The vaccine has been approved for use in The Netherlands. Given as a 15 min infusion, repeated every 21 days. Being used for advanced colon cancers, Muscositis, diarrhoea can be severe, kidney functions are to be adequate as drug is excreted through kidneys. 10 times more cytotoxic than methotrexate. Used as a biological modulator of 5-FU in advanced colonic cancers.
Surgical resection remains the cornerstone of management.
No effective post surgical adjuvant has been established in cases with locally advanced disease who have a high chance of recurrance. The men at greatest risk were those with high Gleason scores, a rise of PSA within 2 years after surgery. and a doubling of PSA in less than 10 months. CT scan is a useful staging tool. Laparoscopic retroperitoneal lymphadenectomy appears to be a feasible tool with acceptable short term morbidity. Primary chemotherapy is not recommended currently as it has not been proven to be superior in patients with high clinical stage I nonseminomas and can cause significant long term sequelae.