It is the most frequently diagnosed cancer in young men. Approximately 7000 cases are diagnosed in the United states annually. This cancer is very sensitive to treatment and is highly curable. It is most commonly seen in ages 20-35. It is a rare condition in African-Americans.
CAUSES OF TESTIS CANCER
Various factors have been linked to an increased risk of developing this cancer:
• Prior testicular cancer
• Undescended testis
• Certain genetic disorders
• Certain chemicals
SIGNS AND SYMPTOMS
• Testicular swelling is the most common complaint of the patients.
• Enlargement of lymph nodes in groins
• Low back pain
• Abdominal pain
Establishing a Diagnosis
When a diagnosis is suspected, patients must be examined carefully by a qualified physician. An ultrasound of both testicles, a chest x-ray, along with blood tests for tumor markers, should be done. The next step is removal of the diseased testicle by way of surgery.
STAGING
The extent of the disease determines the appropriateness of the therapy. Chest x-ray, CT scan of the chest, abdomen and pelvis and bone scan will disclose the degree of the cancer spread. For all practical purposes, testis cancers can be grouped in three categories, depending on the mass and the amount of cancer:
• Stage 1, cancer limited to the testicle
• Stage 2, cancer involving the pelvic and abdominal lymph glands
• Stage 3, disseminated disease, involving lung, liver, brain, etc.
Patterns of spread
Testis cancer can travel to distant sites such as local lymph glands or liver, bones, brain, or the lungs.
Different Types of testis cancer
There are two basic kinds of testis cancer,
1. Seminoma, 30% of the tumors
2. Non-Seminoma, 70% of the tumors
This distinction is rather important since the treatment for the two kinds is different.
TREATMENT
General guidelines for treatment of testis cancer:
1. The involved testicle must be removed, either at the time of diagnosis or later.
2. Patients with widespread disease (Stage 3) must be treated with chemotherapy.
3. Stage 2 Seminoma patients should receive radiation to the abdomen and pelvis.
4. Stage 2 non-Seminoma patients should be treated with aggressive chemotherapy.
5. Stage 1 Seminoma patients, after removal of testicle, may be either closely monitored or be offered radiation to the pelvis and abdomen.
6. Stage 1 non-Seminoma patients, after removal of testicle, may be closely monitored without any further treatment.
7. At any point and in any stage, after completion of the appropriate treatment, any sizable residual tumor should be removed surgically.
The most effective chemotherapy drugs used to treat this condition are; VP-16, Carboplatinum, Cisplatinum, Bleomycin, Velban, Actinomycin D , Ifosfamide. Chemotherapy is normally administered every three to four weeks, for a period of three to six months.
The most commonly used regimen is BEP and VIP.
