|
|
| (17 intermediate revisions by 4 users not shown) |
| Line 1: |
Line 1: |
| | __NOTOC__ |
| | {{Testicular cancer}} |
| | |
| '''For patient information click [[{{PAGENAME}} (patient information)|here]]'''. | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]'''. |
| {{Infobox_Disease | | | |
| Name = Testicular cancer |
| | {{CMG}}; {{MJM}}; {{AE}} {{SC}} |
| Image = |
| | |
| Caption = |
| | {{SK}} Testicular tumor, testicular carcinoma, tumor of testis, cancer of testis, carcinoma of testis, tumor of the testis, cancer of the testis, carcinoma of the testis, malignant neoplasm of testis, testicular neoplasm, malignant tumor of testis, tumor of testicle, cancer of testicle, carcinoma of testicle, tumor of the testicle, cancer of the testicle, carcinoma of the testicle, malignant neoplasm of testicle, malignant tumor of testicle |
| DiseasesDB = 12966 |
| |
| ICD10 = |
| |
| ICD9 = |
| |
| ICDO = |
| |
| OMIM = 273300 |
| |
| MedlinePlus = |
| |
| MeshName = Testicular+Neoplasms |
| |
| MeshNumber = C04.588.322.762 |
| |
| }} | |
| {{Testicular cancer}} | |
| {{CMG}} | |
| {{MJM}} | |
| {{Editor Help}} | |
|
| |
|
| ==[[Testicular cancer overview|Overview]]== | | ==[[Testicular cancer overview|Overview]]== |
|
| |
|
| ==[[Testicular cancer historical perspective|Historical Perspective]]== | | ==[[Testicular cancer historical perspective|Historical Perspective]]== |
| | |
| | ==[[Testicular cancer classification|Classification]]== |
|
| |
|
| ==[[Testicular cancer pathophysiology|Pathophysiology]]== | | ==[[Testicular cancer pathophysiology|Pathophysiology]]== |
|
| |
| ==[[Testicular cancer epidemiology and demographics|Epidemiology & Demographics]]==
| |
|
| |
| ==[[Testicular cancer risk factors|Risk Factors]]==
| |
|
| |
| ==[[Testicular cancer screening|Screening]]==
| |
|
| |
|
| ==[[Testicular cancer causes|Causes]]== | | ==[[Testicular cancer causes|Causes]]== |
| Line 34: |
Line 20: |
| ==[[Testicular cancer differential diagnosis|Differentiating Testicular cancer]]== | | ==[[Testicular cancer differential diagnosis|Differentiating Testicular cancer]]== |
|
| |
|
| ==[[Testicular cancer natural history|Complications & Prognosis]]== | | ==[[Testicular cancer epidemiology and demographics|Epidemiology and Demographics]]== |
|
| |
|
| ==Diagnosis== | | ==[[Testicular cancer risk factors|Risk Factors]]== |
| [[Testicular cancer history and symptoms|History and Symptoms]] | [[Testicular cancer physical examination|Physical Examination]] | [[Testicular cancer staging|Staging]] | [[Testicular cancer laboratory tests|Laboratory tests]] | [[Testicular cancer electrocardiogram|Electrocardiogram]] | [[Testicular cancer x ray|X Rays]] | [[Testicular cancer CT|CT]] | [[Testicular cancer MRI|MRI]] [[Testicular cancer echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Testicular cancer other imaging findings|Other images]] | [[Testicular cancer other diagnostic studies|Alternative diagnostics]] | |
|
| |
|
| ==Treatment== | | ==[[Testicular cancer screening|Screening]]== |
| [[Testicular cancer medical therapy|Medical therapy]] | [[Testicular cancer surgery|Surgical options]] | [[Testicular cancer primary prevention|Primary prevention]] | [[Testicular cancer secondary prevention|Secondary prevention]] | [[Testicular cancer cost-effectiveness of therapy|Financial costs]] | [[Testicular cancer future or investigational therapies|Future therapies]] | |
|
| |
|
| ==Symptoms and early detection == | | ==[[Testicular cancer natural history|Natural History, Complications and Prognosis]]== |
|
| |
|
| | | ==Diagnosis== |
| The nature of any palpated lump in the [[scrotum]] is evaluated by scrotal [[ultrasound]], which can determine exact location, size, and some characteristics of the lump, such as cystic vs solid, uniform vs heterogeneous, sharply circumscribed or poorly defined. The extent of the disease is evaluated by [[CT scan]]s, which are used to locate [[metastasis|metastases]]. Blood tests are also used to identify and measure [[tumor marker]]s that are specific to testicular cancer. The diagnosis is made by performing an orchiectomy, surgical excision of the entire [[testis]] along with attached structures [[epididymis]] and [[spermatic cord]]; the resected specimen is evaluated by a [[pathologist]]. A [[biopsy]] should not be performed, as it raises the risk of migrating cancer cells into the scrotum. The reason why inguinal orchiectomy is the preferred method is that the lymphatic system of the scrotum links to the lower extremities and that of the testicle links to the retroperitoneum. A transscrotal biopsy or orchiectomy will potentially leave cancer cells in the scrotum and create two vectors for cancer spread, while in an inguinal orchiectomy only the retroperitoneal route exists.
