A paradigm shift in understanding testicular cancer

​Research is a precondition for better patient treatment. In rare cases, research also results in a paradigm shift in understanding diseases and the cellular mechanisms behind them.  Such a paradigm shift has been on its way for testicular cancer ever since Niels Skakkebæk from the Department of Growth and Reproduction in 1972 published the first examples of the early stages of testicular cancer (carcinoma in situ) in two patients at Rigshospitalet in the internationally acclaimed journal, The Lancet.

For many years this was a controversial topic. However, the final international breakthrough came this week, when the International Agency for Cancer (IARC) published its 4th edition of the World Health Organization Classification of Tumours of the Urinary System and Male Genital Organs. The detailed report can be viewed as a consensus in this area, and it explains that, because of their characteristics as foetal cells, the early stages of cancer (now called germinal cell neoplasia in situ - GCNIS) have now been identified as having a pivotal role in the development of testicular cancer. 

Where researchers were previously unsure about which cells caused testicular cancer, they now have certain knowledge about the origin of the most common types of testicular cancer (seminomas and non-seminomas). This means that diagnosing testicular cancer has become more precise and this has also improved prevention and treatment of this type of cancer, which is particularly common in young men.

The Department of Growth and Reproduction has been working closely with oncologists, urologists and pathologists from Rigshospitalet and other hospitals in Copenhagen since the 1970s. Consequently, Rigshospitalet and the University of Copenhagen have been international front-runners within testicular cancer research for many years. 

"Our results show the importance of hard work and patience. Five doctoral dissertations, a double-digit number of PhD dissertations and a three-digit number of scientific publications about testicular cancer have been produced by the Department of Growth and Reproduction at Rigshospitalet throughout the years," said Professor Anders Juul, Head of Department. “The final international recognition of GCNIS as an early stage of testicular cancer is a paradigm shift that began in our department and has now been accepted worldwide," he explained. 

“Our department's close link between research and patient treatment has been crucial, and we're privileged with expert knowledge from physicians, biologists, chemists and epidemiologists. Our results also show that continued funding pays off. We would not have come this far without considerable funding from a number of foundations, including the Danish Cancer Society, Rigshospitalet and the University of Copenhagen," Professor Juul concluded.

IARC-WHO Report: Classification of Tumours of the Urinary System and Male Genital Organs. Moch, H., Humphrey, P. A., Ulbright, T. M. & Reuter, V. E. (Ed.). 4th edition January 2016

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