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52-1072: GCT may refer to: Medicine [ edit ] Germ cell tumor Giant-cell tumor of bone Glucose challenge test Granulosa cell tumor Transport [ edit ] Gauge Change Train , a Japanese train Ghazipur City railway station , in Uttar Pradesh, India Grand Canyon Bar 10 Airport , in Arizona, United States Grand Central Terminal , in New York City Great Coates railway station in England Grimsby-Cleethorpes Transport , former municipal bus company of Grimsby and Cleethorpes , England Gwinnett County Transit , in Georgia, United States Other uses [ edit ] Galapagos Conservation Trust ,

104-451: A gonad , but many germ cell tumors are now known to be congenital and originate outside the gonads. The most notable of these is sacrococcygeal teratoma , the single most common tumor diagnosed in babies at birth. Of all anterior mediastinal tumors, 15–20% are GCTs of which about 50% are benign teratomas. Ovarian teratomas may be associated with anti-NMDA receptor encephalitis . Despite their name, GCTs occur both within and outside

156-402: A physical exam , ultrasound , and blood tests . Surgical removal of the testicle with examination under a microscope is then done to determine the type. Testicular cancer is highly treatable and usually curable. Treatment options may include surgery, radiation therapy , chemotherapy , or stem cell transplantation . Even in cases in which cancer has spread widely, chemotherapy offers

208-460: A 100% survival rate. The initial treatment for testicular cancer is surgery to remove the affected testicle ( orchiectomy ). While it may be possible, in some cases, to remove testicular cancer tumors from a testis while leaving the testis functional, this is almost never done, as the affected testicle usually contains pre-cancerous cells spread throughout the entire testicle. Thus removing the tumor alone without additional treatment greatly increases

260-410: A 50 times greater risk of GSTs. In these persons, GSTs usually contain nonseminomatous elements, present at an earlier age, and seldom are gonadal in location. Women with benign GCTs such as mature teratomas (dermoid cysts) are cured by ovarian cystectomy or oophorectomy . In general, all patients with malignant GCTs have the same staging surgery that is done for epithelial ovarian cancer . If

312-677: A British charity Genetic coding technologies , a frequently advertised investment area Geometric complexity theory German Colonial Tovar dialect of German, spoken in Venezuela Global Champions Tour , a show jumping series Gloucester County Times , a daily newspaper in New Jersey Government College of Technology (disambiguation) Grand Chess Tour , an annual circuit of chess tournaments Grande Cadence de Tir (GCT) 155mm , French self-propelled artillery vehicle Green Card Test , used by

364-486: A common form is teratoma with endodermal sinus tumor. Teratocarcinoma refers to a germ cell tumor that is a mixture of teratoma with embryonal carcinoma , or with choriocarcinoma , or with both. This kind of mixed germ cell tumor may be known simply as a teratoma with elements of embryonal carcinoma or choriocarcinoma, or simply by ignoring the teratoma component and referring only to its malignant component: embryonal carcinoma and/or choriocarcinoma. They can present in

416-679: A correlation between cystic and benign tumors, and conversely, solid and malignant tumors. Because the cystic extent of a tumor can be estimated by ultrasound, MRI, or CT scan before surgery, this permits selection of the most appropriate surgical plan to minimize risk of spillage of a malignant tumor. Access to appropriate treatment has a large effect on outcome. A 1993 study of outcomes in Scotland found that for 454 men with nonseminomatous (nongerminomatous) GCTs diagnosed between 1975 and 1989, five-year survival increased over time and with earlier diagnosis. Adjusting for these and other factors, survival

468-467: A cure rate greater than 80%. Globally testicular cancer affected about 686,000 people in 2015. That year it resulted in 9,400 deaths up from 7,000 deaths in 1990. Rates are lower in the developing than the developed world . Onset most commonly occurs in males 20 to 34 years old, rarely before 15 years old. The five-year survival rate in the United States is about 95%. Outcomes are better when

520-509: A family history of cancer, and the American Urological Association recommends monthly testicular self-examinations for all young men. Symptoms may also include one or more of the following: It is not very common for testicular cancer to spread to other organs, apart from the lungs. If it has, however, the following symptoms may be present: Testicular cancer, cryptorchidism , hypospadias , and poor semen quality make up