| | [[Testicular cancer staging|Staging]] | [[Testicular cancer history and symptoms|History and Symptoms]] | [[Testicular cancer physical examination|Physical Examination]] | [[Testicular cancer laboratory findings|Laboratory Findings]] | [[Testicular cancer x ray|X Ray]] | [[Testicular cancer CT|CT]] | [[Testicular cancer MRI|MRI]] [[Testicular cancer ultrasound|Ultrasound]] | [[Testicular cancer other imaging findings|Other Imaging Findings]] | [[Testicular cancer other diagnostic studies|Other Diagnostic Studies]] | [[Testicular cancer biopsy|Biopsy]] |
| | |
| ==Classification==
| |
| | |
| {{main|Germ cell tumor}}
| |
| | |
| Although testicular cancer can be derived from any cell type found in the testicles, more than 95% of testicular cancers are [[germ cell tumor]]s. Most of the remaining 5% derive from [[Leydig cell]]s or [[Sertoli cell]]s. Thus, the focus of diagnosis is on determining which germ cell tumor is present. Correct diagnosis is necessary to ensure the most effective and least harmful treatment. To some extent, this can be done via blood tests for [[tumor marker]]s, but differential diagnosis requires examination of the [[histology]] of a specimen by a [[pathologist]].
| |
| | |
| ===Histology===
| |
| | |
| After removal, a testicular tumor is classified by a [[pathologist]] according to its [[histology]].
| |
|
| |
| ==== Germ cell tumors of the testis, by frequency ====
| |
| {{main|Germ cell tumor}}
| |
| * 40% mixed (usually teratoma plus another)
| |
| * 35% [[seminoma]] ([[germinoma]] of the testis)
| |
| * 20% [[embryonal carcinoma]]
| |
| * 5% [[teratoma]] (pure)
| |
| * <1% [[choriocarcinoma]]
| |
| * [[Gonadoblastoma]]
| |
| | |
| Also: Intratubular germ cell [[neoplasm]]s (the in-situ stage of germ cell tumors)
| |
| | |
| ====Non-germ cell tumors of the testis====
| |
| | |
| * [[Sertoli-Leydig cell tumour|Sertoli-Leydig cell tumor]] (usually [[benign]])
| |
| * Gonadoblastomas [http://www.health.am/cr/testis-non-germ-cell-tumors/]
| |
| | |
| ====Secondary tumors of the testis====
| |
| * [[Lymphoma]]
| |
| * Leukemic infiltration of the testis
| |
| * [[Metastasis|Metastatic]] tumors [http://www.health.am/cr/more/secondary-tumors-of-the-testis/]
| |
|
| |
|
| ==Treatment== | | ==Treatment== |
| The three basic types of treatment are [[surgery]], [[radiation therapy]], and [[chemotherapy]].
| | [[Testicular cancer medical therapy|Medical therapy]] | [[Testicular cancer surgery|Surgery]] | [[Testicular cancer primary prevention|Primary prevention]] | [[Testicular cancer secondary prevention|Secondary prevention]] | [[Testicular cancer cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Testicular cancer future or investigational therapies|Future or Investigational Therapies]] |
| | |
| Surgery is performed by [[urologist]]s; radiation therapy is administered by [[radiation oncologist]]s; and chemotherapy is the work of medical [[oncologist]]s. | |
| | |
| ===Radiation therapy===
| |
| [[Radiation]] may be used to treat stage II seminoma cancers, or as [[adjuvant]] (preventative) therapy in the case of stage I seminomas, to minimize the likelihood that tiny, non-detectable tumors exist and will spread (in the inguinal and para-aortic [[lymph nodes]]). Radiation is never used as a primary therapy for [[nonseminoma]] because a much higher dose is required and chemotherapy is far more effective in that setting.
| |
| | |
| ===Chemotherapy===
| |
| As an [[adjuvant]] treatment, use of [[chemotherapy]] as an alternative to radiation therapy is increasing, because radiation therapy appears to have more significant long-term side effects (for example, internal scarring, increased risks of secondary malignancies, etc.). Two doses of [[carboplatin]], typically delivered three weeks apart, is proving to be a successful [[adjuvant]] treatment, with recurrence rates in the same ranges as those of [[radiotherapy]].
| |
| | |
| Chemotherapy is the standard treatment, with or without radiation, when the cancer has spread to other parts of the body (that is, stage II or III). The standard [[chemotherapy protocol]] is three to four rounds of [[Bleomycin]]-[[Etoposide]]-[[Cisplatin]] (BEP). This treatment was developed by Dr. [[Lawrence Einhorn]] at Indiana University. An alternative, equally effective treatment involves the use of four cycles of [[Etoposide]]-[[Cisplatin]] (EP).
