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Genetic Screening and Testicle Transplants: Hope for the Future A man's genetic code may increase his risk of testicular cancer, according to Dr. Haifin Lin at North Carolina's Duke University. Dr. Lin and his research team believe they have isolated a gene that increases the risk of seminoma, a variety of testicular cancer that develops in sperm-producing germ cells. The gene in question is an overactive variety of the HIWI gene. In a small clinical trial examining nineteen men with seminoma-type testicular cancer, twelve of the participants displayed signs of overactive HIWI genes. The HIWI genes present in the seminoma cells of the twelve men were sixteen times more active than normal. The overactive gene may account for the rapid cell reproduction that characterizes seminoma tumors. If accurate, the study suggests a significant 63 percent of men with seminoma testicular tumors present with overactive HIWI genes. Dr. Lin is also careful to point out that the results of such a small clinical trial will need to be verified by larger studies. If future studies confirm the Duke University research team's findings, the knowledge could eventually yield a screening test for seminoma tumors. As testicular cancer is the most common cancer diagnosed in men under forty, an effective screening test could detect seminoma tumors at early stages of development, increasing treatment options and survival rates. Testicular Transplants: Reversing Chemotherapy-Caused Infertility? Chemotherapy treatments for testicular cancer can result in infertility. For this reason, men planning to have families after treatment are advised to use sperm banking in case of complications. If young boys with testicular cancer are left infertile by chemotherapy, little can be done: sperm banking is not an option prior to pubescence. A New Surgical Treatment A new surgical treatment may offer a solution to this problem. The Christie Hospital, in Manchester, England, performed a human testicle transplant in 2001, apparently curing a man of chemotherapy-induced infertility. The case involved a man who received chemotherapy as treatment for Hodgkin's disease, a blood-borne cancer. Prior to chemotherapy, doctors collected testicle tissue from the patient. The tissue was then frozen in liquid nitrogen. After treatment, which caused his infertility, the tissue was surgically returned to the testicles. The patient was able to father a child after the procedure. Testicular transplants had proven successful when performed on animals, so the results were not entirely surprising. However, some doctors question whether the procedure did indeed restore fertility, or if fertility returned spontaneously (while rare, some men do recover from chemotherapy-induced infertility years after treatment). If the surgery was a success, the procedure offers hope to testicular cancer patients who are too young to bank sperm, or men to ill to produce sperm. Seven men underwent the treatment; only one recovered from his infertility, so the treatment requires more study and clinical investigation. Resources BBC News. (2002). Gene linked to testicular cancer. Retrieved November 12, 2003, from news.bbc.co.uk/1/hi/health/2024344.stm. BBC News. (2002). Testicular transplant first. Retrieved November 12, 2003, from news.bbc.co.uk/1/hi/health/1787030.stm. Mayo Foundation for Medical Education and Research. (2002). Testicular cancer. Retrieved November 14, 2003, from www.mayoclinic.com/invoke.cfm?id=DS00046.

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