Dr. Kenneth Lim Urology – MSU-COM POH McLaren Medical Center 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%) Germ Cell (90-95%) Leydig cell Sertoli cell Germ Cell (90-95%) Seminoma Non-seminoma

Testes Ca - Epidemiology 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 Chest, Abdominal, Pelvic CT Scan Brain Scan 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 >98 >95 >95 86 92 72 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