What Are the Different Types of Testicular Cancer Treatment?

Tumor of testis is one of the common tumors in urology. Testicular tumors are divided into two types: primary and secondary, most of which are primary, and secondary is extremely rare. Testicular tumors are almost all malignant, with germ cell tumors accounting for 90% to 95% and non-germ cell tumors accounting for 5% to 10%. Germ cell tumors are the most common of germ cell tumors, accounting for about 40% to 50% of primary testicular tumors, followed by embryonic cancers, about 20% to 30%, and teratomas again, about 10% Around, testicular tumors of other cell types are rare. There are three peak ages: yolk sac tumors (infant embryonic tumors) are more common in infancy; various types of testicular tumors can be seen between the ages of 20 and 40, but seminoma are still the most common. Blastoma. Its etiology is unknown, and it is currently believed that its onset is related to genetic and acquired factors. Among them, it is most closely related to cryptorchidism. The chance of tumors in cryptorchidism is 10 to 14 times greater than that in normal people. Cryptochidism in the abdominal cavity is higher than that in the groin. Testicular fixation does not reduce the incidence of malignant changes, but it makes tumors more vulnerable Find.

Basic Information

English name: testicular cancer
Visiting department: Oncology, Urology

Common causes: Onset is most closely related to cryptorchidism
Common symptoms: Progressive and painless increase in testes, feeling heavy, swelling and hardening of testes

Causes of testicular cancer

Its etiology is unknown, and it is currently believed that its onset is related to genetic and acquired factors. Among them, it is most closely related to cryptorchidism. The chance of tumors in cryptorchidism is 10 to 14 times greater than that in normal people. The cryptorchidism in the abdominal cavity is higher than that in the groin.

Testicular cancer classification

Testicular tumors are divided into germ cell tumors, non-germ cell tumors, and testicular secondary tumors. Germ cell tumors are the most common, accounting for 90% to 95%. Germ cell tumors are divided into seminoma (35%), non-sperm cell tumors (embryonic cancer; teratoma; chorionic epithelial cancer, yolk sac tumor, etc.) and mixed germ cell tumors. Non-germ cell tumors are divided into stromal cell tumors, supporter cell tumors, gonadal stromal tumors, and mixed tumors.

Clinical manifestations of testicular cancer

The most common symptoms are a gradual, painless enlargement of the testes, with a heavy feeling, and the testes swell and harden. Spermatoma tumors with enlarged testicles often maintain the outline of the testicles, and the texture is consistent, while teratomas are nodular, with inconsistent softness and hardness. About 10% of patients feel pain due to bleeding or infarction in the testis, and 10% of patients may have symptoms of metastasis, such as a large retroperitoneal lymphatic metastasis and back pain that compresses the nerve root. Cough and dyspnea can occur in lung metastases, anorexia, nausea, and vomiting can occur in duodenal metastases, and bone pain can be caused by bone metastases. Testicular stromal cell tumors should be considered in children with testicular masses and symptoms of precocity, or in adults with female breasts and hyposexuality.

Testicular cancer test

The physical examination can touch the affected side of the testicles to be enlarged, tough, and heavy, and the light transmission test is negative. Testicular tumor markers, human chorionic gonadotropin (HCG), and alpha-fetoprotein (AFP) concentrations may be increased in the serum of patients with seminoma, chorionic cell carcinoma, embryo cancer, or mixed germ cell tumor, respectively. B ultrasound showed increased testicular homogeneity, increased and uneven echo, and strong blood flow signals. The sensitivity of scrotum ultrasound to detect testicular tumors is 100%, which can show that the tumor is outside or inside the testis. It can also be used to detect the presence of metastatic tumors in the peritoneum, the presence of metastatic lymph nodes in the kidney area, or the metastasis of the abdominal organs; it is helpful to observe the tumor stage and efficacy. CT examination can clearly show the relationship between tumors and surrounding tissues, and determine the presence or absence of metastases. It is mainly used to observe the metastasis of retroperitoneal lymph nodes.

Testicular cancer diagnosis

The diagnosis of a typical testicular tumor is not difficult, and it can be diagnosed based on clinical manifestations and related examinations.

Differential diagnosis of testicular cancer

It should be distinguished from other masses in the scrotum.

Testicular cancer treatment

Testicular tumor treatment is divided into individual treatment and comprehensive treatment of surgical treatment, radiation treatment and chemotherapy. Once a testicular tumor is identified, radical testicular resection should be performed first, and further treatment options should be decided based on the results of pathological examination. The basic surgical methods are orchiectomy and retroperitoneal lymphadenectomy. The latter is particularly suitable for stage I and stage II non-spermatomatous germ cell tumors that are not sensitive to chemotherapy and radiotherapy, such as embryo tumors, teratomas and Mixed cancer, etc. Radiation therapy is extremely sensitive to seminoma, embryonic cancer and malignant teratoma are less sensitive to radiation, and chorionic epithelial cancer is extremely insensitive to radiation. Radiation therapy can kill tumor tissues without causing significant damage to adjacent normal tissues, and is currently widely used in clinical practice. Testicular tumors have a good effect on chemotherapy. It is generally believed that chemotherapy has a better effect on seminoma, and is also effective on embryonic cancer and chorionic epithelial cancer, especially when several drugs are used in combination, the effect is better and the effect on teratoma is better. Poor, for advanced or relapse cases, chemotherapy also plays a role.

Therefore, localized seminoma can be treated with radical orchiectomy and external peritoneal radiation therapy, with a cure rate of more than 90%. Chemotherapy is used for metastatic seminoma. The most effective triple drugs are cisplatin, bleomycin, and etoposide, with a remission rate of about 90%. For localized seminoma, follow-up after radical testicular resection or retroperitoneal lymph node dissection. High-grade non-spermatogonial tumors are treated with chemotherapy after radical testicular resection, followed by retroperitoneal lymphadenectomy. Comprehensive treatment is more effective than single treatment. Generally, according to the pathological type, development trend, and general conditions, carefully analyze the local recurrence or distant metastasis before going to local or systemic treatment.