Men s Health Testicular Cancer Colon Cancer

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1 Men s Health Testicular Cancer Colon Cancer

2 Testicular Cancer

3 Testicular Cancer Facts Accounts for 1% of cancers in men. About 8,000 men are diagnosed with testicular cancer each year. Only 370 deaths from testicular cancer are expected in the United States annually.

4 Testicular Cancer Types of Testicular Cancer: Seminomas (5%) A type of cancer of the testicles. Seminomas may spread to the lung, bone, liver or brain. Non-seminomatous Germ Cell tumor (95%) A group of testicular cancers that begin in the germs cells (cells that give rise to sperm). Non-seminomas are identified by the type of cell in which they begin and include embryonal carcinoma, teratoma, choriocarcinoma, and yolk sac carcinoma.

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6 Testicular Cancer Risk Factors Age (ages of 20 and 39) Family History (brother and uncle) Hereditary Conditions Abnormality of testicles, penis or kidneys at birth Personal History Undescended testicle at birth (risk does not change with surgery to move the testicle into the scrotum.) History of testicular cancer History of inflammation of the testicles following mumps

7 Testicular Cancer Risk Factors Race: It is more common in white men, especially those of Scandinavian descent. The rate of testicular cancer has more than doubled among white men in the past 40 years. It has only recently begun to increase among black men. The reason for this is not clear.

8 Testicular Cancer Symptoms A painless lump or swelling in a testicle Pain or discomfort in a testicle or in the scrotum An enlargement of a testicle or change in the way it feels A feeling of heaviness in the scrotum A dull ache in the lower abdomen, back or groin

9 Testicular Cancer Symptoms These symptoms can be caused by testicular cancer. However, they can be caused by other conditions as well, such as: hernia, hydrocele (collection of fluid in scrotum), spermatocele (fluid-filled cyst at head of epididymis), varicocele (dilated veins in scrotum), epididymitis (infection of the epididymis)

10 Testicular Cancer Diagnosis Your doctor will want to confirm the physical exam

11 Testicular Cancer Diagnosis Blood tests to measure tumor markers alpha-fetoprotein (AFP) Normally produced by fetal yolk sac but is produced by many tissues that become malignant. Especially prevalent in nonseminomatous germ cell tumors. Beta-human chorionic gonadotropin (ß-HCG) Most commonly elevated tumor larker in testicular cancer. HCG is produced in germ cells of men, so when they become cancerous the levels increase. Lactate dehydrogenase (LDH) Enzyme that is involved in the Kreb s Cycle. Elevated with tissue breakdown, damage to muscle, and cancer due to high rate of turnover with destroyed calls.

12 Testicular Cancer These tests may suggest the presence of a testicular tumor, even if it is too small to be detected by physical exam or imaging.

13 Testicular Cancer Diagnosis Ultrasound This uses sound waves which bounces off the testicles to produce a picture called a sonogram. Ultrasound of the scrotum can show the presence and size of a mass in the testicle. It may also show another cause for the symptoms.

14 Testicular Cancer

15 Testicular Cancer

16 Testicular Cancer Diagnosis Biopsy In nearly all cases of suspected cancer, the entire affected testicle is removed through an incision in the groin. In rare cases, such as when a man has only one testicle, a surgeon may remove a sample of the tissue to examine under a microscope.

17 Testicular Cancer - Treatment Treatment Surgery to remove the testicle. This does not affect your ability to have sexual intercourse. If one testicle is still present, you will not be sterile.

18 Testicular Cancer

19 Testicular Cancer Treatment Surgery to remove the lymph nodes Some of the lymph nodes located in the abdomen may also be removed to prevent further spread and to test for metastasis. This is called Retroperitoneal lymph node dissection.

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21 Testicular Cancer Treatment Radiation Therapy Affects only cancer cells in the treated areas Only seminomas are sensitive to radiation therapy. This is usually given after surgery and may be aimed at the lymph nodes Non-seminomatous germ cell tumors are less sensitive.

22 Testicular Cancer Treatment - Chemotherapy Drugs to kill cancer cells Usually given after surgery to help kill any remaining cancer cells in the body. May be given first if the cancer has spread.

23 Testicular Cancer Prognosis The five year survival rate is over 95%.

24 Testicular Cancer Prognosis While surgery can often cure testicular cancer, regular follow-up exams are extremely important. Remember, men who have had testicular cancer are at an increased risk of developing cancer in the other testicle.

25 Testicular Cancer To screen or not to screen? Primary screening tools: physician exam of testicles at annual exam self exam of testicles.

26 Testicular Cancer Screening Recommendations United States Preventive Services Task Force: There is no evidence to support screening asymptomatic men Why? There is no evidence that there are less deaths if you find the cancer through screening. Concern that more harm comes from screening than benefits

27 Testicular Cancer Screening Recommendations National Cancer Institute No evidence that physician or self-exam will decrease mortality.

28 Testicular Cancer Conclusion Talk with your doctor about screening and self-testicular exams See your doctor immediately if you have any signs of symptoms of testicular cancer.

