⁹

Get More Information From NCI

Call 1-800-4-CANCER

For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.

Chat online

The NCI's LiveHelp® ²⁰ online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.

Write to us

For more information from the NCI, please write to this address:

NCI Public Inquiries Office

Suite 3036A

6116 Executive Boulevard, MSC8322

Bethesda, MD 20892-8322

Search the NCI Web site

The NCI Web site ²¹ provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use our “Best Bets” search box in the upper right hand corner of each Web page. The results that are most closely related to your search term will be listed as Best Bets at the top of the list of search results.

There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.

Find Publications

The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator ²². These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

Changes to This Summary (06/26/2008)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Several enhancements have been made to this summary to better explain certain medical concepts and to help readers find information about clinical trials. The following changes were made:

• Information about patients taking part in clinical trials was added to the Treatment Option Overview ²³ section.
• Links to ongoing clinical trials listed in NCI's PDQ Cancer Clinical Trials Registry were added to the treatment sections.
• A new section called "To Learn More ²⁴" was added. It includes links to general information about cancer.
• The "Get More Information from NCI" section (originally called "To Learn More") was revised.

About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site ²¹. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." In the United States, about two-thirds of children with cancer are treated in a clinical trial at some point in their illness.

Listings of clinical trials are included in PDQ and are available online at NCI's Web site ²⁵. Descriptions of the trials are available in health professional and patient versions. For additional help in locating a childhood cancer clinical trial, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

The PDQ database contains listings of groups specializing in clinical trials.

The Children's Oncology Group (COG) is the major group that organizes clinical trials for childhood cancers in the United States. Information about contacting COG is available on the NCI Web site ²¹ or from the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

The PDQ database contains listings of cancer health professionals and hospitals with cancer programs.

Because cancer in children and adolescents is rare, the majority of children with cancer are treated by health professionals specializing in childhood cancers, at hospitals or cancer centers with special facilities to treat them. The PDQ database contains listings of health professionals who specialize in childhood cancer and listings of hospitals with cancer programs. For help locating childhood cancer health professionals or a hospital with cancer programs, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

Glossary Terms

The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Cancer that has spread to other places in the body and usually cannot be cured or controlled with treatment.

Not cancerous. Benign tumors may grow larger but do not spread to other parts of the body.

A noncancerous growth that does not invade nearby tissue or spread to other parts of the body.

Pertaining to biology or to life and living things. In medicine, refers to a substance made from a living organism or its products. Biologicals may be used to prevent, diagnose, treat or relieve of symptoms of a disease. For example, antibodies, interleukins, and vaccines are biologicals. Biological also refers to parents and children who are related by blood.

The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.

The organ that stores urine.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

Treatment with drugs that kill cancer cells.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called a clinical study.

The small bone at the bottom of the spine. It is made up of 3-5 fused bones. Also called tailbone.

The process of identifying a disease, such as cancer, from its signs and symptoms.

In cancer, refers to how mature (developed) the cancer cells are in a tumor. Differentiated tumor cells resemble normal cells and tend to grow and spread at a slower rate than undifferentiated or poorly differentiated tumor cells, which lack the structure and function of normal cells and grow uncontrollably.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

A rare cancer that forms in germ cells in the testicle or ovary, or in germ cells that have traveled to areas of the body other than the brain (such as the chest, abdomen, or tailbone). Germ cells are reproductive cells that develop into sperm in males and eggs in females.

A rare cancer that develops in germ cells that are found in areas of the body other than the ovary or testicle (such as the brain, chest, abdomen, or tailbone). Germ cells are reproductive cells that develop into sperm in males and eggs in females.

A slender tube through which eggs pass from an ovary to the uterus. In the female reproductive tract, there is one ovary and one fallopian tube on each side of the uterus.

Liquid.

A reproductive cell of the body. Germ cells are egg cells in females and sperm cells in males.

A type of tumor that begins in the cells that give rise to sperm or eggs. Germ cell tumors can occur almost anywhere in the body and can be either benign or malignant.

The area where the thigh meets the abdomen.

