Aditya Bagrodia MD, FACS, presented “Testicular Cancer” during the 30th Annual Perspectives in Urology: Point-Counterpoint, on March 10, 2023, at Humphreys Half Moon Inn, San Diego, California.

How to cite: Bagrodia, Aditya. “Testicular Cancer.” March 10, 2023. Accessed Jun 2024. https://grandroundsinurology.com/testicular-cancer/

Testicular Cancer​​ – Summary

Aditya Bagrodia, MD, FACS, discusses testicular cancer in this lecture. Dr. Bagrodia explains that, though it is highly curable, testicular cancer is the most common cancer in men ages 18-45 and results in the most life years lost for non-pediatric cancers. 

Dr. Bagrodia asserts that delays in diagnoses are associated with worse clinical outcomes. He says it is paramount to minimize toxicity while maintaining excellent oncological outcomes. The United States Preventive Services Task Force (USPSTF) recommends against screening for testicular cancer but if a patient has risk factors, self-exams are warranted. 

Dr. Bagrodia covers signs and symptoms, the most common being abdominal, back, or flank pain and emphasizes that the scrotum should be checked in patients with an abdominal/retroperitoneal mass. He summarizes scrotal evaluation and explains that with a suspicious scrotal mass, ultrasound and serum tumor markers should be obtained (ideally getting staging scans prior to orchiectomy). 

Dr. Bagrodia addresses prosthesis placement, fertility concerns, sperm banking, and anxiety and depression as topics practitioners should address with men who have a testicular cancer diagnosis. He addresses strategies to avoid a full orchiectomy before turning to post-orchiectomy procedures, emphasizing the importance of following serum tumor markers to nadir and a high-quality, contrasted CT scan. 

Dr. Bagrodia explains stage one and stage two seminoma treatment principles and asserts that for patients undergoing both radiation and chemotherapy, the risk of long-term toxicity is significant. He explains efforts to minimize toxicity and summarizes the Surgery for Early Stage Metastatic Seminoma (SEMS) study. Dr. Bagrodia addresses stage two nonseminoma and emphasizes novel strategies to limit toxicity before concluding with a final emphasis on the curability of testicular cancer as well as the significant toxicities associated with its treatment. He asserts that efforts to minimize long-term side effects in early-stage disease are mandatory.

 

About the 30th Annual Perspectives in Urology: Point Counterpoint conference: Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.