Testicular Cancer

Question 1

What is testicular cancer?

Answer 1

Testicular cancer is the most common malignancy in men aged 15-45 years, representing about 1% of adult cancers.

Question 2

What is the 5-year survival rate for testicular cancer if diagnosed early?

Answer 2

The 5-year survival rate is approximately 95% if diagnosed early.

Question 3

What are the primary histological classifications of testicular cancer?

Answer 3

Testicular cancers are primarily classified as germ cell tumours (seminomas and non-seminomas) and non-germ cell tumours.

Question 4

What is cryptorchidism, and how does it relate to testicular cancer risk?

Answer 4

Cryptorchidism is an undescended testicle; it increases the risk of testicular cancer fourfold for unilateral and tenfold for bilateral cases.

Question 5

How does a family history affect the risk of testicular cancer?

Answer 5

A family history, especially in first-degree male relatives, increases the risk by sixfold.

Question 6

What genetic syndromes are associated with an increased risk of testicular cancer?

Answer 6

Klinefelter syndrome and Kallmann syndrome are associated with an increased risk.

Question 7

What is the most common presenting symptom of testicular cancer?

Answer 7

A unilateral painless testicular lump is the most common presenting symptom.

Question 8

What symptoms might indicate metastatic testicular cancer?

Answer 8

Symptoms can include unintentional weight loss, back pain (due to skeletal metastasis), and dyspnoea (due to lung metastases).

Question 9

How does a testicular tumour typically present on physical examination?

Answer 9

As a unilateral, painless, irregular, firm, fixed testicular lump that does not transilluminate.

Question 10

What are common differential diagnoses for a testicular mass?

Answer 10

Differential diagnoses include epididymo-orchitis, hydrocele, varicocele, and inguinal hernia.

Question 11

Which tumour marker is elevated in 30-50% of non-seminomatous germ cell tumours and 5-10% of seminomas?

Answer 11

Beta-human chorionic gonadotropin (Beta HCG).

Question 12

Which tumour marker is raised in non-seminomatous germ cell tumours but not in seminomas?

Answer 12

Alpha-fetoprotein (AFP).

Question 13

What imaging modality is first-line for evaluating a suspected testicular tumour?

Answer 13

Scrotal ultrasound is the first-line imaging modality.

Question 14

What is the standard initial surgical treatment for testicular cancer?

Answer 14

Radical inguinal orchidectomy is the standard initial surgical treatment.

Question 15

What is the purpose of sperm banking in patients diagnosed with testicular cancer?

Answer 15

Sperm banking is offered due to the potential impact of treatment on fertility.

Question 16

What are the main components of the staging process for testicular cancer?

Answer 16

Staging involves imaging (CT scans of the chest, abdomen, and pelvis) and serum tumour marker assessment.

Question 17

What is the role of chemotherapy in testicular cancer treatment?

Answer 17

Chemotherapy is used in cases with metastatic disease or high-risk features.

Question 18

What are potential complications of testicular cancer treatment?

Answer 18

Complications can include hypogonadism, infertility, secondary malignancies, peripheral neuropathy, and surgical complications such as bleeding or infection.

Question 19

How does prior testicular cancer affect the risk of developing a contralateral tumour?

Answer 19

It increases the risk by eightfold for developing a tumour in the opposite testicle.

Question 20

What is the significance of lactate dehydrogenase (LDH) in testicular cancer?

Answer 20

LDH serves as a surrogate marker for tumour volume and necrosis.

Question 21

What is the typical age range for the peak incidence of testicular cancer?

Answer 21

The peak incidence is in men aged 15-45 years.

Question 22

What prenatal exposure is associated with an increased risk of testicular cancer?

Answer 22

Prenatal exposure to oestrogen is associated with an increased risk.

Question 23

What is the importance of early detection in testicular cancer?

Answer 23

Early detection significantly improves prognosis, with a 95% 5-year survival rate if diagnosed early.

Question 24

What is the global trend in testicular cancer incidence?

Answer 24

Testicular cancer rates are increasing globally.

Question 25

What is the recommended follow-up after treatment for testicular cancer?

Answer 25

Regular follow-up with physical examinations, tumour marker assessments, and imaging studies to monitor for recurrence.