Talk:Testicular cancer

From Wikipedia, the free encyclopedia

WikiProject Medicine This article is within the scope of WikiProject Medicine. Please visit the project page for details or ask questions at the doctor's mess.
B This page has been rated as B-Class on the quality assessment scale
Mid This article has been rated as Mid-importance on the importance assessment scale


Contents

[edit] Reversion

I've reverted this change, because it came from an anon with no other edits, and had no resources to back it up. However, it might be legitimate. It certainly doesn't look commercial, or like vandalism. Does anybody know about this? --Arcadian 13:59, 12 December 2005 (UTC)

I agree that my hypothesis requires scientific confirmations. I have sent this informations to scientists working on TC and probably in the near future I will know more about origin of germ cell tumors. My findings are based on informations from patients who suffered from TC —GCTalk.

Thanks for your response. I don't want to discourage you from contributing to Wikipedia, but we do have a policy here called Wikipedia:No original research. But if you can find other sources for your hypothesis, it may turn out to be a useful addition to Wikipedia. If you've got any questions, or if there's any way I can be of help, just ask on my talk page. --Arcadian 17:57, 13 December 2005 (UTC)
You did the right thing. I'm afraid that these undocumented arguments of the change are a complete nonsense, and shouldn't be in the wikipedia. Not only germ cell tumors are from unkown origin to date, with the exception of some weak links to some chemicals, but if semen where the trigger then, in example, a lot of women will suffer testicular cancer as well, that certainly is not the case.

Recent papers about possible association of seminal plasma and cervical cancer:

Muller M, Sales KJ, Katz AA, Jabbour HN. Seminal plasma promotes the expression of tumorigenic and angiogenic genes in cervical adenocarcinoma cells via the E-series prostanoid 4 receptor. Endocrinology. 2006 Jul;147(7):3356-65. Epub 2006 Mar 30. PMID: 16574793 [PubMed - indexed for MEDLINE]

Battersby S, Sales KJ, Williams AR, Anderson RA, Gardner S, Jabbour HN. Seminal plasma and prostaglandin E2 up-regulate fibroblast growth factor 2 expression in endometrial adenocarcinoma cells via E-series prostanoid-2 receptor-mediated transactivation of the epidermal growth factor receptor and extracellular signal-regulated kinase pathway. Hum Reprod. 2007 Jan;22(1):36-44. Epub 2006 Aug 12. PMID: 16905765 [PubMed - indexed for MEDLINE]—GCTalk


I am only trying to say that semen released outside spermatic cord into abdomen cavity can eventually cause testicular cancer. This situation, if occurs is not normal—GCTalk.

This has been discussed at great length in the scientific literature. One of the strongest arguments against this hypothesis is that there is little or no increase in testicular cancer in patients with vasectomies (even "little vs. no" is controversial). Please sign your comments. Novangelis 15:14, 16 May 2006 (UTC)

After Vasectomy seminal vesicle content (65% of the ejaculate volume) can only be released through ejaculatory ducts and in my opinion it can not be compared with semen vesicle rupture.

For example, blood inside veins is not dangerous for people. But blood released outside in brain can create clots that are swelling and it can completely paralyze one side of the body, or just affect one part such as an arm or a leg—GCTalk.

This argument is spurious -- it's not the blood, but the pressure that does the damage. The same volume of blood in the abdomen would cause some discomfort until it is resorbed. Novangelis 15:14, 16 May 2006 (UTC)

What is the reason of pressure?—GCTalk

I did some clean up. The most controversial thing I've done is remove Tim Stollery from the list of famous survivors for two reasons:

  1. I hate trying to define fame, but I didn't think he hit the threshold, and
  2. although he is in remission, I don't think he has been cancer free long enough to qualifiy him as a survivor.
Novangelis 17:34, 16 May 2006 (UTC)

There is a new non-invasive method reffered to as "MR-seminography" for examination of the genital tract. MR-seminography is reported to be useful for the diagnosis of disorders of the vas deferens, seminal vesicle, bladder and prostate.

