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2nd Year - Urinary Diseases > 6.5. Cancer - Testicular Cancer > Flashcards

6.5. Cancer - Testicular Cancer Flashcards

1
Q

What is the significance of Testicular Cancer?

A

This is one of the commonest cancers in young men

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2
Q

What is the peak age of incidence of Testicular Cancer?

A

The 3rd Decade

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3
Q

What is the Aetiology of Testicular Cancer?

A

It is unknown

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4
Q

What is a precursor lesion to Testicular Cancer?

A

Testicular Germ Cell Neoplasia In-Situ

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5
Q

What are the risk factros involved in Testicular Cancer?

A
  1. Being Caucasian
  2. Testicular Maldescent
  3. Infertility
  4. Atrophic Testis
  5. Previous Cancer in the Contralateral Testis
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6
Q

What type of Tumours are in Testicular Cancer?

A
  1. Germ Cell Tumours (GCT) - 95%

2. Non-GCT - 5%

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7
Q

What are the two types of Germ Cell Tumours involved in Testicular Cancer?

A

1, Seminomatous

2. Non-Seminomatous

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8
Q

What age group is most likely to present with Seminomatous Germ Cell Tumours?

A

30-40 year olds

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9
Q

What age group is most likely to present with .Non-Seminomatous Germ Cell Tumours?

A

20-30 year p;ds

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10
Q

What are the 3 sub-types of Seminomatous Germ Cell Tumours?

A
  1. Classic
  2. Spermatocyte
  3. Anaplastic
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11
Q

What are the 3 sub-types of Non-Seminomatous Germ Cell Tumours?

A
  1. Teratomas
  2. Choriocarcinoma
  3. Miced Germ Cell Tumour
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12
Q

What are the Non-Germ Cell Tumours (5%) due to?

A

Carcinoma of the Sex Cord / Stroma

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13
Q

What are the Ckinical Features of Testicular Cancer?

A
  1. Painless Lump
  2. Inflamed Swelling
  3. History of Trauma
  4. Lymphadenopathy
  5. Metastatic Symptoms
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14
Q

What is the most common presentation of Testicular Cancer?

A

A painless lump

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15
Q

What is a less common presentation of Testicular Cancer?

A

An inflamed swelling which can be tender

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16
Q

Where can Lymphadenopathy occur immediately?

A

The Para-Aortic Lymph Nodes

17
Q

Where can Testicular Cancer Metastasis to?

A
  1. Lung

2. Bone

18
Q

what investigations are necessary for Testicular Cancer?

A
  1. Physical Examination
  2. Mid-Stream Sample of Urine
  3. Testicular Ultrasound
  4. Blood Tests
  5. CT Scan
  6. Biopsy
  7. Contralateral Biopsy
19
Q

What is the purpose of the Physical Examination?

A

To exclude:

  1. Infection (Epididymo-Orchitis
  2. Hernia
  3. Cyst
20
Q

What is the purpose of the Mid-Stream Sample of Urine?

A

To exclude infection

21
Q

What is the purpose of the Testicular Ultrasound?

A

To visualize the Testis and exclude a Cyst

22
Q

What are the Blood Tests looking for?

A

Tumour Markers:

  1. Alpha-Fetoprotein
  2. Human Chorionic Gonadotrophin
  3. Lactate Dehydrogenase
23
Q

What is the purpose of the CT Scan?

A

To check for Nodal, and Chest/Abdomen/Pelvic Metastases for Staging purposes

24
Q

What is the purpose of the Contralateral Biopsy?

A

To ensure that this is not bilateral

25
Q

What can be determined from biopsy of the Tumour?

A

The Tumours Grade

26
Q

What staging system is used for Testicular Cancer?

A

TNM staging

27
Q

What are the different stages of Testicular Cancer?

A

Stage 1 - T1N0M0 - Disease is confined to the Testis
Stage 2 - TxN1M0 - Infradiaphragmatic Nodes are involved
Stage 3 - TxN2M0 - Supradiaphragmatic Nodes are involved
Stage 4 - T1NxM1 - Extra Lymphatic Disease

28
Q

What is the 5 year survival rate for a Stage 1 (T1N0M0)?

A

99%

29
Q

What is the 5 year survival rate for a Stage 2 (TxN1M0)?

A

96%

30
Q

What is the 5 year survival rate for a Stage 3 (TxN2M0)?

A

96%

31
Q

What is the 5 year survival rate for a Stage 4 (TxNxM1)?

A

73%

32
Q

What treatment is required for Testicular Cancer?

A

Radical Orchidectomy followed by specific therapy dependent on the Stage

33
Q

What specific therapy is required following a Radical Orchidectomy, in a Stage 1 Testicular Cancer?

A
  1. Surveillance
    2a. Adjuvant Radiotherapy
    OR
    2b. Prophylactic Chemotherapy
34
Q

What specific therapy is required following a Radical Orchidectomy, in a Stage 2/3 Testicular Cancer?

A

Combination Chemotherapy
OR
Lymph Node Dissection

35
Q

What specific therapy is required following a Radical Orchidectomy, in a Stage 4 Testicular Cancer?

A

1st Line Chemotherapy then 2nd Line Chemotherapy

2nd Year - Urinary Diseases (16 decks)

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