1. Dr. Kenneth Lim Urology – MSU-COM POH McLaren Medical Center
Testes Cancer
Dr. Kenneth Lim
Urology – MSU-COM
POH McLaren Medical Center

2. 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

3. 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

4. Testes Ca 1% -Benign Non-Germ Cell (5-10%) Germ Cell (90-95%)
Leydig cell
Sertoli cell
Germ Cell (90-95%)
Seminoma
Non-seminoma

5. Testes Ca - Epidemiology
Age
0-10
20-30
25-35
30-40
>50
Histology
Yolk sac tumor
Choriocarcinoma
Mixed – E,T, TC
Seminoma
Lymphoma

6. Risk factors for Testes Ca
Cryptorchidism
HIV infections
Intratubular Germ Cell Neoplasia
Gonadal dysgenesis with Y chromosome

7. Staging Tumor markers Chest, Abdominal, Pelvic CT Scan Brain Scan
AFP, HCG, LDH
Chest, Abdominal, Pelvic CT Scan
Brain Scan

8. Testes Ca 5 Year Survival
Stage Risk Status I
IIA / IIB
Good
IIC / III Intemed
Poor
Seminoma Nonsem
> >98
> >95 48

9. Surgery for Testes Ca Radical Orchiectomy
Retroperitoneal Lymph Node Dissection (RPLND)

10. Radiation Therapy
Retroperitoneal Templates

11. Testes Ca – Chemotherapy for NSGCT
Bleomycin
Etoposide
Cisplatin