Testicular cancer

Question 1

name 2 types of testicular cancer

Answer 1

seminoma - well differentiated and slower growing
teratoma - more aggressive and least common

Question 2

name 2 radical txs for seminoma cancer

Answer 2

sage 1 - surveillance
stage 2 - orchidectomy followed by adjuvant RT to ipsilateral nodal chain 20Gy in 10# or 30Gy in 25# OR chemotherapy as alternative (4 cycles cisplatin)

Question 3

name 2 radical tx for teratoma cancer

Answer 3

Inguinal orchidectomy - removal of primary tumour by removing both testicles and full spermatic chord.
Chemotherapy - if relapse occurs cisplatin is chemo of choice

Question 4

palliative tx for seminoma and teratoma cancer

Answer 4

EBRT to pelvis //opp A/P 20Gy in 5#
chemo can be used if relapse occurs or metastatic disease

Question 5

give 6 stages of testicular cancer

Answer 5

Stage I = cancer confined to testis
stage II= involved LN inf to diaphragm
Stage III= involved LN sup and inf of Diaphragm
Stage IV= metastatic disease
Stage IVL= lung mets
Stage IVH= liver mets

Question 6

give 4 etiological factors for testicular cancer

Answer 6

age - younger
low fertility - inc. risk
undescended testis - 1 undescended = 5% and both undescended = 12%
hypsopadia = urethra opens underside of penis inc. risk by 141%

Question 7

name 3 histological tumour for testicular cancer and the 2 subgroups

Answer 7

germ cell tumours - seminomas + teratomas
lyphomas
rare types

Question 8

give most common spread for seminoma and teratoma tumours

Answer 8

seminoma - local = scrotum
lymph = para-aortic
blood = rare

teratoma = metastatic to Lungs