Urology

Question 1

What are the investigations for testicular cancer

Answer 1

• Ultrasound with colour doppler of testis → 1st line principal test which shows testicular mass
• Tumour Markers → alpha fetoprotein (AFP - only in non-seminoma), beta-hCG, LDH

Question 1

What are the clinical features of Testicular cancer

Answer 1

• Painless hard nodular testicular mass → unilateral
• Negative transillumination test → light does not shine through
• Gynaecomastia → due to seminoma secreting hCG (increased oestrogen:androgen ratio)
• May be associated hydrocele
• Lymphadenopathy
• Metastatic Disease → cough, SOB, chest pain, bone pain (backache)

Question 2

What are the treatments for testicular cancer

Answer 2

• Prior to surgery → sperm cryopreservation (tumours associated with decreased fertility)
• Surgical Removal → Radical Inguinal Orchidectomy
• Radiotherapy & Chemotherapy