ABSTRACT

This chapter discusses the risk factors for developing testicular cancer, investigations performed in a patient with testicular cancer, and classifications of testicular tumours. Bilateral scrotal orchidectomy in the treatment of advanced prostate cancer, and unilateral scrotal orchidectomy after finding a non-viable torsion are the indications for performing an orchidectomy via a scrotal incision. Orchidectomy is performed under a general anesthetic; the skin should be prepared with a suitable antiseptic and draped to expose the inguinal region, scrotum, penis and upper thighs. In International Union Against Cancer (UICC) TMN system of classification, T denotes the primary tumour, N denotes the regional lymph nodes, and M denotes distant metastasis. RMH Staging system of classification was devised at the Royal Marsden Hospital. Seminomas are highly radiosensitive. External beam radiation is administered in a hockey-stick field for stage I and II disease. Treatment for seminomas above stage III and for most teratomas is by means of adjuvant chemotherapy with bleomycin, etoposide and cisplatin (BEP).