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Principles and Procedures > Testicular Cancer > Flashcards

Testicular Cancer Flashcards

(71 cards)

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1
Q

What percentage of male malignancies does Testicular Cancer account for?

A

Less than 1%

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2
Q

Testicular Cancer is a common malignancy for males of what age group?

A

20-34

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3
Q

There is a higher rate of Testicular Cancer among what demographic of men?

A

White

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4
Q

What is the relation between Testicular Cancer and Gonads?

A

It is believed that gonadal dysgenesis (developmental abnormalities of the testes) could be an origin

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5
Q

What is cryptorchidism and whats its relation to Testicular Cancer?

A

Undescended testes and is a known etiological risk factor

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6
Q

What two conditions are present in men that have a higher incidence of Testicular Cancer?

A

Gonadal Dysgenesis and Cryptorchidism

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7
Q

Patients with one testicular tumor are at increased risk for developing a contralateral malignancy. True or False?

A

True

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8
Q

What other genetic factor is a risk factor for Testicular Cancer?

A

Family History

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9
Q

What are the two types of Testicular Cancer?

A

Seminoma and Non-Seminoma

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10
Q

What is a significant prognostic factor of Seminomas?

A

Tumor Stage

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11
Q

What is the difference in the prognosis of a Stage 1 Seminoma v. Stage 4 Seminoma?

A

Stage 1 has the best prognosis while Stage 4 has the worst prognosis with metastasis likely

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12
Q

What is are the three prognostic factors of Non-Seminomas?

A

Tumor Stage, Tumor Markers and Volume of Mets

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13
Q

What is the pathology of most testicular cancers?

A

Germ Cells (>90%)

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14
Q

What does germ cells produce?

A

Sperm

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15
Q

What is the most common type of testicular cancer?

A

Seminoma

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16
Q

What are the three subtypes of Seminomas?

A

Classic, Anaplastic, Spermatocytic

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17
Q

What are the four subtypes of Non-Seminomas?

A

Embryonal Carcinoma, Yolk Sac, Choriocarcinoma, Teratoma

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18
Q

What is the most common subtype of testicular cancer in children?

A

Yolk Sac

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19
Q

What is the staging of testicular cancer base on?

A

Disease extent and tumor Markers

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20
Q

What staging system is used for Testicular Cancer?

A

TNM staging

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21
Q

What is contained inside the scrotum?

A

Testes

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22
Q

The scrotum is suspended by what structure?

A

Spermatic Cord

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23
Q

What is a common difference between the left and right spermatic cord?

A

The left usually longer than the right

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24
Q

What type of cells do testes house?

A

Spermatozoa

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25
What hormone is produced by the testes?
Testerone
26
What structure is a continuation of the epididymis?
Vas Deferens
27
What structures do the Vas Deferens empty into?
Seminal Vesicles
28
As sperms exits the Seminal Vesicles, It enters the ____ and then proceeds into the ___?
Ejaculatory duct and Prostate
29
What lymphatics are involved in Testicular Cancer?
Periaortic nodes, Common/Internal/External Iliacs
30
Crossover of lymphatic metastasis is common in what direction?
Right to left
31
What does Testicular Cancer present as visually or physically?
Swelling or Nodular Mass
32
What does Testicular Cancer present as in terms of symptoms? (3 answers)
Dull ache, pulling sensation, aching in lower abdomen
33
What is present in 5% of patients with germ cell tumors?
Gynecomastia
34
If testicular tumor is suspected, what test is completed?
Testicular Sonogram
35
What is the procedure that includes an inguinal incision to diagnose and remove the primary tumor?
Radical Orchiectomy
36
Why is a biopsy not appropriate for testicular cancer?
Due to the risk of seeding and manually spreading the cancer
37
How does a blood test indicate a testicular tumor?
High Tumor Markers (Beta HCG and AFP (FOR NON-S))
38
What are the two tests done for testicular cancer with semen?
Semen analysis and Sperm banking
39
What is the primary route of spread for Testicular Cancer?
Lymphatics
40
What nodes are commonly involved in the spread of testicular cancer?
Para-aortics, L-spine and Interior to Kidneys
41
What nodes are involved on the left side of the body?
Para-aortic nodes below renal vein
42
What nodes are involved on the right side of the body?
Nodes along the IVC
43
What nodes are at risk for metastasis from the para-aortic spread through the thoracic duct?
Mediastinum or S'Clav nodes
44
What is a common conception made on the spread of seminomas?
Localized or Lymphatic spread
45
What is a common conception made on the spread of non-seminomas?
Hematogenously or Lymphatic spread to lung or liver
46
What percentage of testicular caner patients present with Stage IV disease?
less than 5%
47
What typically occurs after the staging of Testicular Cancer?
Radical Inguinal Orchiectomy
48
Management after Radical Inguinal Orchiectomy is dependent on what factors?`
Staging and Disease extent
49
Seminomas are not very radiosensitive. True or False?
False, they are very radiosensitive
50
What is the typical dosage for seminomas?
2500 cGy
51
What is the percentage of recurrence if only an orchiectomy is performed?
20%
52
In the U.S what is the treatment of choice for a stage 1 disease?
Post-op XRT
53
What is the difference between Stage 1 and Stage 2A treatment techniques?
The fields and doses are the same but the margins cover the enlarged nodes
54
What is the difference between Stage 1 and Stage 2B treatment techniques?
Para-aortics and ipsilateral pelvic nodes irradiated with margins to cover enlarged nodes
55
What is the name of the field type used to treat testicular cancer?
Dog Leg
56
What are some shielding devices used in the treatment of testicular cancer? (3 answers)
Custom blocks/MLC to block 2/3 of lateral kidneys, Clamshell to avoid radiation to other testicle, AP-PA fields
57
What is the dose for Stage 2B Testicular Cancer?
25-30 Gy
58
What is special about the treatment technique for Stage 2C Testicular Cancer?
The technique is individualized. If mass is central and does not overlap (XRT primarily) but if mass to large or overlaps (Chemo)
59
What is the initial treatment for nonseminomas?
radical inguinal orchiectomy then chemotherapy
60
Why are residual masses usually removed?
40% are teratomas and 10-15% carcinomas
61
Why are teratomas specifically removed?
Evidence shows that higher chances of relapse from teratomas and also better outcomes if mass is removed
62
What is the dosage given for Stage 1 and Stage 2A non- seminomas?
2500 cGy
63
What is the dose limit on the contralateral kidney that is being blocked?
1800 cGy
64
What is the dose limit of a significant portion of the liver?
3000 cGy
65
In Europe, what is changing for testicular cancer treatments?
Pelvic nodal radiation being eliminated
66
What is the 5-year survival rate for Stage 1 Testicular Seminoma?
95-97%
67
What is the 5-year survival rate for Stage 2A & 2B Testicular cancer?
90-95%
68
The survival rates of Stage 2C, 2D, and 3 are dependent upon what factors?
Initial Size of tumor and therapeutic approach
69
What are three side effects of testicular cancer XRT?
Nausea/Vomiting, Diarrhea and Severe Dyspepsia, peptic ulcers
70
50% of patients present with ____ as a result of Testicular Cancer XRT?
Decreased sperm count
71
Permanent sterility occurs at what dose?
200 cGy

Principles and Procedures (27 decks)

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