FunMed: PBL 7 (Testicular Cancer) Flashcards
What increases the risk of developing testicular cancer?
Undescended testicles in infancy, indirect inguinal hernias in infancy, family history, being tall and marijuana use
Define orchidopexy
Operation to place undescended testis into scrotum
Define haematocrit
Ratio of volume of RBCs to total blood volume
What is alpha fetoprotein?
protein produced by foetus which is present in amniotic fluid and the bloodstream of mother
What is lactate dehydrogenase?
Converts lactate to pyruvate
What are the symptoms of testicular cancer?
Firm (often painless) mass of ump on testicle - can cause achy pain, growth/swelling of testicle, abnormality in shape/consistency between testicles, associated abdominal pain
Name the aspects of the testicle
Epididymis (feeds into spermatic cord/vas deferens), testis (seminiferous tubules –> straight tubules –> rete testis –> efferent ductules)
Why is alpha fetoprotein tested for?
Typically elevated in yolk sac tumour
Why is beta hCG tested for?
typically elevated in choriocarcinomas and NSGCTs
Why is lactate dehydrogenase tested for?
Shown to correlate with tumour burden in NSGCTs and some seminomas
What are the two main types of testicular cancer?
Seminomas and non-seminomas (common in younger patients)
What proportion of testicular cancers are germ cell cancers?
~95%
What is meant by tumour staging?
Indicates how far advanced it has become e.g. metastasis
Outline the stages of testicular cancer
Stage I - contained in testicle
Stage II - lymph node spread but no distant metastasis
Stage III - spread to thorax lymph nodes
Stage IV - spread to another organ e.g. lungs
Where does lymph drain from the testes?
Para-aortic lymph nodes
Where does lymph from the scrotum drain?
Superficial inguinal lymph nodes
What does NSGCTs stand for?
non-seminomatous germ cell tumors
What does RPLND stand for?
Retroperitoneal lymph node dissection
What is the treatment for non-seminomatous germ cell tumours?
Retroperitoneal lymph node dissection and radical orchiectomy
Describe how to perform testicle self-examination
Roll testicle between thumb and forefinger to check whole surface free of lumps and familiarise self with feel of epididymis collecting tube (behind testicle), inspect each testicle individually
When and where should testicular self-examination be conducted?
Monthly basis after a warm bath or shower (relaxes scrotal skin)
Define gynaecomastia
Benign enlargement of male breast tissue
Outline the checkpoints in the cell cycle
G1-S: checks organelle replication, have enough organelles to divide
G2-M: DNA replication appropriate and accurate
Mitosis (metaphase): chromosomes attached appropriately to spindle
What things must be present in order for someone to give informed consent?
Patient must be competent (have capacity)
Patient must be offered adequate information (adequate disclosure)
Patient’s decision must not be coerced (Non-coercion)
