Testicular Cancer

Question 1

What are 2 types of testicular cancer?

Answer 1

1. Seminomas – 50%

2. Non-seminomatous germ-cell tumours and teratomas – 30%

Question 2

What are RF for testicular cancer?

Answer 2

1. Cryptorchidism
2. Ectopic testes
3. Testicular atrophy
4. FHX

Question 3

What is cryptorchidism?

Answer 3

one/both testes fail to descend

Question 4

What are the symptoms for testicular cancer?

Answer 4

1. PAINLESS HARD NODULAR testicular mass – unilateral (can be assoictaed with hydrocele)
2. Lymphadenopathy
3. Gynaecomastia
4. Backache

Question 5

How does spread occur in testicular cancer?

Answer 5

will occur with travel directly to the para-aortic lymph nodes

Question 6

Why do you get gynaecomastia and backache in testicular cancer>

Answer 6

1. Gynaecomastia (tumour produeces hCG)

2. Backache due to para-aortic lymph node enlargement

Question 7

What bloods are done for testicular cancer?

Answer 7

1. FBC
2. U&Es
3. LFTs

Question 8

Why do you do LFTs for testicular cancer?

Answer 8

1. high ALP in bone mets

2. high GGT in some Seminomas

Question 9

What tumour markers are tested for?

Answer 9

1. α-fetoprotein
2. β-hcg
3. LDH

Question 10

What imaging is done for testicular cancer and why?

Answer 10

1. Testicular US
2. CTAP: allow visualisation of tumour and monitors treatment response
3. CXR: mediastinal and lung masses

Question 11

Why is a USS done?

Answer 11

allows visualisation and associated hydrocele

Question 12

Why is a CXR done?

Answer 12

1. testicular cancer will travel in para aortic lymph nodes to directly affect the mediatinal area
2. if there are mets it is likely to be in this area
3. So CXR is required for accurate staging work-up)

Question 13

What is the management for testicular cancer?

Answer 13

1. Surgical removal: orchiectomy

2. Chemotherapy