29 Colorectal Cancer

30 Colorectal Cancer Facts Colorectal cancer is the third most common cancer in men and women. Colorectal cancer is the second leading cause of death in men and third leading cause of death in women.

31 Colorectal Cancer Facts New cases in 2007: 153,760 new cases of colorectal cancer 112,340 (colon), 41,420 (rectal) Deaths in ,180 (colon and rectal combined) This accounts for 9% of cancer deaths.

32 Colorectal Cancer Facts Colorectal cancer can be prevented by removing polyps in the colon years before invasive cancer begins. When colorectal cancer is found early and treated, the 5- year survival rate is 90%.

33 Colorectal Cancer Facts In Nebraska, only 38.4% of adults age 50 and over have ever had a sigmoidoscopy or colonoscopy. Nebraska Comprehensive Cancer Control State Plan, Nebraska C.A.R.E.S. Cancer Awareness, Research Education and Service As many as 60 percent of deaths from colorectal cancer could be prevented if everyone age 50 and older were screened regularly.

34 Colorectal Cancer Risk Factors Age: 50 or older (90% of cases occur after 50) Family History: Colorectal Cancer or Polyps Personal History: Colorectal cancers or polyps in the colon A history of ulcerative colitis or Crohn s disease Certain hereditary conditions, such as familial adenomatous polyposis and hereditary nonpolyposis colon cancer (HNPCC; Lynch Syndrome)

35 Colorectal Cancer Modifiable Risk Factors Obesity Physical inactivity Smoking Heavy alcohol consumption Diet high in red or processed meat Inadequate intake of fruits and vegetables

36 Colorectal Cancer Symptoms Early Symptoms: Early colorectal cancer usually doesn t have any symptoms.

37 Colorectal Cancer Symptoms Later symptoms: A change in bowel habits Blood in the stool Stools that are more narrow than usual Frequent gas pains, bloating, fullness or cramps Weight loss that cannot be explained

38 Colorectal Cancer Diagnosis: Physical Exam Fecal occult blood test Tests for blood in stool that may not be seen by the eye Stool placed on card, then sent tested for blood May be done by rectal exam or by sending home pack of three cards.

39 Colorectal Cancer

40 Colorectal Cancer Diagnosis Digital Rectal Exam Checking for unusual lumps in rectum Barium enema Series of x-rays of lower gastrointestinal tract after you have swallowed a silver-white liquid. Sigmoidoscopy Scope placed inside the rectum and sigmoid (lower colon) to look for cancer or polyps.

41 Colorectal Cancer Diagnosis Colonoscopy Scope placed through rectum and is able to visualize the entire colon for unusual findings Biopsy Removal of cells or tissue during sigmoidoscopy or colonoscopy Virtual Colonoscopy Series of computed tomographies (CT s) to create a detailed picture of the colon.

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43 Colorectal Cancer Treatment 1) Surgery: Surgery is the most common treatment for colorectal cancer. For those cancers that have not spread, surgery may be curative. Colorectal cancer is always staged. This will determine the treatment.

44 Colorectal Cancer Staging off Colorectal Cancer Stage 1: Cancer is only in internal and middle wall of colon Stage 2: Cancer has spread to tissue or organs nearby Stage 3 Cancer has spread to 3-4 lymph nodes Stage 4: Cancer has spread to other parts of body, such as lungs or liver

45 Colorectal Cancer

46 Colorectal Treatment Chemotherapy alone, or in combination with radiation (for rectal cancer), is given before or after surgery to most patients whose cancer has penetrated the bowel wall deeply or spread to lymph nodes.

47 Colorectal Cancer Prognosis depends upon: The stage of the cancer Whether the cancer has blocked or created a hole in the colon Blood levels of carcinoembyronic antigen (CEA) before treatment begins Recurrence Patient s general health

48 Colorectal Cancer To screen or not to screen? What are the recommendations?

49 Colorectal Cancer Screening Recommendations United States Preventive Task Force Services: Recommends screening men (and women!) 50 years of age and older. Good evidence that periodic fecal occult blood testing reduces mortality Fair evidence that sigmoidoscopy alone or in combination with FOBT reduces mortality

50 Colorectal Cancer Screening Recommendations United States Preventive Services Task Force: No direct evidence that screening colonoscopy is effective in reducing colon cancer mortality. However, the USPSTF believes that any of the current screening techniques are cost effective and does not show a preference for one over the other.

51 Colorectal Cancer Screening Recommendations American Cancer Society Beginning at age 50, men should begin screening with 1 of the examination schedules below: A fecal occult blood test every year A flexible sigmoidoscopy every 5 years A double-contrast barium enema every 5 years A colonoscopy every 10 years

52 Colorectal Cancer Screening Recommendations American Cancer Society Patients with first degree relatives who have had colon cancer should be screened at an earlier age. No clear consensus as to when that should begin.

53 Colorectal Cancer Conclusion Screening is recommended for colorectal cancer, beginning at age 50. Discuss with your doctor the types of screening most appropriate to you.

54 Questions? Colorectal Cancer