Oh-oka H, Fujisawa M, Kin K, Oshima T, Okada H, Arakawa S, Kamidono S. Usefulness of MR-seminography using Gd-DTPA in intermediate magnetic field MRI equipment. Magn Reson Imaging. 2003 Jun;21(5):497-502.

Antisperm Antibody Test (ASA) test can probably be helpful in diagnosis of spermatic cord rupture. In a high percentage of testicular cancer patients (n=48) serum antisperm antibodies can be detected: 73.3 per cent before orchiectomy and 43.7 per cent overall. The percentage of patients with antibodies decreases with adequate therapy (Urology. 1985 Aug;26(2):139-42)—GCTalk.

[edit] Unexplained incidence increase

From article:

Worldwide incidence has doubled since the 1960s, with the highest rates of prevalence in Scandinavia, Germany, and New Zealand. Testicular cancer is uncommon in Asia and Africa.

There does not seem to be a good explanation for this. Many articles [1][2] say that birth cohort has a major influence. Another [3], if I read it correctly, find a slight correlation between TC and BMI, and TC and height. And why could incidence possibly be decreasing in Denmark [4] ?

I would like to improve the prevalence and distribution section of the article. Are there any theories I missed out? Similarly, have some things like diet or pesticide ingestion been shown to have no influence on testicular cancer at all?

-- Stereo (talk) 09:45, 4 January 2007 (UTC)

[edit] References

  1. ^ Bergström R, Adami H, Möhner M, Zatonski W, Storm H, Ekbom A, Tretli S, Teppo L, Akre O, Hakulinen T (1996). "Increase in testicular cancer incidence in six European countries: a birth cohort phenomenon.". J Natl Cancer Inst 88 (11): 727-33. PMID 8637026. 
  2. ^ Ekbom A, Akre O (1998). "Increasing incidence of testicular cancer--birth cohort effects.". APMIS 106 (1): 225-9; discussion 229-31. PMID 9524583. 
  3. ^ Bjørge T, Tretli S, Lie A, Engeland A (2006). "The impact of height and body mass index on the risk of testicular cancer in 600,000 Norwegian men.". Cancer Causes Control 17 (7): 983-7. PMID 16841265. 
  4. ^ Richiardi L, Bellocco R, Adami H, Torrång A, Barlow L, Hakulinen T, Rahu M, Stengrevics A, Storm H, Tretli S, Kurtinaitis J, Tyczynski J, Akre O (2004). "Testicular cancer incidence in eight northern European countries: secular and recent trends.". Cancer Epidemiol Biomarkers Prev 13 (12): 2157-66. PMID 15598775. 

McGlynn et al., (J Clin Oncol. 2005 Aug 20;23(24):5757-61.) found that the incidence of TGCT began to increase among African-American men between the 1988 to 1992 and 1993 to 1997 periods. Why TC incidence increases in African Americans in US but not in Africa?

Is there any relationship between sexual behavior and lower TC incidence in Africa and Asia?

Findings from a cross-cultural survey of 16,288 people across 10 major world regions showed that only men from Africa and East Asia expressed negative likelihoods of consenting to sex after knowing someone for “1-month” time period. Also number of desired sex partners was lower for men from Africa and Asia.

Schmitt D.P., Universal Sex Differences in the Desire for Sexual Variety: Tests From 52 Nations, 6 Continents, and 13 Islands Journal of Personality and Social Psychology, 2003, Vol. 85, No. 1, 85–104 —GCTalk

[edit] Alternative therapies

(This section was removed because it was unreferenced and remained so for three months. --Captaindan 04:46, 30 January 2007 (UTC))

There are alternative therapies favored by some to help fight testicular cancer. Studies have found that epigallocatechin gallate, found in green tea, has beneficial effects. It can bind to a protein on a tumor cell and slow its growth. Other active ingredients, quercetin and gallic acid, have also shown effectiveness, as well as the aqueous solutions of ardisia and yerba mate teas, as chemopreventative agents.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15450404

The diallyl sulfide component in garlic may be an effective inhibitor in the development of carcinogenic tumors, according to a number of studies which showed some preventative effect.

http://www.krysalis.net/cancer2.htm

Finally the maitake mushroom appears to both inhibit the growth of tumors as well as stimulate immunity. The particular active ingredient is a beta-glucan called D-fraction, which stimulates immune cells. In some cases extracts need to be injected, but the mushroom is effective orally and can be bought as a supplement. It's also been posited that the maitake might make chemotherapeutic drugs more effective, which means lower does of chemotherapy can be used.

