Male genital organs, and of the urinary tract
Rare cancer of the male genital organs, and of the urinary tract
Testicular cancers are rare but they are the most common solid malignancy in men in their 2nd to 4th decades.
Approximately 95% of testicular cancers are germ cell tumors.
Germ cell tumors are subdivided based on histology in two categories:
- seminoma (55%)
- non-seminoma (45%)
Their treatment is very well codified:
Initial management consists of orchidectomy and evaluation for metastases by measurement of serum tumor markers and imaging of the abdomen and thorax. Without signs of metastases at the moment of orchidectomy, a watchful wait-and-see policy is initiated in patients with high risk of metastases one prophylactic course of chemotherapy. If metastases are present, or when they arise during follow-up, systemic treatment with platinum-based chemotherapy is indicated.
After completion of chemotherapy restaging is performed, in case of residual disease this is removed by surgical resection. Overall metastatic testicular cancer has become a highly curable malignancy with a 10-year survival rate of around 80%.
As a result of this favorable prognosis and together with a still increasing incidence, the population of successfully treated testicular cancer survivors is steadily growing. Because of a presumed normal life-expectancy when cured from testicular cancer, the risk for treatment-related complications in these patients is increasingly recognized. Examples of these side-effects are infertility, neurotoxicity, second malignancies and cardiovascular disease (CVD).
Most chemotherapy-treated patients will remain under oncological follow-up for 5 to 10 years after treatment.
Treatment within network of reference centers ensures the accurate application of clinical practice guidelines for curative first line treatment.
Testis cancer is one of the malignancies where imperfect adherence to clinical practice guidelines leads to increased risk of relapse. Participation in clinical and translational research programs at relapse, and also in studies on late treatment effects is encouraged.