TESTICULAR CANCER

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source: dana-farber.org

Testicular cancer mainly affects young males.

Most often it is metastatic, however, effective therapies are available and offer some of the best survival rates in urologic oncology.

Incidence

  • It accounts for 1-1.5% of all male cancers, and 5% of urologic cancers.
  • It is more common in white males, the ratio of white to black males is 5:1
  • It commonly develops on the right testicle (as in cryptorchidism, i.e. undescended testicles)
  • It commonly affects males aged 20 to 40

Predisposing Factors

The predisposing factors associated with the risk of developing cancer are:

  • Cryptorchidism: a history of cryptorchidism increases the risk of developing testicular cancer by 3 to 4 times
  • Infertility
  • Klinefelter syndrome
  • Family history: brothers and sons of patients with testicular cancer show increased risk of developing cancer
  • History of cancer or intratubular germ cell neoplasia of the contralateral (opposite) testicle
  • Testicular microlithiasis (very small stones)

Diagnosis

Palpation of the testicles is required to identify any possible induration (hardening).

The following tests are also needed:

  • Scrotal ultrasound: This test can determine whether the enlargement is due to a solid mass, like cancer, or fluid build-up between the layers of the testicle.
  • Tumor markers: (β-hCG, AFP, LDH)
  • To determine the extent of the disease, the following exams are needed: upper and lower abdomen CT scan, a retroperitoneal region CT scan and a chest CT scan.

Treatment

The affected testicle is surgically removed.

The surgical procedure can be effective, provided the disease is at an early stage and has not spread.

In cases of metastatic disease, radiotherapy or chemotherapy may be used.

Prognosis

The disease has an excellent prognosis if detected at an early stage, and a good prognosis if detected at a later stage.