[edit] Blood in semen?

This is an odd symptom to list. I've never heard of it as a TC symptom, and so I decided to look around online and they're never actually connected. It's a frequent worry apparently, since that's a scary symptom to have, but from my reading it's more indicative of a urinary tract infection, and really no more serious than a bloody nose. Consider this article from the Mayo Clinic What causes blood in semen? It's not listed as a symptom here, or here, and here it's listed as NOT a symptom. I'm going to take the symptom out, and if anyone wants to put it back in, I'd like to see a cite where this is a concrete symptom of TC. --Boradis 23:41, 2 February 2007 (UTC)

Thanks for the cite on the symptom, I've corrected the way it was placed and it works now. There seems to be some disagreement about this issue between the US and the UK. I'm more and more of the opinion that Wikipedia is the absolute LAST place to go to learn about medical issues. --Boradis 23:27, 9 February 2007 (UTC)
And I say the above because a page like this really needs a fully qualified and responsible MD reviewing and maintaining it. Us average Web shmoes aren't qualified to weigh these issues and make judgment calls about which symptoms are noteworthy or not. --Boradis 23:30, 9 February 2007 (UTC)

Germ cell tumors are known since 1972 (paper in Lancet). In paper published in 2005 we can only find that: “The aetiology and pathogenesis of neoplastic transformation of germ cells remain poorly understood and a number of outstanding questions are awaiting answers.” Cell Tissue Res. 2005 Oct;322(1):159-65. Only patients may know early symptoms of the disease. Medical doctors have second-hand information only.—GCTalk


I never knew that TC is more common in younger men than older men. Wonder why. This has to be one of the the only cancers like this.

There are several peer reviewed papers showing decreased volume of semen in TC patients(e.g. J Clin Oncol. 1999 Mar;17(3):941-7). Gandini et al., (Hum Reprod. 2003 Apr;18(4):796-801) showed that the difference in ejaculate volume between testicular cancer (n=232) and male Hodgkin's disease (HD) patients (n=110) was not statistically significant. Bothan et al., (Human Reproduction vol.12 no.1 pp.73–76, 1997) showed statistically significant difference in ejaculate volume between patients with Hodgkin’s disease (n=65) and non- Hodgkin’s lymphoma (n=18). From mathematical point of view we can ask where is the rest? One possible answer is that it stays somewhere inside and causes healthy problems leading to TC. TC can be more common in younger men (21-25 years) because they produce more semen than elderly men (above 50) (Andrologia. 2002 Apr;34(2):116-22) and usually they do not have as stable sexual life like elderly men. I think that spermatic cord has some limitations in terms of capacity, and weak abdomen pain probably caused by spermatic cord rupture (temporary state) may be recognized by patients as one of the first TC symptoms. —GCTalk

We have already discussed this. Please find a citation, and please sign your comments. —Captaindan 17:59, 14 February 2007 (UTC)

About pain I have found only few articles. Symptoms are described as back pain.

1. Cantwell BM, Mannix KA, Harris AL. Back pain--a presentation of metastatic testicular germ cell tumours.Lancet. 1987 Jan 31;1(8527):262-4.

2. Cantwell BM, MacDonald I, Campbell S, Millward MJ, Roberts JT. Back pain delaying diagnosis of metastatic testicular tumours. Lancet. 1989 Sep 23;2(8665):739-40.

Location of pain may be related to the site of retroperitoneal lymph node metastases.

