Testicular Cancer
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Transcript Testicular Cancer
Testicular Cancer
Presentation at WHRHS
Alex Hohmann
February 25-26, 2013
Alex’s testicular cancer
First diagnosis in October 1996 (age 30):
surgery, radiation therapy and surveillance
Second diagnosis in March 2008:
surgery and surveillance
Excellent prognosis
Alex’s post-diagnosis goals
Lead healthy lifestyle and survive cancer well
Advocate, fund raise and educate
Run 2 half-marathons & other races in 2013
Run full marathon before turning 50
Basic facts about TC
Testicular
cancer includes different cancer
cell types (seminoma vs non-seminoma) that
typically appear first in the testes
TC
does not have any clearly identified causes
Men
with TC were most likely born
predisposed to it
TC
rates seem to be higher in men born with
an undescended testicle and are highest
among Caucasian men
TC by the numbers*
Over
8000 new cases expected in 2013
Most
common cancer in men ages 15 to 40
Lifetime
Just
risk is 1 in 270
under 400 expected to die in 2013
Overall
5-year survival rate of 95%
Localized
Early
(confined to testes) survival of 99%
detection is critical to survival
If
TC is caught early and treated correctly,
survivors live full and healthy lives
* All figures from the Sean Kimerling Testicular Cancer Foundation, National Cancer Institute, and American Cancer Society
Anatomy of testes and pelvis
http://www.urologyhealth.org/urology/index.cfm?article=36
Early detection of TC
Examine testicles at least once a month
Look for presence of a pea-sized mass
attached to testes or for scrotal enlargement
Other symptoms may include feeling of
heaviness in scrotum, severe and worsening
back ache, breast tenderness
See a urologist at the first sign of any of
these symptoms. Do not delay.
Diagnosis of TC
Urologist will examine testicle and, if
indicated, order a scrotal ultrasound to be
done right away
The ultrasound is quick and painless
Ultrasound images are examined by a
radiologist who will report back to the
urologist if there are signs of a tumor
Urologist will draw blood and order a CT
scan to be done right away
Diagnostic and staging tools
Treatment of TC: first steps
Entire testicle must be removed in a short
procedure called an inguinal orchiectomy,
usually done on an outpatient basis
Biopsy of the testicle, CT scan, and blood
tests determine type (seminoma vs nonseminoma) and staging (1, 2, 3)
Post-orchiectomy treatment and follow-up
vary according to type and stage and are
done under the care of an oncologist
TC Stages
http://www.urologyhealth.org/urology/index.cfm?article=36
Treatment of TC: next steps
Depending on cell type, stage 1 TC may
require only follow-up testing (surveillance)
Non-seminoma may require further surgery
(e.g. RPLND) for biopsy or treatment
Some stage 1 patients elect adjuvant radio- or
chemotherapy to reduce relapse risk
Relapse (cancer shows up again, often in
lymph nodes) must be treated immediately
with chemo- or radiotherapy
Effects of TC and treatment
Loss of one testicle does not usually impair
testosterone and sperm production
Radio- or chemotherapy can impair sperm
production so some men bank sperm first
A second TC is very rare but results in loss of
fertility and need for hormone replacement
Properly treated and followed up by a doctor,
majority of TC survivors have normal sexual
performance and live a fully and healthy life
Alex’s lessons from cancer
There was no known way of avoiding TC
There are others facing the same thing
Keep a sense of humor
Alex’s lessons from cancer
Don’t take health or life for granted
Be grateful for life by giving back to others
Don’t be shy about speaking up
Embrace new challenges
Points to remember
Know your body
Live a healthy lifestyle
Get a complete physical regularly
See a doctor ASAP at any sign of trouble
Have someone (e.g. loved ones) with you if
you have to see a urologist or oncologist
Ask questions and take good notes
Reach out for support
Don’t be shy about discussing health issues
Above all, don’t die of embarrassment!
Diagnosis-related definitions
Urologist: doctor specializing in genito-urinary
disorders such as testicular cancer, bladder cancer,
prostate cancer, incontinence, infection, etc.
Oncologist: doctor specializing in treatment of cancer,
often specializing in specific cancers
CT (computed tomography) scan: x-ray “slices” of the
body to produce three-dimensional image
Ultrasound: widely used sound wave technology used
to produce medical images
Biopsy: examination of tissue samples under
microscope for isolation and identification of
abnormalities such as cancer cells
Treatment-related definitions
Inguinal orchiectomy: surgical removal of a testicle
done through a small incision in the groin and thus not
involving incision in the scrotum itself
Radiotherapy: destruction or reduction in size of
masses in isolated parts of the body using radiation of
specific form, intensity, duration and frequency,
usually but not always in exterior beam form
Chemotherapy: destruction or reduction of solid
masses or diffuse cancer cells using cell-specific
chemical agents in precise combination, timing, and
dosage, usually but not always intravenously
Other disorders of the testes
Varicocele: swelling of testicular blood vessels
Hydrocele: accumulation of fluid in scrotum
Epididymitis: inflammation of the epididymis
Orchitis: inflammation of the testicles
Primary hypogonadism: low testosterone due to failure
of testes to produce it
Cryptorchidism: undescended testicle
Testicular torsion: interruption of blood supply due to
twisting of spermatic chord
Testicular rupture due to blunt force