"I now know how cancer can strike anyone whatever their situation or circumstance. I hope by taking part in a trial it will help others in my position in the future.”
A trial to find the best way of using scans to monitor men after treatment for seminoma testicular cancer (TRISST MRC TE24)
Please note - this trial is no longer recruiting patients. We hope to add results when they are available.
This trial aims to find the best way of using scans to monitor men following their treatment for testicular cancer. It is recruiting men with stage one seminoma testicular cancer. This monitoring is sometimes called surveillance. This trial is supported by Cancer Research UK.
Some men with early stage testicular cancer will only need surgery, followed by monitoring. Scans are part of this. At the moment, men usually have regular CT scans to pick any sign of the cancer coming back (recurrence). Cancer can come back in a small number of men. But with further treatment, most men can still be cured of their disease.
Having a CT scan exposes you to some radiation. This may slightly increase your risk of developing other cancers at a later date. So when arranging CT scans doctors have to consider the benefits and whether these outweigh any risks. It is important for you to have scans to pick up any signs of your cancer coming back. But doctors want to find out if men can have CT scans less often, or have MRI scans instead. MRI scans use magnetism to build up a picture, so you are not exposed to any radiation.
This trial aims to find out
- Whether it is better to use MRI scans instead of CT scans to monitor men following treatment for testicular cancer
- How often these scans should be
Who can enter
You can enter this trial if you
- Have been diagnosed with pure seminoma testicular cancer (if you have non seminoma testicular cancer cells in your tumour you will not be able to take part)
- Have stage one testicular cancer
- Have had surgery to remove your cancer (orchidectomy) within the last 2 months
- Have normal levels of the tumour markers
alpha feta protein (AFP)and human chorionic gonadotrophin (HCG)when you start this trial (you may have had a raised HCG before your surgery)
- Are able to attend regular hospital appointments
- Are at least 16 years of age
You cannot enter this trial if you
- Have non seminoma testicular cancer cells in your tumour
- Your doctor has recommended that you have further treatment, such as radiotherapy or chemotherapy for your testicular cancer (
- Have had cancer in the last 10 years (apart from non melanoma skin cancer which has been treated)
- Are unable to have an MRI scan for medical reasons, for example, you have a pacemaker or certain types of metal surgical clips or plates in your body
There are 4 different groups in this trial and it is randomised. This means that men are put into the different groups by a computer. Neither you nor your doctor will be able to decide which group you are in. The group will determine whether you have CT scans or MRI scans, and whether you have 3 or 7 scans.
- If you are in group 1, you will have 7 CT scans over the next 5 years. These will be every 6 months for the first 2 years, then yearly for the next 3 years. Most doctors’ monitor in this way at the moment.
- If you are in group 2, you will have 7 MRI scans over the next 5 years. As with group 1, you will have a scan every 6 months for the first 2 years, then yearly for the next 3 years.
- If you are in group 3, you will have 3 CT scans. These will be 6 months after your surgery, then at 18 months and 3 years.
- If you are in group 4, you will have 3 MRI scans. You will have these at the same times as men in group 3
You will also see a doctor for check ups at the hospital. You will have an examination, a chest X-ray and blood tests to measure tumour markers. You would have these appointments whether you take part in this trial or not. They appointments will be
- Every 3 months for the first 2 years
- Every 4 months in the third year
- Every 6 months up until the end of year 6
Where possible, your scans will be on the same day as your check ups. You may continue to have these follow up appointments after 6 years. They will be arranged by your own consultant and are not part of this trial.
Before you take part in this trial you will have various tests including
- Blood tests to measure tumour markers
- Chest X-ray
- CT scan of your chest, stomach and
During the trial you will go to hospital for a CT scan or MRI scan, either 7 or 3 times, depending on the group you are in. Either scan takes about 20 to 40 minutes.
You will fill out a questionnaire 8 times during the trial. The first will be when you have agreed to take part. Then every 6 months for the first 2 years, and yearly after that. This will ask questions about
- Your health
- Your GP and hospital visits
- Care you have had outside of hospital, if applicable
The trial doctors will ask you for a sample of the cancer that was removed when you had surgery. This will be stored and may be used for future research. This part of the trial is optional. You do not have to agree to this if you don’t want to. You will still be able to take part in the trial.
Having a CT scan does mean that you are exposed to a low dose of radiation. Any exposure to radiation slightly increases the risk of developing cancer in the future. But this small increase in risk should be balanced against the possible benefit of diagnosing and treating cancer if it comes back.
Before the CT scan, you may have a drink or injection of 'contrast medium'. This is a sort of dye that shows up body tissues more clearly on the scan. The injection may make you feel hot and flushed for a minute or two. You will probably not have a contrast medium before your MRI scan.
For either scan, you lie on a couch and your body passes through the centre of the machine. Some people feel anxious about being closed in (claustrophobic). If you think this might be a problem for you, tell the department before you go. You may be able to have a tablet or injection to help you relax.
The MRI scan is quite noisy. You will be offered ear plugs or headphones to wear.
How to join a clinical trial
Dr J. Joffe
Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
Medical Research Council (MRC)
NIHR Clinical Research Network: Cancer
This is Cancer Research UK trial number CRUK/07/020.