Condition- Testicular Cancer

Question 1

What percentage of testicular cancers are germ cell tumours?

Answer 1

95%

Question 2

Germ cell testicular cancer can be split into two groups what are they?

Answer 2

• Seminomas (50%)
• Non-seminomas (30%): yolk sac, teratoma etc

Question 3

List some non-germ cell testicular cancers

Answer 3

Sertoli + Leydig cell tumours + non-hodgkin’s lymphoma

Question 4

List some risk factors for developing testicular cancer

Answer 4

• Maldescended testes
• Positive FHx
• Testicular atrophy
• Previous Hx
• White

Question 5

In which age group does testicular cancer peak?

Answer 5

20-34yr olds

Question 6

List some symptoms of testicular cancer

Answer 6

• PRIMARY: Swelling/ testicular discomfort
• METS:
  
  • Lung mets–> SOB, haemoptysis
  • Bone mets–> bone pain
  • Lymph mets–> Back ache becuause of lymph nodes
• SYSTEMIC: FLAWS

Question 7

List some signs of Testicular cancer on physical examination

Answer 7

• Painless, testicular mass
• Secondary hydrocoele
• Lymphadenopathy (Supraclavicular, para-aortic)
• Gynaecomastia (tumour produces hCG)

Question 8

Which testicular tumour markers could you look for in bloods

Answer 8

• a-fetoprotein
• b-hCG
• LDH

Question 9

State an easy test to identify the presence of a testicular cancer tumour marker

Answer 9

Pregnancy test

Looks for hCG

Question 10

Other than bloods- which investigations would you conduct on a pt with testicular cancer and why?

Answer 10

• CXR - show lung metastases
• Testicular Ultrasound- Allows visualisation of the tumour + associated hydrocoele
• CT Abdomen and Thorax - allows staging
  
  • Staging System: Royal Marsden Hospital Staging