3. Wilson JP, Cooksey G. Testicular pain as the initial presentation of testicular neoplasms. Ann R Coll Surg Engl. 2004 Jul;86(4):284-8.

Testicle pain represents in my opinion more advanced stage of the disease and at this point germ cell tumors can be find in testicle. Diagnosis is easier because of enlarged testicle. Apart from pain one more symptom can be characteristic for TC patients in early stages of the disease. The moment when spermatic cord can probably be ruptured.

Papers below are very interesting:

1. Rzeszutko M, Rzeszutko W, Nienartowicz E, Jelen M. Paratesticular localization of burned out non-seminomatous germ cell tumor--NSGCT: a case report. Pol J Pathol. 2006;57(1):55-7.

2. Radha S, Afroz T, Satyanarayana G. Paratesticular malignant peripheral nerve sheath tumour: a case report. Indian J Pathol Microbiol. 2006 Oct;49(4):614-5. —GCTalk

[edit] CLEANUP: Germ cell tumors

Some of the text on this page concerning germ cell tumors probably should be moved to that page. The text here is a little like blind men describe the elephant: only part of the story. --Una Smith 02:22, 1 July 2007 (UTC)

I'm sorry. English is my second language. The origin of germ cell tumors presents a neglected field of study. Dear Una please move or rewrite my sentences accordingly.—GCTalk

Will do. I have cleaned up germ cell tumor (the other page) and below are some stray references from there that may be useful for this article. --Una Smith 18:10, 28 July 2007 (UTC)

  • Crawford ED, Eisenberger MA, McLeod DG et al: Testicular Cancer
  • Catalona WJ, Bigg SW: Nerve-sparing radical prostatectomy: evaluation of results after 250 patients, J Urol 143:538-544, 1990.
  • Donohue JP, Thornhill JA, Foster RS et al: The role of retroperitoneal lymphadenectomy in clinical stage B testis cancer: the Indiana University experience (1965 to 1989), J Urol 153:85-89, 1995.

[edit] Staging

The section on staging needs a rewrite. Staging is not done by a pathologist; the pathologist sees only the in situ tumor, via a specimen. The pathology specimen might reveal evidence of infiltration into other tissues, but reveals nothing about regional lymph nodes nor distant mestastases. Staging is a team effort, involving pathologist, radiologist, surgeon(s), and oncologist. I recommend: leave all detailed explanations of staging to pages describing cancer staging. --Una Smith 16:30, 29 July 2007 (UTC)

[edit] Donald H. Bensen

Is this person actually famous? Also, the level of detail about his treatment and who he credits for support seems off-topic. --Intx13 17:07, 30 July 2007 (UTC)

[edit] Causes

Any notes on particular causes of this cancer? Have their been any particular risk factors such as, tight underwear, etc ? Rfwoolf (talk)

Yes, there are. I'll add a risk factors section as soon as I gather my sources. Novangelis (talk) 18:16, 20 January 2008 (UTC)

Are there any papers about mechanical properties of spermatic cord? Collagen is an integral part of many types of connective tissue. Activity of hydroxyprolines can also influence physicochemical properties of collagen depending on age. We can also speculate that genes coding for elastine, hydroxyprolines and different types of collagen can have point mutations that can predispose to spermatic cord rupture or translocation of seminal fluid to testicle (only speculation) and eventually to TC (GCTalk (talk) 01:33, 23 January 2008 (UTC)).

