Testicular cancer

Question 1

The vast majority of testicular cancers arises from what cells, and what do these cells produce?

Answer 1

Germ cells - produce gametes

Question 2

When is the highest incidence of testicular cancer?

Answer 2

15 and 35 years

Question 3

What are the 2 subtypes of germ cell testicular cancers?

Answer 3

• Seminomas
• Non-seminomas (mostly teratomas)

Question 4

Name 2 risk factors for developing testicular cancer

Answer 4

• Undescended testes
• Male infertility
• Family history
• Increased height

Question 5

1) What is the typical presentation of testicular cancer?
2) How else can it present?
3) Gynaecomastia is a presentation that is associated with what kind of testicular cancer?

Answer 5

1) Painless testicular lump
2) Gynaecomastia, hydrocele
3) Leydig cell tumour

Question 6

1) What is usually the initial diagnostic method for testicular cancer?
2) Name a tumour marker for testicular cancer
3) Which of these is specific to teratomas and not seminomas?

Answer 6

1) Scrotal ultrasound
2) Alpha-fetoprotein and beta-hCG
3) Alpha-fetoprotein

Question 7

Name 2 common places for testicular cancers to metastasise to

Answer 7

• Lymphatics (most commonly para-aortic)
• Lungs
• Liver
• Brain

Question 8

1) What is the initial management of testicular tumours?
2) Name another option for the management of testicular cancer

Answer 8

1) Radical orchidectomy
2) Chemotherapy, surgery, radiotherapy, sperm banking

Question 9

1) Why are the long term side effects of treatment particularly significant?
2) Name 2 long term side effects associated with treatment

Answer 9

1) Most patients are young and expected to live many years after treatment of testicular cancer
2) Infertility, hypogonadism (testosterone replacement may be required), peripheral neuropathy, hearing loss, lasting kidney, liver or heart damage, increased risk of cancer in the future