Testicular Cancer
Testicular cancer is a relatively rare but highly treatable cancer that develops in the testicles (testes), the male reproductive glands responsible for sperm and testosterone production.
It most commonly affects young men between the ages of 15 and 40 and is often detected as a painless lump or swelling in the testicle. Risk factors include a history of undescended testes (cryptorchidism), family history, and certain genetic conditions. Diagnosis involves a testicular ultrasound, tumour marker blood tests (AFP, β-hCG, LDH), and imaging scans. The primary treatment is an orchidectomy (surgical removal of the affected testicle), with further treatment depending on the cancer stage and type.
Retroperitoneal Lymph Node Dissection (RPLND)
For certain cases of testicular cancer, especially non-seminomatous germ cell tumours (NSGCTs) with lymph node involvement, retroperitoneal lymph node dissection (RPLND) may be necessary. This is either done near the time of first presentation or, more commonly, for residual lymph node masses after initial chemotherapy. This complex surgical procedure involves removing lymph nodes from the retroperitoneum (the area behind the abdominal organs) to eliminate cancer that may have spread beyond the testicle. RPLND is particularly valuable for patients with residual lymph node disease after chemotherapy or for those with low-volume metastatic disease to avoid the need for further systemic treatment.
RPLND requires meticulous surgical precision to preserve surrounding structures, including nerves responsible for ejaculation. In experienced hands, nerve-sparing techniques can help maintain reproductive function. The decision to proceed with RPLND depends on tumor staging, response to chemotherapy, and overall patient health.
Description
A complex surgery to remove lymph nodes in the retroperitoneum (behind the abdominal organs). Used for non-seminomatous germ cell tumours (NSGCTs) with lymph node involvement or residual disease after chemotherapy.
Benefits
Reduces the risk of cancer recurrence
Reduces the need for additional chemotherapy
Nerve-sparing techniques can help preserve ejaculation function
Post-Operative Care & Considerations
Hospital stay: 3-5 days
Impact: Possible impact on ejaculation
Follow-up: Usually consultation and CT scanning regularly with treating medical oncologist
Patient Resources
Beyond the Basics
Testicular cancer
Additional Considerations for Patients
Choosing the Right Treatment: The best treatment depends on cancer stage, overall health, and personal preferences. A consultation with an experienced urological surgeon like Dr. Dewar ensures the most suitable approach.
Importance of High-Volume Surgeons: Studies show that outcomes improve when surgeries are performed by experienced, high-volume specialists at advanced centers.