Testes cancer
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Testes Cancer. Dr. Kenneth Lim Urology – MSU-COM POH McLaren Medical Center. Testes Cancer. Most common solid tumor in 20s High cure rate Delay in diagnosis due to fear, ignorance, failure for self examination Presentation – painless testicular mass. Testes Cancer -Treatment.

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Testes cancer

Testes Cancer

Dr. Kenneth Lim

Urology – MSU-COM

POH McLaren Medical Center


Testes cancer1

Testes Cancer

  • Most common solid tumor in 20s

  • High cure rate

  • Delay in diagnosis due to fear, ignorance, failure for self examination

  • Presentation – painless testicular mass


Testes cancer treatment

Testes Cancer -Treatment

  • Cure milestones – 2 and 5 years

  • Surveillance protocols – reliabilty

  • Serum markers – use to justify treatment

  • Surgery(RPLND) – diagnostic and therapeutic

  • Chemotherapy – must weigh therapeutic advantage vs. salvage cure rate


Testes ca

Testes Ca

  • 1% -Benign

  • Non-Germ Cell (5-10%)

    • Leydig cell

    • Sertoli cell

  • Germ Cell (90-95%)

    • Seminoma

    • Non-seminoma


Testes ca epidemiology

Age

0-10

20-30

25-35

30-40

>50

Histology

Yolk sac tumor

Choriocarcinoma

Mixed – E,T, TC

Seminoma

Lymphoma

Testes Ca - Epidemiology


Risk factors for testes ca

Risk factors for Testes Ca

  • Cryptorchidism

  • HIV infections

  • Intratubular Germ Cell Neoplasia

  • Gonadal dysgenesis with Y chromosome


Staging

Staging

  • Tumor markers

    • AFP, HCG, LDH

  • Chest, Abdominal, Pelvic CT Scan

  • Brain Scan


Testes ca 5 year survival

Stage Risk Status

I -

IIA / IIB -

Good

IIC / III Intemed

Poor

Seminoma Nonsem

>98 >98

>95 >95

86 92

72 80

48

Testes Ca 5 Year Survival


Surgery for testes ca

Surgery for Testes Ca

  • Radical Orchiectomy

  • Retroperitoneal Lymph Node Dissection (RPLND)


Radiation therapy

Radiation Therapy

  • Retroperitoneal Templates


Testes ca chemotherapy for nsgct

Testes Ca – Chemotherapy for NSGCT

  • Bleomycin

  • Etoposide

  • Cisplatin


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