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Feature Article

A potentially curable disease: optimising testis cancer treatment

Mark Frydenberg

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Abstract

Modern treatment and management of testis cancer means that survival rates for patients with early disease approach 100%, and at least 70% for those with advanced disease. Although survival rates are relatively high, patients and their families will need counselling through all stages of diagnosis and treatment.

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 -human chorionic gonadotropin and alfa-fetoprotein (AFP).
  • Once testis cancer has been diagnosed patients should be referred to a urologist for staging investigations and surgical orchidectomy (via inguinal approach).
  • After orchidectomy, patients with stage 1 nonseminomatous tumours usually undergo surveillance, whereas those with stage 1 seminomas usually undergo a discussion about options including adjuvant radiotherapy, or surveillance or single course of intravenous chemotherapy as alternatives in selected patients.
  • 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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