I'll look into this. I need to re-review the association with vasectomy which is related to the discussion of displaced seminal fluid. I need to look at the data before making a statement regarding vasectomy. I added some material, but couldn't find the paper I was looking for.Novangelis (talk) 05:24, 23 January 2008 (UTC)
According to Harrison's Principles of Internal Medicine, the causes are cryptorchism and isochromosome of the short arm of chromosome 12 are the main associations; excess copy number of 12p occurs in nearly all germ cell tumors. Several years ago, people were saying that excess testosterone, as in testosterone supplements, can increase the incidence of testicular cancer, but I don't know if they ever found good evidence. You might see a reference to it on the package insert of testosterone supplements. Nbauman (talk) 05:44, 23 January 2008 (UTC)
I read the Harrison's article. They had more risk factors in previous editions, but some recent articles have shaken up the traditional associations. The excess 12p is a rearrangement found in the tumor cells, but is not a risk factor. Determining the key genes in the rearrangement will provide a better understanding of the molecular pathogenesis. That's another aspect. Novangelis (talk) 06:36, 23 January 2008 (UTC)

[edit] Harvey Pekar

I pulled his inclusion from the list of notable survivors as he had lymphoma, as discussed in Our Cancer Year. Lymphoma can affect the testes, but is a different entity. I suggest documentation if he did, in fact, have testicular cancer, not just involvement. Novangelis (talk) 22:23, 15 February 2008 (UTC)

[edit] Figures do not add

Article says 1 in 250 men develop testicular cancer. There were 138 million men in the 2000 census. That means roughly 552,000 men get it in their life. Roughly an American life is 74 years, so there should be no more than 7459 diagnosis/year, not 8,000 to 9,000 as the article states.

71.198.177.64 (talk) 11:28, 25 March 2008 (UTC)

It is roughly 1 in 250, as the article states. If it were 1 in 200, there would be over 9,000 cases. The conservative round number is the one generally used. Your observation is well founded. I plan to review the literature a bit to see if the number has changed. It was <9000 in 2004, but the 2000 numbers will align with the census. For now, I don't recommend an uncited change (use a number from the relevant literature). This is a matter of being imprecise, not inaccurate and 1 in 250 often is better understood than 0.4%. Using 1 in 225 (0.45%) would be more accurate, but overly precise. Given the incidence has increased in recent years, the numbers should be checked. Thank you for taking a good look at the article and looking for ways to improve it.Novangelis (talk) 12:37, 25 March 2008 (UTC)
I finally got around to checking the numbers and you were right. I cited ACS numbers for 2003 and 2007, being the first and last to use the 2000 census data. Although the data does not affect raw number of cases, it may impact population derived statistics if used later in the article. I've broadened the range around my two timepoints, 7,600 (2003) and 7,920 (2007). I'd suggest that anyone using the ACS Cancer Facts and Figures not go back past 2003, especially if using population dependent numbers.Novangelis (talk) 20:00, 24 April 2008 (UTC)

[edit] Famous survivors

This section is (mostly unsourced) trivia that adds nothing to understanding the topic of testicular cancer. I don't think it's really all that appropriate in an encyclpedia article, the only use it has is as semi-interesting factoids and even then only if you've heard of any of the people listed. I definitely think it should be removed or at the very least trimmed. Thoughts? -- Naerii 20:44, 30 March 2008 (UTC)

[edit] External links

Wikipedia's external links policy and the specific guidelines for medicine-related articles do not permit the inclusion of external links to non-encyclopedic material, particularly including internet chat boards and e-mail discussion groups. Because I realize that most normal editors haven't spent much time with these policies, please let me provide specific information from the guidelines:

  • This page, which applies to all articles in the entire encyclopedia, says that links "to social networking sites (such as MySpace or Fan sites), discussion forums/groups (such as Yahoo! Groups), USENET newsgroups or e-mail lists" are to be avoided.
  • This page deprecates ""helpful" external links, such as forums, self-help groups and local charities."
  • This medical-specific page reinforces the pan-Wiki rules, with a note that "All links must meet Wikipedia's external links guidelines, which in particular exclude discussion forums."

Wikipedia is an encyclopedia, and while it may occasionally be useful to patients or their families, it is not an advertising opportunity for support groups. Please do not re-insert links that do not conform to the standard rules. Any editor, BTW, is welcome to read all of the rules and perform an "audit" in the remaining links. Thanks, WhatamIdoing (talk) 21:44, 16 April 2008 (UTC)

I followed your guidelines and removed external link. (GCTalk (talk)