Testicular Cancer Flashcards
What is the most common type of testicular cancer?
Germ cell seminoma
What are the 3 types of testicular cancer?
1) Germ cell (95%) - seminoma and non-seminoma
2) Non-germ cell (5%)
What is the typical age group of testicular cancer?
20-30 years
What are risk factors for testicular cancer?
- Undescended testes/crypto-orchidism
- PMH of STI esp. HIV or infertility
- Caucasian
- FH
What are the symptoms of testicular cancer?
- Painless testicular mass - maybe discomfort
- Hydrocele (scrotal/testicular swelling)
- Gynaecomastia
What is a complication of testicular cancer?
Dyspnoea (lung mets)
How do you diagnose testicular cancer?
US - 100% sensitive and assesses blood supply, fluid and size - allows for comparison
How do you treat testicular cancer curatively?
- Surgery (orchiectomy)
- Seminoma - adjuvant radiotherapy (external beam radiation)/chemo BEP (carboplatin -bleomycin/cisplatinum/etoposide)
- Non-seminoma - above + retroperitoneal lymph node dissection post-orchiectomy
What is a complication of orchidectomy?
Reduced fertility (can freeze sperm before)
What might you find on examination of the testes in testicular cancer?
- Asymmetrical testes - one is larger (swollen) and low-lying
- Testicular mass - smooth, non-fluctuating and firmly
attached (immobile) - not painful
What is a type of non-seminoma germ cell tumour?
Choriocarcinoma
What are some additional potential symptoms of testicular cancer?
- Lower extremity swelling
- Supraclavicular lymph nodes
- Gynaecomastia
- Lumbar back pain
- Neurological deficits
- Inguinal swelling
What blood tests might you do in testicular cancer?
- Serum beta-HCG
- Serum AFP
- Serum LDH
What would you find in blood test results in testicular cancer?
- b-HCG > 0.7 elevated in all choriocarcinomas
- AFP > 25 elevated in germ cell
- LDH > 25 elevated in 50% of cases
What other investigations might you do after diagnosis of testicular cancer by US?
- CT AP + CXR to assess metastasis and and post-treatment follow-up - staging
- Histology - evaluate histology of mass for
treatment options + grade
