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Testes Cancer

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

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  1. Testes Cancer Dr. Kenneth Lim Urology – MSU-COM POH McLaren Medical Center

  2. 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

  3. 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

  4. Testes Ca • 1% -Benign • Non-Germ Cell (5-10%) • Leydig cell • Sertoli cell • Germ Cell (90-95%) • Seminoma • Non-seminoma

  5. Age 0-10 20-30 25-35 30-40 >50 Histology Yolk sac tumor Choriocarcinoma Mixed – E,T, TC Seminoma Lymphoma Testes Ca - Epidemiology

  6. Risk factors for Testes Ca • Cryptorchidism • HIV infections • Intratubular Germ Cell Neoplasia • Gonadal dysgenesis with Y chromosome

  7. Staging • Tumor markers • AFP, HCG, LDH • Chest, Abdominal, Pelvic CT Scan • Brain Scan

  8. 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

  9. Surgery for Testes Ca • Radical Orchiectomy • Retroperitoneal Lymph Node Dissection (RPLND)

  10. Radiation Therapy • Retroperitoneal Templates

  11. Testes Ca – Chemotherapy for NSGCT • Bleomycin • Etoposide • Cisplatin

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