572-414: A lump in the testicle or swelling or pain in the scrotum . Treatment may result in infertility . Risk factors include an undescended testis , family history of the disease, and previous history of testicular cancer. More than 95% are germ cell tumors which are divided into seminomas and non-seminomas . Other types include sex-cord stromal tumors and lymphomas . Diagnosis is typically based on

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624-512: A pregnancy test is not very sensitive for making out testicular cancer. The stressful event of testicular cancer not only affects the patient that is diagnosed but also affects the caregiver. The psychological stress model consists of stressful experiences that a patient with testicular cancer may go through after diagnosis, that caregivers may want to look out for. The stressful experiences consist of 4 main categories: These side effects may need physical and emotional care which in turn can cause

676-562: Is associated with decreased risk and sedentary lifestyle is associated with increased risk. Early onset of male characteristics is associated with increased risk. These may reflect endogenous or environmental hormones . Higher rates of testicular cancer in Western nations have been linked to the use of cannabis. Most testicular germ cell tumors have too many chromosomes , and most often they are triploid to tetraploid . An isochromosome 12p (the short arm of chromosome 12 on both sides of

728-454: Is called retroperitoneal lymph node dissection (RPLND). However, this approach, while standard in many places, especially the United States, is out of favor due to costs and the high level of expertise required to perform successful surgery. Sperm banking is frequently carried out prior to the procedure (as with chemotherapy), as there is a risk that RPLND may damage the nerves involved in ejaculation, causing ejaculation to occur internally into

780-476: Is called PEB (or BEP), and consists of bleomycin , etoposide , and a platinum-based antineoplastic ( cisplatin ). Targeted treatments, such as immunotherapy, hormonal therapy and kinase inhibitors, are being evaluated for tumors that do not respond to chemotherapy. The 1997 International Germ Cell Consensus Classification is a tool for estimating the risk of relapse after treatment of malignant germ-cell tumor. A small study of ovarian tumors in girls reports

832-416: Is only given to the patients that need it. The number of patients ultimately cured is the same using surveillance as post-operative "adjuvant" treatments, but the patients have to be prepared to follow a prolonged series of visits and tests. For both non-seminomas and seminomas, surveillance tests generally include physical examination, blood tests for tumor markers, chest x-rays, and CT scanning . However,

884-422: Is performed by urologists ; radiation therapy is administered by radiation oncologists ; and chemotherapy is the work of medical oncologists . In most patients with testicular cancer, the disease is cured readily with minimal long-term morbidity . While treatment success depends on the stage, the average survival rate after five years is around 95%, and stage 1 cancer cases, if monitored properly, have essentially

936-435: Is proving to be a successful adjuvant treatment, with recurrence rates in the same ranges as those of radiotherapy . The concept of carboplatin as a single-dose therapy was developed by Tim Oliver, Professor of Medical Oncology at Barts and The London School of Medicine and Dentistry . However, very long-term data on the efficacy of adjuvant carboplatin in this setting do not exist. Since seminoma can recur decades after

988-699: Is shown to be as good at detecting relapses, it may be preferable to CT. For more advanced stages of testicular cancer, and for those cases in which radiation therapy or chemotherapy was administered, the extent of monitoring (tests) after treatment will vary on the basis of the circumstances, but normally should be done for five years in uncomplicated cases and for longer in those with higher risks of relapse. A man with one remaining testis may maintain fertile. However, sperm banking may be appropriate for men who still plan to have children, since fertility may be adversely affected by chemotherapy and/or radiotherapy . A man who loses both testicles will be infertile after

1040-567: Is three, or sometimes four, rounds of Bleomycin - Etoposide - Cisplatin (BEP). BEP as a first-line treatment was first reported by Professor Michael Peckham in 1983. The landmark trial published in 1987 which established BEP as the optimum treatment was conducted by Dr. Lawrence Einhorn at Indiana University . An alternative, equally effective treatment involves the use of four cycles of Etoposide - Cisplatin (EP). Lymph node surgery may also be performed after chemotherapy to remove masses left behind (stage 2B or more advanced), particularly in

