Anasayfa » Testicular Cancer Treatment Methods
This method involves taking out the cancerous testicle and the spermatic cord. Lymph nodes may also be taken out in the event that the cancer has spread. This could lead to retroperitoneal lymph node dissection, which would impact ejaculation and sperm production. Some men with stage one disease may not need further treatment, but may have regular follow-ups. These can involve: blood tests, chest x-rays, and CT scans.
A man may wish to store his sperm if he has not yet begun treatment. Radiotherapy uses X-rays to treat cancer and is sometimes used to treat testicular cancer. If a patient has seminoma and is planning to have chemotherapy, he may wish to store his sperm; he may not be able to father a child during chemotherapy and then for a year or more after its completion. Side effects of radiotherapy may include tiredness, red sore skin, and upset bowels.
Treatment for testicular cancer may cause infertility. A man may wish to store his sperm if he has not yet begun treatment. If the patient has metastatic testicular cancer, his doctor may recommend a combination of treatments and may also refer him to an oncologist. Testicular cancer is one of the most curable forms of cancer. There are a number of testicular cancer treatment choices. The treatment of testicular cancer may involve a single treatment or a combination of treatments, which might include surgery, radiotherapy, and chemotherapy.
Surgical resection from an inguinal approach – radical orchiectomy – could be considered a curative therapy, as well as a definitive diagnostic method. In the majority of cases, the histopathological exam identifies the histological subtypes, tumor invasion degree of scrotal envelopes, tunica albuginea, spermatic cord with or without vascular or lymphatic vessels, rete testis, or distant metastasis.
This information is important not only for disease stage and treatment approach but also for prognosis and survival prediction. Some patients refuse immediate surgical treatment or cannot undergo an orchiectomy with the idea to preserve the testis and maintain a good overall quality of life. For these particular cases, a biopsy is performed.
It is also mandatory for tumors with advanced lymphatic, venous, or arterial invasion. However, this surgical technique is not able to establish the final diagnosis and usually leaves 20-50-year-old patients with smaller testis, one piece, significant pain, and could produce evident scars, and an increase in anxiety related to the histopathological result for 1-4 weeks.
The answer is not very simple since testicular cancer has a few different types of phenotypes. Testicular self-examination usually isn’t helpful in testicular GCT early cancer detection because of non-hard testicular tumors. They are usually painless and, due to this fact, are diagnosed incidentally by patients or during clinical examination by intimate partners or during some ambulatory examination for other diseases.
Usually, patients at an advanced stage or presenting metastasis as the first clinical sign would have higher tumor marker concentrations. Being young at the moment of the testicular GCT diagnosis could represent one factor for the earlier and aggressive tumor markers’ secretion by tumor cells in arterial blood.
The most common symptom is a painless enlargement of one testicle. This is why it is important for every male to do a testicular self-exam monthly, ideally after a warm shower. This should be done gently with the palms of the hands and the fingers. Other symptoms may include a feeling of heaviness, enlargement of the scrotum (the ball sack), increased fluid in the scrotum, painful testicular swelling, or pain in the back or groin.
It is important for men to remember that most testicular lumps are not cancerous. Additionally, symptoms may also be caused by other conditions that are unrelated to cancer. However, if any of these symptoms are present, men should seek medical attention so that they can be properly examined and obtain prompt advice. Testicular cancer is a rare disease, accounting for about 1% of all cancers in men.
However, it is the most common solid organ malignancy among men between the ages of 20 and 34. Testes are part of the male reproductive system and they are responsible for producing sperm and the male hormones that control the development of male physical features. Although it is considered an uncommon cancer, most patients will do well once the disease is detected and treated in its earlier stages.
There are many testicular cancer subtypes but all are classified according to the type of cells involved in their formation – germ cells and non-germ cells. The location of the tumor in the testicle (inside or on the surface) is also used to classify each subtype. While the reasons why men develop testicular cancer are unclear, factors that may increase a man’s risk of developing the disease.
