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Urology

Testis cancer

Omar Khan, Andrew Protheroe

Cancer Research UK, Medical Oncology Unit, Churchill Hospital, Oxford, UK

Correspondence to:
Dr Omar Khan, Cancer Research UK, Medical Oncology Unit, Churchill Hospital, Oxford OX3 7LJ, UK; omar.khan{at}cancer.org.uk

Testis cancer is an increasing problem, especially in northern European male populations. However, survival has improved dramatically over one generation. Environmental factors may have a role in the aetiology with high oestrogen concentrations implicated. Testis cancer is subdivided between seminoma and non-seminoma. At presentation, a testicular lump is the most common finding and radical inguinal orchidectomy is recommended for most. Further multidisciplinary management is determined by histological subtype and stage and involves chemotherapy, radiotherapy and surgery, with many patients only undergoing surveillance. There is increasing emphasis on reducing toxicity of treatments in long term survivors. Treatment refractory testis cancer remains a significant challenge.

Abbreviations: AFP, -fetoprotein, AUC, area under the concentration x time curve; ß-HCG, ß-human chorionic gonadotrophin; BEP, bleomycin, etoposide and cisplatin; CT, computed tomography; EORTC, European Organisation for Research and Treatment of Cancer; EP, etoposide and cisplatin; GCT, germ cell tumour; IGCCG, International Germ Cell Cancer Collaborative Group; ITGCN, intratubular germ cell neoplasia; LDH, lactate dehydrogenase; MRC, Medical Research Council; NSGCT, non-seminomatous germ cell tumour; PET, positron emission tomography; RPLND, primary retroperitoneal lymph node dissection; SMR, standardised mortality ratio; VIP, vinblastine, etoposide and cisplatin

Keywords: testis cancer; epidemiology; aetiology; treatment; long-term toxicity

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