1092-578: The AJCC Cancer Staging Manual. Testicular cancer is categorized as being in one of three stages ( which have subclassifications ). The size of the tumor in the testis is irrelevant to staging. In broad terms, testicular cancer is staged as follows: Further information on the detailed staging system is available on the website of the American Cancer Society . Although testicular cancer can be derived from any cell type found in

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1144-475: The anterior mediastinum . Some investigators suggest that this distribution arises as a consequence of abnormal migration of germ cells during embryogenesis. Others hypothesize a widespread distribution of germ cells to multiple sites during normal embryogenesis, with these cells conveying genetic information or providing regulatory functions at somatic sites. Extragonadal GCTs were thought initially to be isolated metastases from an undetected primary tumor in

1196-495: The histology of a specimen by a pathologist . Testicular tumors are best classified by radical inguinal orchiectomy, which allows for both histologic evaluation of the whole testicle and provides local tumor control. Most pathologists use the World Health Organization classification system for testicular tumors: The three basic types of treatment are surgery , radiation therapy , and chemotherapy . Surgery

1248-622: The ovary and testis . They are found in: } In females, GCTs account for 30% of ovarian tumors, but only 1 to 3% of ovarian cancers in North America . In younger women, they are more common, thus in patients under the age of 21, 60% of ovarian tumors are of the germ-cell type , and up to one-third are malignant . In males, GCTs of the testis occur typically after puberty and are malignant ( testicular cancer ). In neonates , infants , and children younger than 4 years, most are sacrococcygeal teratomas . Males with Klinefelter syndrome have

1300-496: The scrotum is often evaluated by scrotal ultrasound , which can determine exact location, size, and some characteristics of the lump, such as cystic vs solid, uniform vs heterogeneous, sharply circumscribed, or poorly defined. The extent of the disease is evaluated by CT scans , which are used to locate metastases . The differential diagnosis of testicular cancer requires examining the histology of tissue obtained from an inguinal orchiectomy —that is, surgical excision of

1352-509: The 2,300 men diagnosed each year in the U.K. were deemed cured, a rise by almost a third since the 1970s, the improvement attributed substantially to the chemotherapy drug cisplatin . In the United States, when the disease is treated while it is still localized, more than 99% of people survive 5 years. For many patients with stage I cancer, adjuvant (preventative) therapy following surgery may not be appropriate and patients will undergo surveillance instead. The form this surveillance takes, e.g.

1404-474: The UK, the procedure is known as a radical orchidectomy. In the case of non-seminomas that appear to be stage I, surgery may be done on the retroperitoneal / paraaortic lymph nodes (in a separate operation) to accurately determine whether the cancer is in stage I or stage II and to reduce the risk that malignant testicular cancer cells that may have metastasized to lymph nodes in the lower abdomen. This surgery

1456-738: The United States Internal Revenue Service Green Crescent Trust, in Sindh, Pakistan Greene County Tech School District , in Greene County, Arkansas, United States Greenwood Community Theatre , in South Carolina, United States GCT, a codon for the amino acid Alanine Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with the title GCT . If an internal link led you here, you may wish to change

1508-566: The affected testicle. The type of adjuvant therapy depends largely on the histology of the tumor (i.e., the size and shape of its cells under the microscope) and the stage of progression at the time of surgery (i.e., how far cells have 'escaped' from the testicle, invaded the surrounding tissue, or spread to the rest of the body). If the cancer is not particularly advanced, patients may be offered careful surveillance by periodic CT scans and blood tests, in place of adjuvant treatment. Before 1970, survival rates from testicular cancer were low. Since

1560-481: The bladder rather than externally. Many patients are instead choosing surveillance, where no further surgery is performed unless tests indicate that the cancer has returned. This approach maintains a high cure rate because of the growing accuracy of surveillance techniques. Since testicular cancers can spread, patients are usually offered adjuvant treatment —in the form of chemotherapy or radiotherapy —to kill any cancerous cells that may exist outside of