A chest and abdomen computerized tomography (CT) scan is often suggested to help check if the disease has spread to other organs. A version of positron computed tomography using fluorodeoxyglucose (FDG-PET), an imaging examination that analyzes the metabolism of the cells, can also be recommended in specific cases of testicular cancer, especially for patients with a germ cell tumor, which is the most common type, to evaluate if the disease has hypermetabolic lymph nodes. In patients with localized testicular cancer and low levels of tumor markers, the physician can choose the so-called surveillance (watchful waiting) strategy which generally does not need to have imaging tests, allowing the need for immediate follow-up in relation to symptoms.
If the diagnosis is testicular cancer and exact classification, the other test results are required, including tumor markers. In general, testicular cancer is discovered by men when they find an unusual mass in a testicle or have other symptoms of the disease, such as changes in the testicles, scrotum, or lower part of the abdomen. A man with such signs will undergo a physical exam performed by a physician. If the physician suspects testicular cancer, they may order imaging tests, especially ultrasound, to confirm the presence of a testicular mass and analyze the disease characteristics. These tests may have their use individually or together.
Staging of testicular cancer is done so that the stage can be used to help select appropriate treatment options as well as to provide a prognosis. The principle “the earlier the stage, the better the cure rate” is often quoted for testicular cancer. In the studies of men with stage I testicular cancer, 84% to 99% were cured with good results observed in 35-65%.
This includes cure rates of 98% to 100% in seminomas and 85% to 91% in NSGCTs. Half of the patients with non-seminoma have stage I, and the cure rate can well exceed 95%. More cure rates in stage I seminoma with good results have advanced to about 100%. Staging includes a complete history and physical examination, testicular ultrasound, biopsy and results of orchiectomy, tumor markers, and imaging scans.
Primary treatment for testis cancer includes radical orchiectomy, with or without the removal of the nearby lymph nodes: Retroperitoneal Lymph Node Dissection (RLND) and RPLND. Therapy is usually for selected patients with stage I seminoma. In contrast, all patients with stage I non-seminoma benefit from lymphadenectomy, especially those with LVI and high tumor markers, even though appropriate selection criteria have not yet been established.
The tumor may be any size and may or may not have spread to the blood vessels, lymph nodes, scrotum, or nearby organs. The tumor may be any size, but it has not spread to the blood vessels, lymph nodes, scrotum, or nearby organs. The tumor may be any size, but it has spread beyond the testicles to the blood vessels or to the lymph nodes in the middle of the body where the aorta is present.
The following stages of testicular cancer are used: Stage I. In stage I, the tumor is found only in the testicles. Which of the following can be used to classify stage I testicular germ cell tumors? The tumor may be any size and may or may not have spread to the blood vessels, lymph nodes, scrotum, or nearby organs. Stage II. In stage II, the tumor has spread beyond the testicles to nearby lymph nodes. Stage III. In stage III, the tumor has spread beyond the testicles to distant organs (such as the lungs, liver, bone, or brain) or distant lymph nodes.
Staging is the term used to describe whether a cancer has spread from the part of the body where it started (the primary site) to other parts of the body. It is important because the stage of a cancer can affect the treatment options. The stage of testis cancer is based on a variety of factors. These include the results of the pathologic evaluation of the tumor, the tumor markers, and the results of any radiologic imaging that might have been done before, during, and after surgery.
Radiation therapy is generally considered a treatment option when cancer, left without radiation therapy, could result in overtreatment determined by the stage according to the American Joint Committee on Cancer (AJCC). Treatment alternatives currently in use include adjuvant radiotherapy following the radical operation of clinical stage I seminomas with involved retroperitoneal lymph nodes and mixed-germ cell tumors (NSGCT) following chemotherapy with tumor markers or relapse after 24-90 days for pure teratoma.
The use of the annulus/phenterimazole approach is recommended in the bundled retroperitoneal lymphadenectomy or the increasing retroperitoneal networks that contain most seminoma and NSGCT affecting structures and beyond nodular lesions. This is particularly interesting for patients with small structures containing TSGT. More unpalatable combinations may be useful, particularly in young/nutritionist patients. Patients with biopsy-confirmed adjuvant alterations should be advised to avoid pregnancy with treatment information.
