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Feature Article

Testis cancer: assessment and management

Mark Frydenberg

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Abstract

The improved survival rate of patients with testis cancer should be regarded as one of the successes of modern oncology; however, this cancer still claims lives and creates a major psychological burden for affected men and their families.

Key Points

  • Patients with testis cancer usually present with a painless, hard, swollen mass in the testis.
  • Initial investigations comprise testicular ultrasonography and assessment of the tumour markers beta-human chorionic gonadotropin and alpha-fetoprotein.
  • Once testis cancer has been diagnosed patients should be referred to a urologist for staging investigations and surgical orchidectomy.
  • After orchidectomy, patients with stage 1 non-seminomatous tumours usually undergo surveillance, while those with stage 1 seminomas usually undergo adjuvant radiotherapy.
  • The use of cisplatin has revolutionised the treatment of metastatic testis cancer.
  • Survival rates for patients with early disease approach 100% and for those with advanced disease range from 70 to 95%.

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