Cancer - Penile and Testicular Flashcards
1
Q
What symptoms could be indicative of testicular cancer?
A
- lump in body of testis (usually painless)
- Heaviness in scrotum
- Dull ache lower abdomen
- Back pain
- Breast tenderness/gynaecomastia
- Varicocele (left side – swollen pampiniform complex due to testicular vein branching off of left renal vein)
2
Q
What are the main types of testicular cancer?
A
- Germ cell tumours (seminoma or teratoma): usually in men <45 years old
- Risk factor: undescended testis (ipsi or contralateral)
- Older men: consider lymphoma as differen
3
Q
What history and investigations would you do if you suspected testicular cancer?
A
- Examination and sexual history
- Exclude STI with swabs
- Check testis tumour markers if testicular mass on US:
- aFP: may be raised in teratomas (not in seminomas)
- hCG: may be raised in teratomas or seminomas but more often in teratomas
- LDH
- Refer via 2ww wait to urology
- Non painful enlargement or change of shape or texture of the testis
- Consider direct access US scan for men with unexplained/persistent testicular symptoms
4
Q
What is the treatment for testicular cancer?
A
- Inguinal orchidectomy: 1st line treatment
- Chemotherapy/radiotherapy based on staging
- Monitoring post-treatment with tumour markers and imaging
5
Q
Penile cancer: epidemiology, index of suspicion, risk factors and behaviour of cancer
A
- 20% less than 50 years old
- Suspect penile cancer if STI has been excluded or lump/ulcer/lesion is persistent despite treatment
- Risk factors: phimosis (smegma) and HPV 16 and 18
- Very aggressive cancer: most die within 2 years if untreated
6
Q
When should you refer someone for the 2WW penile cancer clinic?
A
- Penile mass or ulceration where STI has been excluded
- Persistent penile ulceration after a course of treatment for STI has been completed
7
Q
What type of penile cancer is most common?
A
- Squamous cell carcinoma