Since types of TC are varied, after the initial pathology results from the removed testicle, a decision is made as to the appropriate procedure to stage the patient and decide on further therapy. In certain cases, a lymph node dissection is performed to gain more information about the spread of cancer based on disease symptoms before the procedure. Your provider can use information about the cancer from pathology, the stage of the cancer, the patient’s age, with consideration of fertility, and costs to assist in finding the best possible treatment in individual cases.
A newer surgical option to a nerve sparing lumbar lymph node dissection (R-RPLND) emphasizes reduced morbidity: a more precise procedure if able, smaller incision when possible and shorter post-op narcotic medication. The consensus is that all benign masses should always be resected if were found with the initial RPLND. A follow-up is important.
“Watchful waiting” is feasible when the cancer is only found in the testes and was identified at an early stage. The main problem with surveillance is that the disease can come back after an initial treatment and require a more aggressive management. Cancer can recur regardless of any type of treatment, and most male reproductive system cancers recur in the first two years after orchiectomy. It is important that you work with an experienced oncologist who can help make sure the attempt at cure is excellent.
The kind of treatment approach chosen for a patient would depend mostly on the patient’s age, the stage and aggressiveness of the cancer, the patient’s overall health status, and whether the patient already fathered children or is interested in paternity.
Because testicular cancer often tends to affect other parts of the body, often including the lungs and liver, the patient may need surgery to treat testicular cancer. Other related procedures are required to look at and assess the lungs and liver. Therapy to take a biopsy of the patient’s lungs, abdomen, liver and other affected regions can confirm or refuse the spread of testicular cancer.
When testicular cancer is confirmed to spread, the necessary steps are removed. If the other side is affected and the patient has an orchiectomy, both nodes may also be removed during the procedure. The body has other methods of removing cancerous lymph nodes. Lastly, although a variety of bloodborne diseases are rumored to cause lesions, it should be remembered that the spread of cancers throughout the body is another way to ensure the fight against spreading cancers.
Testicular cancer is considered relatively easy to treat and has a good prognosis. Surgical treatment is important in the treatment process. Removing the patient’s testicular tissue is the first step in the surgical treatment of testicular cancer. This procedure is done by a urologist. Other surgical procedures that the urologist will perform to treat testicular cancer include any procedures to look at and evaluate the scrotal contents first to remove and examine testicular tissue where cancer is suspected. Also, because testicular cancer tends to move to lymph nodes above the kidneys, the surgical treatment plan may include removal of the lymph nodes to which testicular cancer is likely to move.
The side effects of different ten to 14-day cisplatin-based regimens have been compared with those in men treated with orchiectomy alone. This study included a total of 50,507 patients with stage I seminoma with and 151,521 without cancer. The chemotherapy-treated men had a higher absolute risk of late effects than the control group but a later onset of several non-life threatening side effects.
However, subpopulations of patients who did not have a potential benefit of chemotherapy had an increased mortality, as well as the risk of second cancers, five or more years after commencing the treatment. In those men who had received abdominal radiotherapy and remained alive for over ten years, there was also a clear increased risk of developing a second cancer. The absolute risk of having one or more late effects and an increased number of comorbidities is substantial for nearly all men at age 65 and, as expected, increases with age. The impact on mortality was, however, low and without a significant difference between groups.
The side effects of chemotherapy depend mainly on the specific anticancer drugs and the normal cells affected. High dose chemotherapies are likely to have more and worse side effects than lower doses. Some drugs can affect a man’s ability to father children permanently, while others may cause temporary sterility. Some of the effects of chemotherapy on sexual functions may last long after treatment ends.
Recommendations regarding discussion of fertility preservation prior to chemotherapy depend on the risk for infertility related to the prevalent treatment and the patient’s wishes. In a Swedish study, many of the responders (61 out of 86; 71%) would have preferred being offered discussions about fertility. In Denmark, less than half of the patients younger than 55 years of age are referred to a specialist and informed about the option of sperm banking. Despite these results, patients that received such bank options had a better quality of life during and after their treatment.