Testicular tumors
100man's risk of testicular cancer is roughly 1 in 250 (0.4%). It is most common
among males aged 15–35 years.Testicular cancer has one of the highest cure rates of
all cancers: in excess of 90 percent; essentially percent if it has not
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factor for the development of testis cancer is
A major risk
(undescended testicles .Other risk factors include
. Physical activity is associated with decreased risk . Early onset of
orchitis
male characteristics is associated with increased risk.
Signs and symptoms
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The cardinal diagnostic finding in the patient with testis cancer is
a mass in
the substance of the testis
. Unilateral enlargement of the testis
with or
without pain
in the adolescent or young adult male should raise concern for
testis cancer.
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BUT
differential diagnosis
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Stage I (Local).
The cancer is limited to the testicles and has not spread
to the lymph nodes or a more distant organ. Approximately 72% of
testicular cancers are in Stage I.
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Stage II (Regional).
The cancer has spread to the lymph nodes in the
abdomen, but not to a more distant organ. Approximately 19% of
testicular cancers are in Stage II.
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Stage III (Distant).
The cancer has spread to the lymph nodes and one
or more distant organs (above the diaphragm), such as the liver, lungs
and brain. Approximately 9% of testicular cancers are in Stage III.
Classification:1- germcell tumors (95%)
A- pure seminoma(35%)
B- mixed(40%) terAtoma plus another type
C-Embryonal carcinoma(20%)
D-Pure teratoma(5%) .>1%yolk sac tumors.
2- non germcell tumors(sertoli and lydeg cell tumors(5%)
Treatment
The three basic types of treatment are
is almost always removed completely in a procedure called
. (The testicle is almost never removed through the scrotum; an incision is
made beneath the belt line in the inguinal area.) In the UK, the procedure is known as a
radical orchidectomy
that appear to be stage I, surgery may be done on the
In the case of
(in a separate operation) to accurately
determine whether the cancer is in stage I or stage II and to reduce the risk that
to lymph nodes in the
testicular cancer cells that may have
Retroperitoneal Lymph Node Dissection
lower abdomen. This surgery is called
(RPLND).
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may be used to treat stage 2 seminoma cancers, or as
Radiation
(preventative) therapy in the case of stage 1 seminomas, to minimize the
likelihood that tiny, non-detectable tumors exist and will spread (in the
). Radiation is never used as a primary
-
inguinal and para
therapy for
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Chemotherapy is the standard treatment for non-seminoma when the cancer
stage 2B or 3). The standard
has spread to other parts of the body (that is,
is three, or sometimes four, rounds of
(BEP).
PROGNOSES
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While treatment success depends on the stage, the average survival rate after
five years is
around 95%,
and
stage 1
cancers cases (if monitored properly)
have essentially a 100% survival rate (which is why prompt action, when
testicular cancer is a possibility, is extremely important).
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with sustained response to treatment in more than
90% of cases
, regardless
of stage. Because of advances in chemotherapy, cure rates now
approach 85%
overall
, with better than 95% for localized disease and 80% for metastatic
the best response by any solid tumor.
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disease