New Clinical Guideline for Testicular Cancer Diagnosis, Treatment

Scrotal Ultrasound and Obtaining Serum Tumor Markers Among 45 Recommendations

The American Urological Association (AUA) has released a new clinical guideline on the diagnosis and treatment of early stage testicular cancer.

Testicular cancer is the most common cancer in men aged 20 to 40 years. Although it is a less common form of cancer, approximately 9,600 men in the U.S. will be diagnosed with the disease in 2019.

Men born with cryptorchidism (undescended testicle) are at increased risk for testicular cancer, as are men with a family history of the disease or men with a personal history of testis cancer. However, testicular cancer is one of the most treatable cancers. When caught early, the cure rate is almost 100 percent.

Treatment of testicular cancer depends on the type and stage of cancer, and the patient’s age, overall health, and personal preferences. Therefore, AUA’s guideline panel strongly recommends shared decision-making between physician and patient to select the best care option for that individual.

The new clinical guideline includes 45 recommendations. Completing a scrotal ultrasound and obtaining serum tumor markers as part of the initial diagnosis are among the recommendations.

A radical, inguinal orchiectomy to remove and treat the cancer is also recommended for all men with the disease; but testis-sparing surgery is not recommended for those with a normal contralateral testis.

The guideline panel suggests that sperm-bank options are discussed prior to orchiectomy. For patients with stage 2 disease, the guideline recommends offering retroperitoneal lymph node dissection, chemotherapy, and/or active surveillance, post-orchiectomy.

The full guideline can be accessed at www.auanet.org/TesticularCancer.

Source: BioSpace, May 2, 2019