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15 Cards in this Set
- Front
- Back
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What is the most common cause for solic tumors in 20-35 year olds?
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Germ Cell Tumors!
Incidence of 9,000. |
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What are the FOUR kinds of non-seminoma GCT's?
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1) Yolk sac tumor
2) Choriocarcinoma 3) Embryonal carcinoma 4) Terratomas |
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How do you surgically evaluate testicular cancer?
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Ultrasound.
Then, if removal and prognosis needed, perform RADICAL INGUINAL ORCHECTOMY... Don't go through scrotum because can damage and push cancer cells into INGUINAL LYMPH NODES. |
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How do you treat Stage 1 patients?
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SEMINOMA: Radiation
NSGCT: RPLND 95%-100% 5-year survival if STAGE 1. 70% of seminomas are STAGE 1 |
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How do you treat Stage 2?
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SEMINOMA: XRT + Chemotherapy.
NSGCT: RPLND + chemo Stage 2 means metastases have reached the RETROPERITONEUM. Typical ipsilateral flank pain. 90-95% 5-yr survival. |
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How do you treat stage 3?
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Chemotherapy and surgical resection.
Stage III means metastases have traveled BEYOND retroperitoneum. |
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What is a typical CHEMO agent?
What are potential toxicities? |
CISPLATIN. Increased platinum levels in patients for decades!
IMMEDIATE SIDE-EFFECTS: 1) Emesis 2) Fatigue 3) Myelosuppression (rarely severe) 4) Nephrotoxicity, ototoxicity, neuropathy LONG-TERM 1) Cardiovascular disease due to increase platinum levels. |
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What are important AFP and hCG levels in determining RISK LEVEL for patients?
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GOOD RISK
<1000 AFP and hCG < 5000. 90% survival INTERMEDIATE RISK 1000<AFP<10,000 and 5000<hCG<50000 80% survival POOR RISK: AFP>10,000 hCG >50,000 45-50% survival |
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What percentage of patients are azospermic upon completion of CHEMO?
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100%. ~80% will recover sperm levels within 3-4 years.
HIGHLY RECOMMENDED to freeze sperm. |
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What percentage of MALIGNANT TESTICULAR TUMORS are GCT's?
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~95%
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If AFP levels are obtained in analysis, this must be what kind of GCT?
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NON-SEMINOMA.
hCG can be in EITHER NON or SEMINOMA. |
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What is in the differential for testicular swelling/pain.
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Orchitis (mumps). Hydrocele. Varicoele. Epididimytis.
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What is a toxicity associated with BLEOMYCIN.
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Pulmonary toxicity.
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What is a good test to locate tumor progression?
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PET. Measures glucose utilization. CANCER CELLS have higher rates.
ONLY GOOD FOR SEMINOMAS |
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For NSGCT's, what is usually performed AFTER CHEMO?
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Post-chemo resection of residual disease.
In NSGCT's, there is NO WAY to determine if remaining cells are live/dead tumors cells, etc. Removal of these products increases likelihood of survival. |
