Early Detection P r i m a ry care providers should p e rf o rm testicular exams

Early detection p r i m a ry care providers should p

This preview shows page 3 - 4 out of 9 pages.

Early Detection P r i m a ry care providers should p e rf o rm testicular exams when they conduct physical exams on male patients. At that time, educa- tion also should be off e red con- c e rning testicular self-exam. Many studies have shown that primary c a re providers do not examine or educate their patients re g a rd i n g the occurrence and early detection of testicular cancer. Genetics may play a role in early detection of tes- ticular cancer. Significantly higher levels of an overactive hiwi gene have been discovered in men with testicular cancer. Early detection of this gene and development of a means to inactivate the gene may be beneficial in eliminating testicu- lar cancer (NCI, 2008b). At this time, genetic testing is being evalu- a t e d . Signs and Symptoms The signs and symptoms of testicular cancer may be vague. One of the signs is a painless lump in the testicle that may be associ- ated with diffuse swelling or e n l a rgement of the testicle. Gynecomastia (swelling of the b reast) also may occur. Some symptoms in men with metastatic disease could include shortness of breath, masses in the neck, and back pain (Stevenson & McNeil, 2004). Diagnosis Although the number of deaths is decreasing, the inci- dence of testicular cancer is ris- ing. Delay in diagnosis has been c o rrelated with a lower response rate to treatment, a higher stage of cancer, and a higher mortality rate (Vasudev, Joffe, Cooke, Richards, & Jones, 2004). Early diagnosis and treatment are keys to curing testicular cancer. Physical exam, tumor marker measurement, and radiological tests assist with diag- nosis of testicular cancer. A thor- ough physical exam should include careful palpation of the testes, the abdomen, and any lymph nodes. A firm mass often is palpated on physical exam and may be mistaken for epididymitis, an inflammation of the epididymis ( s p e rm maturation and storage site). The health care provider may initiate antibiotics in any questionable case to treat epi- didymitis. For all others, a testicu- lar ultrasound is indicated to eval- uate the mass. The ultrasound will distinguish between hydrocele (a collection of fluid in the scrotu m ) , epididymitis, or a testicular mass (Stevenson & McNeil, 2004). Tumor markers are extre m e ly i m p o rtant and sensitive indicators of testicular cancers (see Ta b le 1 ) . S e rum markers, such as alpha f e t o p rotein, human chorionic gonadotropin, and lactate dehy- drogenase, are important blood tests to diagnose and monitor tes- ticular cancer. Serum markers may detect testicular cancer b e f o re a small tumor appears (NCI, 2008b). A testicular needle biopsy or trans-scrotal orch ie c to- my is contraindicated because of the chance of metastatic spre a d (Stevenson & McNeil, 2004). If a testicular tumor is confirmed by ultrasound, additional diagnostics Figure 2.
Image of page 3
Image of page 4

You've reached the end of your free preview.

Want to read all 9 pages?

  • Winter '13
  • washington ali
  • testicular cancer

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture