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Urology (Expert Forum)
A series of questions
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
A series of questions
by Kobi, Oct 30, 2003 12:00AM
My partner, who is 61, has a lump in his scrotum. Our doctor said that given his age, testicular cancer is highly unlikely.
The urologist looked at the ultrasound and because there's some fluid which makes ot hard to determine the lump's nature, says we need to do a biopsy to determine what this "suspicous mass" is.
I checked this site and saw reference to an MRI as a next possible step. We raised this and the urologist said an MRI isn't standard procedure and anyway wouldn't tell us anything.
Now, is there blood work that could tell us if the lump is cancerous or not and thus possibly preclude the need for a biopsy?
How likely is it that the lump may be benign? My partner has no history of testicular cancer in his family, did not have an undescended testicle, or any of the other "markers" we've found mentioned on avrious medical web sites.
If the lump is cancerous, however, what are the potential side effects of removing the testicle? And must it always be removed? What about potential psychological problems attendant to the removal? And if the lump is benign, what are the potential side effects of the biopsy itself?
The urologist looked at the ultrasound and because there's some fluid which makes ot hard to determine the lump's nature, says we need to do a biopsy to determine what this "suspicous mass" is.
I checked this site and saw reference to an MRI as a next possible step. We raised this and the urologist said an MRI isn't standard procedure and anyway wouldn't tell us anything.
Now, is there blood work that could tell us if the lump is cancerous or not and thus possibly preclude the need for a biopsy?
How likely is it that the lump may be benign? My partner has no history of testicular cancer in his family, did not have an undescended testicle, or any of the other "markers" we've found mentioned on avrious medical web sites.
If the lump is cancerous, however, what are the potential side effects of removing the testicle? And must it always be removed? What about potential psychological problems attendant to the removal? And if the lump is benign, what are the potential side effects of the biopsy itself?
Doctor's Answer
by Kevin Pho, MD, Nov 02, 2003 12:00AM
, Nov 02, 2003 12:00AM
It is difficult to give odds on whether the lump is benign or not. It typically occurs in younger men, but can occur at age 61.
CT scan would be the next step in evaluation if the ultrasound is not conclusive - it is used to find any swollen lymph nodes around the area that may be associated with cancer.
There are several serum tumor markers that may be elevated in the blood in the presence of testicular cancer. They include alpha fetoprotein (AFP), the beta subunit of human chorionic gonadotropin (beta-hCG), and lactate dehydrogenase (LDH). They are typically drawn in those who are suspected to have testicular cancer.
The best test would be the biopsy - this should be considered if there is still concern about the diagnosis. Side effects of any biopsy would include bleeding or infection. This should be discussed with the urologist.
Surgery, radiation treatment and chemotherapy are all used in the treatment of testicular cancer. The decision to use which modality is based on the type and spread of the cancer.
Questions on testicular cancer treatment (i.e. side effects) can be found here:
http://www.cancer.org/docroot/CRI/content/CRI_2_4_5X_What_happens_after_treatment_41.asp
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
CT scan would be the next step in evaluation if the ultrasound is not conclusive - it is used to find any swollen lymph nodes around the area that may be associated with cancer.
There are several serum tumor markers that may be elevated in the blood in the presence of testicular cancer. They include alpha fetoprotein (AFP), the beta subunit of human chorionic gonadotropin (beta-hCG), and lactate dehydrogenase (LDH). They are typically drawn in those who are suspected to have testicular cancer.
The best test would be the biopsy - this should be considered if there is still concern about the diagnosis. Side effects of any biopsy would include bleeding or infection. This should be discussed with the urologist.
Surgery, radiation treatment and chemotherapy are all used in the treatment of testicular cancer. The decision to use which modality is based on the type and spread of the cancer.
Questions on testicular cancer treatment (i.e. side effects) can be found here:
http://www.cancer.org/docroot/CRI/content/CRI_2_4_5X_What_happens_after_treatment_41.asp
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
