Testicular Cancer

Testicular cancer (choose one):
Causes of testicular cancer
Developmental story (germ line tumors and testicular cancer)
Symptoms of testicular cancer
Diagnosis of testicular cancer
Histology of testicular cancer
Cancer staging of testicular cancer
Treatment of testicular cancer
5-year survival of testicular and germ cell cancers
What's new with testicular cancer
Summary
Plea for testicle self examination

Introduction:

There has been a quiet revolution between the early 1970's and the early 1990's with regard to treatment of testicular cancer. As a result the 5-year cancer survival rates, which were only 10% in the 1970's, have increased to 90% or more in the 1990's. Testicular cancer is derived from the germ cells. These are rapidly dividing cells, which makes them a good target for both radiotherapy or chemotherapy.

There have been major advances in the treatment with radiotherapy in the 1970's where it became apparent that much higher survival rates could be achieved when lymph glands of the paraaortic region were included in the treatment field. Lately cisplatin was introduced as a new chemotherapeutic modality and this was the other link to the success for testicular cancer. As testicular cancer usually occurs only in one testicle, it is often possible to preserve the other testicle by proper shielding from radiotherapy and a washout period following chemotherapy. In this way the patient can still father children after the completed treatment and does not need hormone replacement as the remaining testicle can take over the missing testicle's hormone function.

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Summary:

The testicular form of germ cell tumors (testicular cancer) has become less of a menace. Early detection and treatment has brought about these good survivals for stage I and II and most men are in this category. Even with germ cell cancers outside the tesicle the survival rates have improved, but the physician must have a high index of suspicion and think of ordering the appropriate CT scan, MRI scan and ultrasound scan coupled with appropriate blood tests. Usually these germ cell tumors are only found in a late stage, but this could improve in future with newer screening tests, which have yet to be developed.

Let me leave you with one thought and plea: Examine your testicles once per month consciously or ask your sex partner to examine them once per month for you. If there is any change or a new hard area, see your physician right away. It may not be cancerous, but have it checked out, just in case!

 

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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. Cancer: Principles &Practice of Oncology.4th edition. Edited by Vincent T. DeVita, Jr. et al. Lippincott, Philadelphia,PA, 1993. Chapter on Cancer of the Testis.

2. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter on Cancer of the Testis.

3. Votrin II et al. Drugs Exp Clin Res 2000;26(5-6):267-273.

4. B Aschhoff Drugs Exp Clin Res 2000;26(5-6):249-252.

5. Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

6. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc

Last Modified: Dec. 6, 2008