Types of Treatment for Childhood Germ Cell Tumor

Executive Summary

Treatment (Germ Cell Tumor) recommendations depend upon the size, grade and type of tumor, metastasis, possible side effects, and patient’s preferences and overall health. The common treatment for childhood germ cell tumor involves surgery and chemotherapy (systemic chemotherapy, use of drugs such as bleomycin, cisplatin, etoposide, and ifosfamide). Palliative care includes medication, nutritional changes, emotional and spiritual support and other relaxation therapies.

Treatment of Childhood Germ Cell Tumor

In general, tumors are uncommon in children. This means it can be challenging for doctors to plan treatments unless they know what is most effective in other children. This is why more than 60% of children are treated as part of a clinical trial.

“Standard to care” refers to the best-known treatment. In cancer care, different doctors work together to bring out an overall treatment plan for the patient ​1​. This is a multidisciplinary team. 

Treatments recommendations depend on many factors:

  • The size, grade and type of tumor
  • Whether the tumor is applying pressure on vital parts of the brain
  • If the tumor has increased to other parts of the CNS or body
  • Possible side effects
  • The patient’s preferences and overall health

Surgery for germ cell tumor

Surgery is the removal of the tumor and some nearby healthy tissue during an operation. The goal of surgery is to remove as many tumor cells as possible. Some people with a germ cell tumor can be treated with surgery alone, such as a testicular germ cell tumor or an ovarian germ cell tumor ​2​. For others, additional treatments after surgery may be recommended.


Chemotherapy uses medicine to kill or stop the growth of cancerous cells. So, depending upon the stage, doctors give different chemotherapy. The point that makes a difference is how the chemotherapy enters the body and which cells it affects ​3​.

Systemic chemotherapy enters the bloodstream to reach cancerous cells all over the body. 

Standard methods for chemotherapy include an intravenous (IV) tube placed into a vein using a needle or by capsule or pill taken orally.

A chemotherapy schedule usually consists of a certain number of cycles over a fixed period. A patient can be given one drug at a time or a combination of different medications given simultaneously.

The drugs used for treating germ cell tumors include bleomycin (available as a generic drug), cisplatin (available as a generic drug), etoposide (Etopophos), and ifosfamide (Ifex) ​4​

The side effects of chemotherapy depend on the patient and the dose used. Still, they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhoea. These side effects usually go after completion of treatment.

Palliative Care

Cancer and its treatment have side effects that can be mental, physical or financial and managing the effects are palliative or supportive care. Therefore, Palliative care includes medication, nutritional changes, emotional and spiritual support and other relaxation therapies. 

Palliative care focuses on alleviating how you feel during treatment by managing symptoms and supporting patients and their families with other non-medical needs. Regardless of type and stage of Cancer age, any person may receive this type of care.

Remission and the chance of recurrence

When cancer can’t be detected in the body, and there are no symptoms, this is known as remission. This may also be called having ‘no evidence of disease’ or ‘NED.’

A remission can either be temporary or permanent. Many people worry about the recurrence of cancer.

If the tumor returns after the original treatment, it is a recurrent tumour. It may return in the same place ( local recurrence), nearby (regional recurrence), or in another place (distant recurrence).

The doctor performs another round of tests to know the extent of the recurrence.

Mainly the treatment plan includes the treatments explained above, like surgery, chemotherapy, radiation therapy, and targeted therapy. Still, doctors use it in a different combination or given at a different pace. 

If treatment doesn’t work

If cancer can’t be treated or controlled, it leads to advanced or terminal cancer. Therefore, it is vital to have straightforward conversations with your health care team to express your feelings, preferences, and concerns. The health care team has unique skills, knowledge, and experience to assist patients and their families. Thus, ensuring that a person is physically comfortable, free from pain, and emotionally supported is extremely important.


  1. 1.
    Beyer J, Albers P, Altena R, et al. Maintaining success, reducing treatment burden, focusing on survivorship: highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer. Annals of Oncology. Published online April 2013:878-888. doi:10.1093/annonc/mds579
  2. 2.
    Murray MJ, Coleman N. A new generation of biomarkers for malignant germ cell tumours. Nat Rev Urol. Published online May 1, 2012:298-300. doi:10.1038/nrurol.2012.86
  3. 3.
    Leão R, Nayan M, Punjani N, et al. A New Model to Predict Benign Histology in Residual Retroperitoneal Masses After Chemotherapy in Nonseminoma. European Urology Focus. Published online December 2018:995-1001. doi:10.1016/j.euf.2018.01.015
  4. 4.
    Koul S, McKiernan JM, Narayan G, et al. Mol Cancer. Published online 2004:16. doi:10.1186/1476-4598-3-16