testicular%20cancer
TESTICULAR CANCER

Testicular cancer is a rare neoplasm that arises from the testis. It commonly presents as a painless testicular mass.

It has high prevalence in young and middle-aged men in the age of 15-40 years old.

It is a highly treatable disease with a high cure rate.

Testicular primary germ cell tumors coming from the malignant transformation of primordial germ cells make up 95% of all testicular cancer.

 

Radiotherapy

Seminoma

  • Seminomas are radiosensitive & adjuvant radiation therapy to para-aortic & ipsilateral iliac lymph nodes reduces relapse rate to 1-3%
  • Treatment should begin once the orchiectomy wound has completely healed & it should be given w/ a scrotal shield in all patients except in those who underwent bilateral orchiectomy

Stage I

  • Adjuvant radiation therapy to include para-aortic nodes may be considered for patients who are not candidates for chemotherapy
    • Careful consideration must be made for patients <40 yr due to increased risk of radiation-induced secondary malignancies 
  • For stage IS, primary treatment is w/ radiation
    • Repeat tumor markers & obtain an abdominal/pelvic CT for assessment of extent of disease
    • If w/ recurrence, treat based on disease extent at relapse; persistently elevated tumor markers are treated w/ chemotherapy similar to that of nonseminoma

Stage II

  • Nonbulky retroperitoneal disease is treated alternatively w/ radiation therapy to include para-aortic & ipsilateral iliac lymph nodes
    • It is preferred for stage IIA seminoma (lymph node mass <2 cm)