Week 18 - testicular cancer, testicular torsion, urinary tract calculi, UTI Flashcards
where do testicular cancers arise from
the germ cells in the testes
what are germ cells and what do they produce
are cells that produce gametes (sperm in males)
what is the highest incidence of age in testicular cancer
Testicular cancer is more common in younger men, with the highest incidence between 15 and 35 years.
what are the two types of testicular cancer
Seminomas
Non-seminomas (mostly teratomas)
what are the risk factors for testicular cancer
Undescended testes
Male infertility
Family history
Increased height
what is the typical presentation of testicular cancer
painless lump on the testicle and can occasionally present with testicular pain
what are the characteristics of the lump
Non-tender (or even reduced sensation)
Arising from testicle
Hard
Irregular
Not fluctuant
No transillumination
what can rarely be a presentation of testicular cancer, particularly in a rare type of tumour called a Leydig cell tumour
gynaecomastia can be a presentation
about 2% of patients presenting with gynacomastia have a testicular tumour
what is the usual initial investigation to confirm the diagnosis of testicular cancer
scrotal ultrasound
what are the 3 tumour markers for testicular cancer
Alpha-fetoprotein – may be raised in teratomas (not in pure seminomas)
Beta-hCG – may be raised in both teratomas and seminomas
Lactate dehydrogenase (LDH) is a very non-specific tumour marker
what is the staging system used for testicular cancer
the Royal Marsden Staging System
what are the stages of the RMSS for testicular cancer
Stage 1 – isolated to the testicle
Stage 2 – spread to the retroperitoneal lymph nodes
Stage 3 – spread to the lymph nodes above the diaphragm
Stage 4 – metastasised to other organs
where are the 4 most common places testicular cancer metastasises to
lymphatics
lungs
liver
brain
what are the four things that treatment can involve for testicular cancer
Surgery to remove the affected testicle (radical orchidectomy) – a prosthesis can be inserted
Chemotherapy
Radiotherapy
Sperm banking to save sperm for future use, as treatment may cause infertility
what are the side effects of testicular cancer treatment
Infertility
Hypogonadism (testosterone replacement may be required)
Peripheral neuropathy
Hearing loss
Lasting kidney, liver or heart damage
Increased risk of cancer in the future
what is the prognosis for testicular caner
early testicular cancer prognosis is good, with a greater than 90% cure rate
is metastatic testicular cancer curable
yes often
what kind of testicular cancers have better prognosis
Seminomas have a slightly better prognosis than non-seminomas.
what does testicular torsion refer to
the twisting of the spermatic cord, with rotation of the testicle.
what is testicular torsion often triggered by
an activity, such as playing sports