Testicular Cancer Flashcards
Where do testicular cancers arise from?
Germ cells in the testes
What age range is most commonly affected by testicular cancer?
15-35 years old
What are the risk factors for testicular cancer?
Undescended testes
Male infertility
Family history
Increased height
What is the presentation of testicular cancer?
Painless lump
Occasionally can have testicular pain
What is a rare presentation of testicular cancer?
Gynaecomastia
Particularly in leydig cell tumours
How common is it for a patient presenting with gynaecomastia to have a testicular tumour?
2%
What is the initial investigation in testicular cancer?
Scrotal ultrasound
Staging CT used to look for spread and to stage
What tumour markers are raised in testicular cancer?
Alpha-fetoprotein
Raised in teratomas, not in pure seminomas
Beta-hCG
Teratomas + seminomas
LDH
Very non-specific tumour marker
What staging system is used for testicular cancer?
Royal Marsden Staging System
What are the most common places for testicular cancer to metastasise to?
Lymphatics
Lungs
Liver
Brain
How is testicular cancer managed?
Surgery
-Radical orchidectomy, prosthesis can be inserted
Chemotherapy
Radiotherapy
Sperm banking
-Treatment may cause infertility, saves sperm for future use
Why are long-term side effects of testicular cancer treatment so significant?
Most patients are young, so effects of treatment affect the patient for many years
What are the side effects of testicular cancer treatment?
Infertility
Hypogonadism
Peripheral neuropathy
Hearing loss
Lasting kidney, liver or heart damage
Increased cancer risk
What is the prognosis of testicular cancer?
90% cure rate
Seminomas have a slightly better prognosis than non-seminomas
When patients are monitored after treatment of testicular cancer what is involved?
Tumour markers
CT scans
CXRs
