Testicular Cancer Flashcards
What is the MC type of testicular tumor?
germ cell tumors
Clinical Px of testicular tumors
painless mass/swelling in testicle
right side> left side
back pain/ abd mass
Places of metastasis for testicular tumors
bilateral testis tumor
lymphatic: retroperitoneal lymph nodes
distant: lung, liver, bone, kidney, adrenal, GI, spleen
Where would lymphatic metastases of testicular cancer spread?
retroperitoneal lymph nodes
Where would distant metastasis of testicular cancer spread?
lung, liver, brain, bone, kidney, adrenal, GI, spleen
Dx of testicular cancer
H&P: lymph nodes, abdomen
US
Tumor markers: AFP, Beta HCG, lactate dehydrogenase (LDH)
LFTs, CBC, creatinine
CXR
1st line Tx option for testicular cancer
Radical orchiectomy + radical inguinal orchiectomy
_**NOT SCROTAL**_
How many half lives must you wait before assessing tumor markers?
5
Which tumor markers should you asssess post-orchiectomy & how long?
AFP: 5 wks
B-HCG: 1-2 wks
LDH: 3 wks
T/F: You should perform a CT of the chest/abd/pelvis post-orchiectomy
TRUE
Timeline for surveillance of tumor markers post-orchiectomy
q 3-4 mos x 2yr
THEN
q 6-12 mos x 2yr
THEN
annually
Imaging surveillance post-orchiectomy
CT abd/pelvis q 6 mos x 2yrs
THEN
CT abd/pelvis q 6-12 mos x 1 yr
THEN
annually x 2 yr
**CXR as indicated
Tx post-orchiectomy
BEP:
Bleomycin
Etoposide
CIsplatin
**all chemotherapies**
What are the side effects of post-orchiectomy chemotherapy?
myelosuppression
nausea
fatigue
poss infertility
What are the stages and survival rates of testicular tumors?
Stage I: >98%
Stage IIA or Stage IIB: >95%
Stage IIC or III (good): 86%
Stage IIC or III (intermediate): 72%
Stage IIC or III (poor):