SYNOPSIS OF TESTICULAR CANCER IN MALE PATIENTS

SYNOPSIS OF TESTICULAR CANCER IN MALE PATIENTS

                                                               

UGWUBUJO CALEB (RN, DEAN,)

Department of Accident and Emergency unit

                                                                                 

Testicular cancer

Predisposing factors

Clinical manifestation

Diagnostic studies

Management

Testicular self exam

TESTICULAR CANCER

Testicular cancer is a relatively rare but most common type of cancer found in young men between the ages of 15-35 years of age. It account for less than 1% of all cancers found in males.

STATISTICS

In 2002, 7500 cases and 400 deaths were recorded in the US. The incidence is four times higher in white males than in African American males and it occurs more to the right testes than the left.

PREDISPOSING FACTORS

·         Common in male with history of undescended testes (cryptorchidism)

·         Family history of testicular cancer or other anomaly

·         Ochitis

·         HIV infection

·         Maternal exposure to DES

·         Testicular cancer in the contralateral testes

             

CLINICAL MANIFESTATION

·         Lump in the scrotum

·         Scrotal swelling and feeling of heaviness

·         Dull and heavy ache in the lower abdomen, perianal area or scrotum

·         Acute pain

·         Manifestations associated with metastasis to other system of the body are varied and may include papiloedema, cough, back pain, hemoptysis, dyspnoe and seizures.

DIAGNOSTIC STUDIES

Diagnostic studies will involve physical examination of the testes to dictate any lump, ultrasound of the testes when a mass is detected.

If a testicular neoplasm is suspected, obtain blood for serum levels of ɒ feto-protein (AFT) and human chorionic gonadotrophin (hCg). A chest X-ray and CT scan to detect any metastasis.

MANAGEMENT (NURSING AND COLLABORATIVE)

As for all cancer, early detection of growth is essential to treatment and survival. Each male must be taught and encouraged to perform a monthly testicular self examination for the purpose of detecting testicular tumors and abnormilities especially for males with history of undescended testes. A testicular examination can detect the causes of pain, inflammation, swelling, congenital abnormalities (such as an absent or undescended testicle), and lumps or masses that may indicate testicular cancer.

Collaborative care of testicular cancer care generally involves an orchiectomy or a radical orchiectomy (surgical removal of the affected testes, spermatic cord and regional nodes). Post orchiectomy treatment involves chemotherapy, radiation therapy depending on the stage of the cancer.

All patients with testicular cancer regardless of the cause and stage of the cancerous growth, requires a careful follow up visit and physical examination, chest X-ray, hCg and AFP. The aim of these is for early detection of relapse when the tumor burden is minimal. The man testicular cancer should be able to discuss fertility and sperm banking before any treatment. This is because treatment has the potential interfering with patient fertility and erection. The health care provider must be interested and ready to provide psychological support and other management.

                                             

                                                      

 

 TESTICULAR SELF EXAMINATION

·         A testicular examination includes a complete physical exam of the groin and genital organs (penis, scrotum, and testicles) ·         Normally done in the shower while taking a bath. Warm water makes the testes to hang down into the scrotum. ·         Use both hands to palpate each testis separately. ·         Identify the structures, the testes feel like a hardboiled egg , round and smooth ·         The left testes hang slightly lower than the right testes. ·         Check for irregularities, pain in the testes or a dragging sensation. ·         Select a permanent day of the month for self examination of the testes, this will ensure that it is not forgotten, eg birthday etc. ·         Always notify a health care provider whenever an abnormality is observed.

 

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