Testicular Cancer Flashcards
Testicular cancer
Unregulated growth of abnormal cells within testicles
Most common type of cancer in young men between 15-35 years of age
Risk factors
Cryptorchidism Family h/o testicular cancer Orchitis HIV infection Maternal exposure to exogenous estrogen White men are more likely to develop this type of cancer
Cancers that grow from germ cells, cells that make sperm
Seminoma
Nonseminoma
Seminoma
Slow-growing form of testicular cancer usually found in men in their 30s and 40s.
Cancer usually just in testes, can spread to lymph nodes
Very sensitive to radiation therapy
Nonseminoma
More common
Tends to grow more quickly than seminomas
Made up of more than one type of cell often
Spread and metastasis through body
Clinical manifestations
Slow or rapid depending on type of tumor Painless lump in scrotum, non-tender and firm Dull ache in pelvis or scrotum Scrotal swelling Weight loss and fatigue
Diagnosing
Palpation
Cancerous mass - firm and does not trans illuminate
Scrotal ultrasound
Elevated Alpha fetoprotein (AFP), lactate dehydrogenase (LDH), HCG
Testicular self examination
Best done during a shower or in a warm room
Palpate each testicle separately
Should feel round and smooth
Check for lumps, irregularities, pain, or dragging sensation
Perform TSE consistently every month
Radical orchiectomy
Removal of affected testis, spermatic cord, and regional lymph nodes
Post orchiectomy
Surveillance, radiation, chemotherapy
Chemotherapy is more sensitive to what?
Germ cell tumors
Which is more aggressive: nonesminoma or seminoma?
Nonseminoma.
When elements of both are presents, or alpha-fetoprotein concetration is elevated, tumor shoudl be treated as nonseminoma
Complications
Treatment: r/t toxicity Pulmonary: bleomcycin Renal: cisplastin CVS: etoposide, radiotherapy Infertility: with LN excision Hematological Neurological: cisplastin Secondary malignancy
Bleomecyin
Can cause pneumonitis and pulmonary fibrosis
Pulmonary function tests done before starting chemotherapy that includes this agent
Bleomnycin-induced lung toxicity is cumulative and although can be fatal, it rarely is. Total cumulative dose is less than 400 units
Cisplastin
Renal toxicity
20-30% of pts who receive this have a reduction in GFR
Can also cause hypomagnesemia, hypophosphatemia, hypokalemia
neuropathy (along wtih oxaliplatin)
