April 29, 2019

Targeting testicular cancer, a ‘young man’s disease’

Urologists and oncologists work together to ensure high-quality care for patients with this rare cancer.

Nine out of 10 cancers are diagnosed in people 50 and older, but certain cancers occur more commonly in young people. Chief among these is testicular cancer, the most commonly diagnosed cancer for men 15 to 44. The average age of diagnosis is 33 — but 6% of cases are diagnosed in boys and adolescents.

A team of Kaiser Permanente urologists and medical oncologists created the Testicular Cancer Review Panel in 2016. The panel brings together a group of specialists twice a month to review new cases throughout Kaiser Permanente in Northern California.

This approach is particularly important with a rare disease like testicular cancer, which occurs in fewer than 10,000 men annually. Each of our urologists may diagnose just 1 case in any given year.

“The Testicular Cancer Review Panel exemplifies what Kaiser Permanente does best — bringing together teams of specialists who are leaders in their fields to determine the ideal care for each patient,” said Mark St. Lezin, MD, chair of the chiefs of urology for Kaiser Permanente in Northern California.

“The panel’s work could mean that a young man avoids chemo he doesn’t need — or gets treatment that prevents a recurrence of his cancer,” Dr. St. Lezin added.

Sharing knowledge and expertise

In its first year, the panel reviewed 131 cases. That number grew to 216 in 2018.

“We are identifying patients as quickly as we can to make sure they are all on the right treatment path,” said medical oncologist Andrea Harzstark, MD, who launched the effort with urologist Joseph Presti, MD.

Kaiser Permanente medical oncologist Andrea Harzstark and urologist Joseph Presti.
The Testicular Cancer Review Panel was launched by medical oncologist Andrea Harzstark and urologist Joseph Presti.

Support from research and technology partners was essential in the creation of the Testicular Cancer Review Panel. Lisa Herrinton, PhD, a research scientist at the Kaiser Permanente Division of Research, began by creating a miniregistry of all new and ongoing testicular cancer cases in Northern California.

Panel members access the registry from within Kaiser Permanente’s electronic health record system, helping to ensure that follow-up imaging and laboratory tests happen as needed based on the patient’s specific type and stage of cancer.

For patients with testicular cancer and their families, the Testicular Cancer Review Panel affords much-needed peace of mind.

“The mother of one patient told me, ‘I cannot tell you how comforted I am to hear that a panel of experts has reviewed my son’s case,’” Dr. Presti said.