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

6.5. Cancer - Testicular Cancer Flashcards

(35 cards)

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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?

Study These Flashcards
A

The Para-Aortic Lymph Nodes

17
Q

Where can Testicular Cancer Metastasis to?

18
Q

what investigations are necessary for Testicular Cancer?

Study These Flashcards
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?

Study These Flashcards
A

To exclude:

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

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

Study These Flashcards
A

To exclude infection

21
Q

What is the purpose of the Testicular Ultrasound?

Study These Flashcards
A

To visualize the Testis and exclude a Cyst

22
Q

What are the Blood Tests looking for?

Study These Flashcards
A

Tumour Markers:

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

What is the purpose of the CT Scan?

Study These Flashcards
A

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

24
Q

What is the purpose of the Contralateral Biopsy?

Study These Flashcards
A

To ensure that this is not bilateral

25
What can be determined from biopsy of the Tumour?
The Tumours Grade
26
What staging system is used for Testicular Cancer?
TNM staging
27
What are the different stages of Testicular Cancer?
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
What is the 5 year survival rate for a Stage 1 (T1N0M0)?
99%
29
What is the 5 year survival rate for a Stage 2 (TxN1M0)?
96%
30
What is the 5 year survival rate for a Stage 3 (TxN2M0)?
96%
31
What is the 5 year survival rate for a Stage 4 (TxNxM1)?
73%
32
What treatment is required for Testicular Cancer?
Radical Orchidectomy followed by specific therapy dependent on the Stage
33
What specific therapy is required following a Radical Orchidectomy, in a Stage 1 Testicular Cancer?
1. Surveillance 2a. Adjuvant Radiotherapy OR 2b. Prophylactic Chemotherapy
34
What specific therapy is required following a Radical Orchidectomy, in a Stage 2/3 Testicular Cancer?
Combination Chemotherapy OR Lymph Node Dissection
35
What specific therapy is required following a Radical Orchidectomy, in a Stage 4 Testicular Cancer?
1st Line Chemotherapy then 2nd Line Chemotherapy

2nd Year - Urinary Diseases (16 decks)

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