Testicular Cancer

Testicular Cancer

Overview

  • More than 95% of testicular tumours arise from the germ cells which produce sperms and may involve one or both testis.
  • Testicular germ cell tumours can be subdivided into seminoma and non-seminomatous germ cell tumours (NSGCTs).
  • Testicular cancer is a relatively rare cancer with an incidence of 7.0 per 100,000 population
  • Testicular cancer can occur at any age but is most common between the ages of 15 and 40 years.
  • Non seminomatous cancer is rare in younger age group and seminoma is common in age group above 60 years

Risk Factors

  • Cryptorchidism or testicular maldescent
  • Klinefelter's syndrome
  • Family history
  • Male infertility (increases risk of cancer).
  • Low birth weight, young maternal age, young paternal age, multiparity, breech delivery
  • Height - taller men are more at risk of developing germ cell tumours

Of all risk factors, cryptorchism and malignancy in the contralateral testis are by far the strongest

What are the signs and symptoms?

  • A painless swelling of testis
  • Change in shape or size of one testis compared to opposite side
  • Feeling of heaviness in scrotum
  • Dull aching dragging lower abdominal pain
  • History of recent trauma (which made patient notice the symptom)
  • Swelling in inguinal region

Evaluation

  • Diagnosis is usually confirmed by ultrasound
  • Tissue histopathology is done only after a high inguinal orchidectomy
  • Disease can be staged by thoraco-abdominal CT scan or PET scan
  • Elevation of tumour markers supports the diagnosis but normal marker levels do not exclude testicular cancer
  • Alpha-fetoprotein (AFP) is produced by yolk sac elements but not produced by seminomas
  • Beta-hCG may be elevated levels both in teratomas and in seminomas

Treatment options

All patients need to undergo High inguinal orchidectomy to diagnose the disease. Staging is done by CECT abdomen or PET CT. Further treatment depends upon stage of disease or based on histology (seminoma or non-seminoma).

Seminoma are radiotherapy and chemo sensitive and hence treated with chemotherapy / radiotherapy in advanced stages. Non-seminoma patients are treated with adjuvant chemotherapy and may need lymph nodal dissection in advanced cases

What we offer in our centre?

  • Surgical options of High orchidectomy + Ilio inguinal Block dissection
  • Adjuvant Chemotherapy and Radiotherapy whenever necessary
  • Option of fertility preservation/ sperm banking available and offered to our patients
  • Testicular implants if necessary

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