Testicular cancer is the second most common cancer in young men. The two most common types of testicular cancer are: Seminoma and Non-Seminoma. The main risk factors for testicular cancer are undescended testis (as an infant) and family history.
What are the signs and symptoms of testicular cancer:
Testicular cancer often has no symptoms. The most common symptom is painless swelling or lump in the testis. Other symptoms include:
- Pain in testicles
- Change in size or shape of testis
- Back pain or pain in the abdomen
- Enlargement of breast tissue
What to do if you notice a lump?
Testicular cancer requires an urgent referral and investigation. If diagnosed early, the prognosis is significantly better.
The investigations include
- ultrasound of the scrotum
- blood test for testicular markers
- CT scan of the abdomen and chest
What are the treatment options for testicular cancer?
The initial treatment of testicular cancer is removal of the affected testis. If testicular cancer is suspected, the urologist will perform radical orchidectomy, an operation where the testis is removed through an incision in the groin.
Patients who have involvement of the nodes or other sites, will require additional treatment. The treatment options include:
- Radiation therapy
- Surgery (retroperitoneal node dissection)
Retroperitoneal Node Dissection (RPLND):
Testicular cancer often spreads in a predictable pattern. Retroperitoneal node are usually the first landing place for the cancer metastasis. These nodes are often situated around the two major vessels of the body, Aorta and Inferior Vena Cava (IVC). Retroperitoneal node dissection (RPLND) is an operation, where the nodes of the retroperitoneum are removed. It can be done as a primary treatment for selected early stage testicular cancer patients or as a secondary treatment for patients with prior chemotherapy who have disease recurrence or residual masses after chemotherapy. RPLND is a risky operation and the patients undergoing this procedure often require a lengthy hospital stay. The main risk of this operation includes: bleeding, infection, lymphatic leakage, slow return of bowel function, problems with ejaculation and prolonged hospital stay. This type of surgery should be performed in tertiary referral centres expertise and high volume experience.
What is Robotic retroperitoneal node dissection (RPLND)?
Robotic surgery has enabled surgeons to perform the same type of surgery without using large incisions. Subsequently patients experience significantly lower pain and achieve faster recovery after surgery. Dr Ahmadi is a high volume robotic cancer surgeon with dedicated fellowship training in robotic surgery. Along with his team at Chris O’Brien Lifehouse, he offers robotic RPLND to suitable patients with testicular cancer. If you wish to obtain more information, contact our friendly team for an appointment.