Taming Germinoma, a Unique Brain Cancer in Youngsters

What is it about?

Ten children and teenagers have been cured of germinoma inside the brain. The strategy comprises chemotherapy with radiation treatment sandwiched in the middle. The treatment duration is short, largely outpatient, and mostly safe. It condenses from a 20-year experience of a team of talented people when I was still working at Queen Mary Hospital in Hong Kong. At that time, radiation therapy to the whole brain and spine was considered standard treatment. Prof Louis Low, Prof Karen Lam, and Prof Jonathan Shum were thinking otherwise and I was charged to start chemotherapy in order to reduce the dose and extent of radiation treatment and thus long-term side effects.

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Photo by Robina Weermeijer on Unsplash

Photo by Robina Weermeijer on Unsplash

Why is it important?

We started with cisplatin, etoposide and bleomycin combination. After the first two patients, we knew we were on the right track. This was later modified to carboplatin and etoposide combination and the result was even better. Almost half of the patients have disorder of water balance (diabetes insipidus) because of the brain cancer and the current treatment regimen does not subject the patients to the risk of overhydration or dehydration. The European and American groups have also experimented with various chemotherapy combinations and eventually come to the same drugs, albeit at higher doses.

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