|
Table of Contents Description
Stage Explanation
Treatment Option Overview
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:
Testicular germ cell tumors of early childhood
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.
Testicular germ cell tumors of adolescence and young adulthood
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 for more information.)
Extragonadal, extracranial germ cell tumors of early childhood
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.
Extragonadal, extracranial germ cell tumors of adolescence and young adulthood
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 tumors
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 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.
Back to Top 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.
Extracranial Germ Cell Tumors
The following stages are
used for all extracranial germ cell tumors:
Stage I
Cancer has not spread from the tumor to surrounding tissues or lymph nodes and
can be surgically removed with no cancer cells remaining.
Stage II
Cancer has spread to surrounding tissues or lymph nodes, and surgery cannot
remove all cancer cells from the surrounding tissues.
Stage III
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.
Stage IV
Cancer has spread to other organs in the body.
Recurrent
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.
Ovarian Germ Cell Tumor
The following stages are used for ovarian germ cell tumor:
Stage I
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.
Stage II
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.
Stage III
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.
Stage IV
Cancer is found in one or both ovaries and has spread outside the abdomen or
has spread to the inside of the liver.
Recurrent
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.
Back to Top 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:
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.
Treatment in a clinical trial
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.
Back to Top 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.
Back to Top 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 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.
Back to Top 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:
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 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.
Back to Top 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.
Back to Top 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.
Back to Top To Learn More About Childhood Cancer
For more childhood cancer information and other general cancer resources from the National Cancer Institute, see the following:
Back to Top 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® 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 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. 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.
Back to Top 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 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" was added. It includes links to general information about cancer.
- The "Get More Information from NCI" section (originally called "To Learn More") was revised.
Back to Top 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. 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. 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 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.
Back to Top |
