Cancer: Testicular seminoma — Chemotherapy. Treatment
Seminoma is an extremely malignant testicular tumor, which commonly occurs in men 20 to 40 years old. In rare cases, the disease is diagnosed in childhood. Seminomas feature a rapid growth and early metastasis formation. Most of the patients at time of diagnosis already have metastasizes in the retroperitoneal lymph nodes. The main treatment method is surgery. The further treatment tactics is determined in view of the disease stage.
Regardless of the formation size, all patients are indicated a radical removal of the testicle (orchofuniculectomy). Through an incision in the groin, the surgeon excises the affected organ with the spermatic cord. The removed tissue is sent for histological examination in order to confirm the tumor nature.
The surgery is performed under general or epidural anesthesia. In the course of intervention, the prosthesis can be installed to preserve the natural look of the scrotum.
For seminoma of the 1st stage, the treatment is usually limited to orchofuniculectomy. However, in the future, these patients are subject to follow-up by the oncologist. In the later stages, the patients are offered the complementary therapies.
External beam radiotherapy after surgery is prescribed to patients with seminoma of the 2nd stage. Irradiation is subjected to retroperitoneal lymph nodes to which cancer cells migrate. The procedure is repeated daily for several weeks. The total exposure dose is less than 40 Gy.
After a course of complete cure is possible to achieve 95% of patients. In case of relapse used anticancer drugs.
Upon serious condition of the patient, the initial chemotherapy can be prescribed, and the removal of the testicle is performed later.
Postoperatively, the anticancer drugs are often recommend to the patients with advanced seminoma. 3 to 4 courses of therapy under EP or BEP program are considered the most effective. One course takes 3 weeks.
After treatment completion, there is still a high risk of tumor recurrence, so all patients need a follow-up. During the first year, the patient must visit the oncologist once a month, during year 2 and 3 year, once every 2 to 3 months, and after 5 years, every six months. Each visit should include a physical examination, a series of laboratory tests and ultrasound of the abdomen. The CT and ultrasound of the healthy testicle is performed, subject to availability of indications.Hide