1612-455: The bloodstream) that are specific to testicular cancer. Alpha-fetoprotein , human chorionic gonadotropin (the "pregnancy hormone"), and LDH-1 are the typical tumor markers used to spot testicular germ cell tumors. A pregnancy test may be used to detect high levels of chorionic gonadotropin; however, the first sign of testicular cancer is usually a painless lump. Note that only about 25% of seminomas have elevated chorionic gonadotropin, so

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1664-449: The body. However, as more information about the genetics of these tumors become available, they may be classified based on specific gene mutations that characterize specific tumors. They are broadly divided in two classes: The two classes reflect an important clinical difference. Compared with germinomatous tumors, nongerminomatous tumors tend to grow faster, have an earlier mean age at time of diagnosis (around 25 years versus 35 years, in

1716-495: The caregiver an emotional burden. The American Academy of Family Physicians recommends against screening males without symptoms for testicular cancer. After removal, the testicle is fixed with Bouin's solution because it better conserves some morphological details such as nuclear conformation. Then the testicular tumor is staged by a pathologist according to the TNM Classification of Malignant Tumors as published in

1768-433: The case of testicular cancers ), and have a lower five-year survival rate. The survival rate for germinomatous tumors is higher in part because these tumors are very sensitive to radiation, and they also respond well to chemotherapy. The prognosis for nongerminomatous tumours has improved dramatically, however, due to the use of platinum-based chemotherapy regimens. Mixed germ cell tumors occur in many forms. Among these,

1820-440: The case of stage I seminomas, to minimize the likelihood that tiny, non-detectable tumors exist and will spread (in the inguinal and para-aortic lymph nodes ). Radiation is ineffective against and is therefore never used as a primary therapy for non-seminoma . Chemotherapy is the standard treatment for non-seminoma when the cancer has spread to other parts of the body (that is, stage 2B or 3). The standard chemotherapy protocol

1872-434: The cases of large non-seminomas . As an adjuvant treatment, use of chemotherapy as an alternative to radiation therapy in the treatment of seminoma is increasing, because radiation therapy appears to have more significant long-term side effects (for example, internal scarring, increased risks of secondary malignancies, etc.). Two doses, or occasionally a single dose of carboplatin , typically delivered three weeks apart,

1924-498: The disease remains localized. One of the first signs of testicular cancer is often a lump or swelling in the testes. The U.S. Preventive Services Task Force (USPSTF) recommends against routine screening for testicular cancer in asymptomatic adolescent and adults including routine testicular self-exams. However, the American Cancer Society suggests that some men should examine their testicles monthly, especially if they have

1976-434: The entire testis along with attached structures ( epididymis and spermatic cord ). A biopsy should not be performed, as it raises the risk of spreading cancer cells into the scrotum. Inguinal orchiectomy is the preferred method because it lowers the risk of cancer cells escaping. This is because the lymphatic system of the scrotum, through which white blood cells (and, potentially, cancer cells) flow in and out, links to

2028-528: The introduction of adjuvant chemotherapy , chiefly platinum-based drugs like cisplatin and carboplatin , the outlook has improved substantially. Although 7000 to 8000 new cases of testicular cancer occur in the United States yearly, only 400 men are expected to die of the disease. In the UK, a similar trend has emerged: since improvements in treatment, survival rates have risen rapidly to cure rates of over 95%. Radiation may be used to treat stage II seminoma cancers, or as adjuvant (preventative) therapy in

2080-429: The link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=GCT&oldid=1247169179 " Category : Disambiguation pages Hidden categories: Short description is different from Wikidata All article disambiguation pages All disambiguation pages Germ cell tumor GCTs are classified by their histology , regardless of location in

2132-429: The lower extremities, while that of the testicle links to the back of the abdominal cavity (the retroperitoneum ). A trans-scrotal biopsy or orchiectomy will potentially leave cancer cells in the scrotum and create two routes for cancer cells to spread, while in an inguinal orchiectomy, only the retroperitoneal route exists. Blood tests are also used to identify and measure tumor markers (usually proteins present in

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2184-414: The optimum frequency of scans and visits, and the schedules vary very widely across the world, and within individual countries. In the UK there is an ongoing clinical trial called TRISST. This is assessing how often scans should take place and whether magnetic resonance imaging (MRI) can be used instead of CT scans. MRI is being investigated because it does not expose the patient to radiation and so, if it

