In general, testicular cancers respond well to chemotherapy (chemo), but not all of them are cured. Even though higher doses of chemo might work better, they're not given because they could severely damage the bone marrow, which is where new blood cells form. This could lead to life-threatening infections, bleeding, and other problems because of low blood cell counts.
But a stem cell transplant allows doctors to use higher doses of chemo. Stem cells used to be taken from the bone marrow, but this is done less often now. In the weeks before treatment, a special machine collects blood-forming stem cells from the patient's bloodstream. They are frozen and stored.
The patient then gets high-doses of chemo. After chemo, the patient gets his stem cells back again. This is called a transplant, but it doesn’t involve surgery – the cells are infused into a vein much like a blood transfusion. The stem cells settle in the bone marrow and start making new blood cells over the next few weeks.
Stem cell transplant is most often used to treat testicular cancers that have come back after treatment with chemo. Current studies are looking at whether a stem cell transplant may be valuable as part of the first treatment for some patients with advanced germ cell cancers.
A stem cell transplant is a complex treatment that can cause life-threatening side effects because of the high doses of chemotherapy used. Be sure you understand the possible benefits and risks. If the doctors think you might benefit from a transplant, it should be done at a hospital where the staff has experience with the procedure and with managing the recovery phase.
Stem cell transplants sometimes require a long hospital stay and can cost a lot. Even if your insurance covers the transplant, your co-pays or other costs could add up to a lot of money. Before deciding on a transplant It's important to find out what your insurer will cover to get an idea of what you might have to pay.
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Allen JC, Kirschner A, Scarpato KR, Morgans AK. Current Management of Refractory Germ Cell Tumors and Future Directions. Curr Oncol Rep. 2017;19(2):8.
Last Revised: May 17, 2018