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Testes Cancer

Dr. Kenneth Lim


Urology MSU-COM
POH McLaren Medical Center

Testes Cancer
Most common solid tumor in 20s
High cure rate
Delay in diagnosis due to fear,
ignorance, failure for self examination
Presentation painless testicular
mass

Testes Cancer -Treatment

Cure milestones 2 and 5 years


Surveillance protocols reliabilty
Serum markers use to justify treatment
Surgery(RPLND) diagnostic and
therapeutic
Chemotherapy must weigh therapeutic
advantage vs. salvage cure rate

Testes Ca
1% -Benign
Non-Germ Cell (5-10%)

Leydig

cell
Sertoli cell

Germ Cell (90-95%)


Seminoma
Non-seminoma

Testes Ca - Epidemiology
1.
.
.
.
.
.

Age
0-10
20-30
25-35
30-40
>50

Histology
Yolk sac tumor
Choriocarcinoma
Mixed E,T, TC
Seminoma
Lymphoma

Risk factors for Testes Ca


Cryptorchidism
HIV infections
Intratubular Germ Cell Neoplasia
Gonadal dysgenesis with Y
chromosome

Staging

Tumor markers
AFP, HCG,

LDH

Chest, Abdominal, Pelvic CT Scan


Brain Scan

Testes Ca 5 Year Survival

Stage Risk
Status
I
IIA / IIB
Good
IIC / III
Intemed
Poor

Seminoma
Nonsem
>98
>95
86
72

>98
>95
92
80
48

Surgery for Testes Ca


Radical Orchiectomy
Retroperitoneal Lymph Node
Dissection (RPLND)

Radiation Therapy

Retroperitoneal Templates

Testes Ca Chemotherapy
for NSGCT
Bleomycin
Etoposide
Cisplatin