2236-697: The patient is in her reproductive years, an alternative is unilateral salpingoophorectomy , while the uterus, the ovary, and the fallopian tube on the opposite side can be left behind. This is not an option when the cancer is in both ovaries. If the patient has finished having children, the surgery involves complete staging, including salpingoophorectomy on both sides, as well as hysterectomy . Patients with germ-cell cancer often need to be treated with combination chemotherapy for at least three cycles, but female patients with early-stage disease may not require this treatment. The chemotherapy regimen most commonly used in GCTs

2288-558: The primary tumor is removed, patients receiving adjuvant chemotherapy should remain vigilant and not assume they are cured 5 years after treatment. Treatment of testicular cancer is one of the success stories of modern medicine, with sustained response to treatment in more than 90% of cases, regardless of stage. In 2011 overall cure rates of more than 95% were reported, and 80% for metastatic disease—the best response by any solid tumor, with improved survival being attributed primarily to effective chemotherapy. By 2013 more than 96 per cent of

2340-468: The radiation exposure. For patients treated for stage I non-seminoma, a randomized trial ( Medical Research Council TE08) showed that, when combined with the standard surveillance tests described above, 2 CT scans at 3 and 12 months were as good as 5 over 2 years in detecting relapse at an early stage. For patients treated for stage I seminoma who choose surveillance rather than undergoing adjuvant therapy, there have been no randomized trials to determine

2392-601: The requirements of a surveillance program differ according to the type of disease since, for seminoma patients, relapses can occur later, and blood tests are not as good at indicating relapse. CT scans are performed on the abdomen (and sometimes the pelvis) and also the chest in some hospitals. Chest x-rays are increasingly preferred for the lungs as they give sufficient detail combined with a lower false-positive rate and significantly smaller radiation dose than CT. The frequency of CT scans during surveillance should ensure that relapses are detected at an early stage while minimizing

2444-402: The risk that another cancer will form in that testicle. Since only one testis is typically required to maintain fertility, hormone production, and other male functions, the affected testis is almost always removed completely in a procedure called inguinal orchiectomy . (The testicle is almost never removed through the scrotum; an incision is made beneath the belt line in the inguinal area.) In

2496-576: The same centromere) is present in about 80% of the testicular cancers, and also the other cancers usually have extra material from this chromosome arm through other mechanisms of genomic amplification. The main way testicular cancer is diagnosed is via a lump or mass inside a testis. More generally, if a young adult or adolescent has a single enlarged testicle, which may or may not be painful, this should give doctors reason to suspect testicular cancer. Other conditions may also have symptoms similar to testicular cancer: The nature of any palpated lump in

2548-452: The syndrome known as testicular dysgenesis syndrome . A major risk factor for the development of testis cancer is cryptorchidism (undescended testicles). It is generally believed that the presence of a tumor contributes to cryptorchidism; when cryptorchidism occurs in conjunction with a tumor then the tumor tends to be large. Other risk factors include inguinal hernias , Klinefelter syndrome , and mumps orchitis . Physical activity

2600-402: The testicles, more than 95% of testicular cancers are germ cell tumors (GCTs). Most of the remaining 5% are sex cord–gonadal stromal tumours derived from Leydig cells or Sertoli cells . Correct diagnosis is necessary to ensure the most effective and appropriate treatment. To some extent, this can be done via blood tests for tumor markers , but definitive diagnosis requires examination of

2652-403: The type and frequency of investigations and the length time it should continue, will depend on the type of cancer ( non-seminoma or seminoma ), but the aim is to avoid unnecessary treatments in the many patients who are cured by their surgery, and ensure that any relapses with metastases (secondary cancers) are detected early and cured. This approach ensures that chemotherapy and or radiotherapy

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2704-399: Was 60% higher for men treated in a cancer unit that treated the majority of these men, though the unit treated more men with the worst prognosis. Choriocarcinoma of the testicles has the worst prognosis of all germ-cell cancers. Testicular cancer Testicular cancer is feinous that develops in the testicles , a part of the male reproductive system . Symptoms may include

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