Testicular carcinoma

The diagnosis and treatment options for testicular carcinoma from Dr. Shanzah Shahbaz, a medical oncologist. This comprehensive guide covers staging, tumor markers, false elevation risks, chemotherapy regimens, and management of residual masses.

• Testicular carcinoma
• diagnosis
• treatment options
• staging
• tumor markers
• false elevation
• chemotherapy regimens
• residual masses

tully Follow

Uploaded on Dec 21, 2023 | 3 Views

Download Presentation

Please find below an Image/Link to download the presentation.

The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.

You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.

The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.

Presentation Transcript

1. Testicular carcinoma DR SHANZAH SHAHBAZ MEDICAL ONCOLOGIST

2. BEFORE START OF TREATMENT

3. Treatment is by stage

4. Complete staging workup is mandatory before start of treatment. Contrast enhanced CT/scan of abdomen and pelvis CXR-PA View Chest CT if: positive abdomen CT or abnormal chest x ray Brain MRI ,if clinically indicated Neurological symptoms, Extensive lung metastasis, Non- pulmonay visceral metastases, beta-hCG > 5000 IU/L

5. Tumour markers, (Post-Orchiectomy) AFP ( half life 3 to 5 days) B-HCG ( 24 to 48 hours) LDH

6. Be Aware Of False Elevation AFP: Liver disease, Hepatocellular carcinoma, Carcinoma of Pancreas, Stomach B-HCG : Chemotherapy related hypogonadism, Marijauna use, Cross reactivity with LH , Hyperthyroidism, Gastrointestinal cancers

10. Chemotherapy regimens BEP ( Bleomycin, Etoposide, Cisplatin ) X 3 cycles Pulmonary Toxicity , Low Fi02 and hydration because of decreased DLCO during aneathesis EP ( Etoposide, Cisplatin) X 4 Cycles Myelosuppression, Nephrotoxicity, Neuropathy VIP ( Etoposide, Ifosfamide, Cisplatin) X3 cycles Myelosuppression, Highly emetogenic

11. Management of residual masses (Seminoma) Normalization of LDH, BHCG No residual mass more than 3 cm Residual mass more than 3 cm Residual mass more than 3 cm FDG-PET PET POSITIVE PET NEGATIVE Consider RT to or resection of FDG- avidmass Surveillance surveillance

12. Management of residual masses ( Non-Seminoma) Normalization of LDH, B-HCG, AFP No residual masses more than 1 cm Raised tumour marker Surveillance Residual mass More than 1 cm Second line chemotherapy Retroperitoneal lymph node dissection

13. Follow up Late relapses are common with pure seminoma and teratoma Young Patient followed for long term complications . Cardiovascular disease Secondary malignancies Infertility

14. Thankyou