| |
| | |
| While treatment success depends on the stage, the average survival rate after five years is around 95%, and stage I cancers cases (if monitored properly) have essentially a 100% survival rate (which is why prompt action, when testicular cancer is a possibility, is extremely important).
| |
| | |
| ==Actions after treatment==
| |
| ===Surveillance===
| |
| For stage I cancers that have not had any adjuvant (preventive) therapy, close monitoring for at least a year is important, and should include blood tests (in cases of [[nonseminoma]]s) and CT-scans (in all cases), to ascertain whether the cancer has [[Metastasis|metastasized]] (spread to other parts of the body). For other stages, and for those cases in which radiation therapy or chemotherapy was administered, the extent of monitoring (tests) will vary on the basis of the circumstances, but normally should be done for five years (with decreasing intensity).
| |
| | |
| ===Fertility===
| |
| A man with one remaining testis can lead a normal life, because the remaining testis takes up the burden of [[testosterone]] production and will generally have adequate fertility.[http://www.fda.gov/fdac/features/196_test.html] However, it is worth the (minor) expense of measuring hormone levels before removal of a testicle, and sperm banking may be appropriate for younger men who still plan to have children, since fertility may be lessened by removal of one testicle, and can be severely affected if extensive [[chemotherapy]] and/or [[radiotherapy]] is done.
| |
| | |
| Less than five percent of those who have testicular cancer will have it again in the remaining testis. A man who [[castration|loses both testicles]] will normally have to take hormone supplements (in particular, [[testosterone]], which is created in the testicles), and will be infertile, but can lead an otherwise normal life.
| |
| | |
| ==Famous survivors==
| |
| * Decorated cyclist Lance Armstrong
| |
| * In 1997, figure-skater Scott Hamilton
| |
| * Mike Lowell, Boston Red Sox third baseman was diagnosed during spring training of his rookie year.
| |
| * Christopher Arena, National Basketball Association and co-founder of ArenaTilton Golf
| |
| * Hockey player Phil Kessel of the Boston Bruins, diagnosed during his rookie season in 2006-07
| |
| | |
| | |
| | |
| ==References==
| |
| {{Reflist|2}}
| |
|
| |
|
| == External links == | | == External links == |
| *[http://www.bidmc.org/YourHealth/ConditionsAZ.aspx?ChunkID=11513 Beth Israel Deaconess Medical Center: Testicular cancer]
| |
| *[http://testicularcancer.org.uk/ UK testicular cancer support forums]
| |
| *[http://tcrc.acor.org/ Testicular Cancer Resource Center]
| |
| *[http://www.nlm.nih.gov/medlineplus/testicularcancer.html National Institute of Health information and links] | | *[http://www.nlm.nih.gov/medlineplus/testicularcancer.html National Institute of Health information and links] |
| *[http://www.cancercouncil.com.au/html/patientsfamiliesfriends/typesofcancer/testicular/downloads/testicular.pdf Understanding Testicular Cancer] from [http://www.cancercouncil.com.au/editorial.asp?pageid=894 The Cancer Council Australia]
| |
| *[http://gallery.hd.org/_c/medicine/_more2006/_more01/scan-xray-X-Ray-testicular-testicle-scrotal-scrotum-for-cancer-or-other-lesions-or-abnormalities-all-clear-shrunk-tweaked-mono-1-ANON.jpg.html Images of scans for testicular cancer]
| |
| *[http://www.checkemlads.com/ checkemlads.com Testicular cancer support and awareness, run by survivors]
| |
| *[http://www.checkyourballs.co.uk/ checkyourballs] Support and Awareness site, created by a survivor.
| |
|
| |
|
| {{Tumors}} | | {{Tumors}} |
| {{SIB}}
| | |
| [[da:Testikelkræft]]
| |
| [[de:Hodenkrebs]]
| |
| [[es:Cáncer de testículo]]
| |
| [[fr:Cancer du testicule]]
| |
| [[no:Testikkelkreft]]
| |
| [[pl:Nasieniak]]
| |
| [[pt:Câncer testicular]]
| |
| [[ro:Cancer la testicole]]
| |
| [[simple:Testicular cancer]]
| |
| [[fi:Kivessyöpä]]
| |
| {{WikiDoc Help Menu}} | | {{WikiDoc Help Menu}} |
| {{WikiDoc Sources}} | | {{WikiDoc Sources}} |
| Line 144: |
Line 47: |
| [[Category:Oncology]] | | [[Category:Oncology]] |
| [[Category:Mature chapter]] | | [[Category:Mature chapter]] |
| | [[Category:Up-To-Date]] |
| | [[Category:Oncology]] |
| | [[Category:Medicine]] |
| | [[Category:Urology]] |