A rare type of malignant (cancer) germ cell tumor (type of tumor that begins in the cells that give rise to sperm or eggs) that often contains several different types of tissue such as hair, muscle, and bone.

A cut made in the body to perform surgery.

An operation in which the testicle is removed through an incision in the groin.

Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."

The long, tube-shaped organ in the abdomen that completes the process of digestion. The intestine has two parts, the small intestine and the large intestine. Also called the bowel.

Into or within a vein. Intravenous usually refers to a way of giving a drug or other substance through a needle or tube inserted into a vein. Also called I.V.

A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.

A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

Cancerous. Malignant tumors can invade and destroy nearby tissue and spread to other parts of the body.

A type of benign (noncancerous) germ cell tumor (type of tumor that begins in the cells that give rise to sperm or eggs) that often contains several different types of tissue such as hair, muscle, and bone. Also called a dermoid cyst.

NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research. It conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://www.cancer.gov. Also called National Cancer Institute.

A group of testicular cancers that begin in the germ cells (cells that give rise to sperm). Nonseminomas are identified by the type of cell in which they begin and include embryonal carcinoma, teratoma, choriocarcinoma, and yolk sac carcinoma.

A doctor who specializes in treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation.

A part of the body that performs a specific function. For example, the heart is an organ.

An abnormal mass of tissue that forms in germ (egg) cells in the ovary (female reproductive gland in which the eggs are formed). These tumors usually occur in teenage girls or young women, usually affect just one ovary, and can be benign (not cancer) or malignant (cancer). The most common ovarian germ cell tumor is called dysgerminoma.

One of a pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus.

PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.

Having to do with children.

A surgeon who specializes in the treatment of children. A surgeon removes or repairs a part of the body by operating on the patient.

The lower part of the abdomen, located between the hip bones.

Having to do with the parietal peritoneum (the tissue that lines the abdominal wall and pelvic cavity) and visceral peritoneum (the tissue that covers most of the organs in the abdomen, including the intestines).

The likely outcome or course of a disease; the chance of recovery or recurrence.

A specialist who can talk with patients and their families about emotional and personal matters, and can help them make decisions.

A doctor who specializes in using radiation to treat cancer.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.

The last several inches of the large intestine closest to the anus.

To come back or to return.

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrence.

An egg or sperm cell. Each mature reproductive cell carries a single set of 23 chromosomes.

The organs involved in producing offspring. In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). In men, it includes the prostate, the testes, and the penis.

The large, triangle-shaped bone in the lower spine that forms part of the pelvis. It is made of 5 fused bones of the spine.

A type of cancer of the testicles. Seminomas may spread to the lung, bone, liver, or brain.

A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.

The bones, muscles, tendons, and other tissues that reach from the base of the skull to the tailbone. The spine encloses the spinal cord and the fluid surrounding the spinal cord. Also called backbone, spinal column, and vertebral column.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. It is important to know the stage of the disease in order to plan the best treatment.

In medicine, treatment that experts agree is appropriate, accepted, and widely used. Health care providers are obligated to provide patients with standard therapy. Also called standard of care or best practice.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

Treatment using substances that travel through the bloodstream, reaching and affecting cells all over the body.

A type of germ cell tumor that may contain several different types of tissue, such as hair, muscle, and bone. Teratomas occur most often in the ovaries in women, the testicles in men, and the tailbone in children. Not all teratomas are malignant.

One of two egg-shaped glands inside the scrotum that produce sperm and male hormones. Also called testis.

A group or layer of cells that work together to perform a specific function.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.

Surgical removal of as much of a tumor as possible. Tumor debulking may increase the chance that chemotherapy or radiation therapy will kill all the tumor cells. It may also be done to relieve symptoms or help the patient live longer. Also called debulking.

A term used to describe cells or tissues that do not have specialized ("mature") structures or functions. Undifferentiated cancer cells often grow and spread quickly.

Surgery to remove the ovary and fallopian tube on one side of the body.

The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a baby grows. Also called the womb.

The muscular canal extending from the uterus to the exterior of the body. Also called birth canal.