Seminomas account for about 30-40% of all testicular tumours. These are usually is found in men in their 30s and 40s. The condition is usually localised to the testes, although in about 25% of cases it has spread to lymph nodes. Non-seminomas account for 60% of all testicular tumours; subcategories of these tumours are listed below. Non-seminoma tumours often contain more than one of the following cell types: Testicular cancer is an abnormal, rapid, and invasive growth of cancerous (malignant) cells in the testicles. Embryonal carcinoma (about 20% of testicular cancers) occurs in 20-30 year olds and is highly malignant. It grows rapidly and spreads to the lung and liver. Yolk sac tumour (about 60% of all testicular cancers in young boys). Teratomata (about 7% of testicular cancers in adult men and 40% in young boys). Choriocarcinoma is rare. Stromal cell tumours are a kind of tumour that is made of Leydig cells (testosterone-secreting cells), Sertoli cells (cells where sperm matures), and granulose cells. These tumours account for only 3-4% of all testicular tumours. However, they do make up nearly 20% of all childhood testicular tumours. These tumours may secrete a hormone -- estradiol -- that can cause one of the symptoms of testicular cancer, gynecomastia (excessive development of breast tissue). This book presents leading-edge research in the field.
Testicular cancer (TC) is the most common cancer in males aged 20-40 years, with a worldwide incidence of 7.5 per 100,000, but the rates vary considerably between countries and ethnic groups and there is evidence also for an increasing incidence in last decades. About 95% of all TCs are represented by testicular germ cell tumors (TGCTs), which include seminoma and non-seminoma histological types. It is generally assumed that the development of TGCT is under endocrine control. In particular, unbalanced androgen/estrogen levels and/or activity are believed to represent the key events for TGCT development and progression. Furthermore, recent evidence has suggested genetic association of TGCT with variations in genes involved in hypothalamic-pituitary-testicular axis and steroidogenic enzymes. This recent evidence expands the current knowledge on the role of genetic contribution in testicular cancer susceptibility, and supports the hypothesis that variations in hormone metabolism genes might change the hormonal environment implicated in testicular carcinogenesis. Therefore, hormonal carcinogenesis is an important and controversial area of current research in TGCT, and further attention is given to genetic factors influencing hormone-related cancer risk. The genetic component to TGCT is in general strong. In fact, although environmental factors clearly contribute to TGCT development (and probably to its increasing incidence in some geographical areas), the proportion of TGCT susceptibility accounted for by the genetic effects is estimated at 25%. TGCT has high familial risks compared with most other cancer types that are generally no more than two-fold: brothers of individuals with TGCT have an 8- to 12-fold increased risk of disease, and sons of affected individuals have a 4- to 6-fold increased risk. Despite this strong familial relative risk, early results from linkage studies identified a limited relationship with genetic factors, suggesting that TGCT is a genetically complex trait. However, more recently, four genome-wide association studies (GWAS) from the UK and USA have reported association of TGCTs with six new loci (KITLG, SPRY4, BAK1, DMRT1, TERT, and ATF7IP). The strongest association for TGCT susceptibility was found for SNPs in KITLG (ligand for the membrane-bound receptor tyrosine kinase KIT) gene with a greater than 2.5-fold increased risk of disease per major allele, which is the highest reported for any cancer to date. These studies are being now replicated by other researches and attention is given to the relationship between these genetic variations, TGCT risk and frequently associated anomalies of the reproductive tract, such as cryptorchidism and infertility. Finally, over the past few decades, TCGT research has focused also on external environmental causes acting mainly as endocrine disrupters of androgen and oestrogen pathways, even during the foetal development of the testis. It is well known that the testicular dysgenesis syndrome (TDS) hypothesis, proposed ten years ago, suggests that disturbed testicular development in fetal life may result in one or more of four disorders postnatally, named cryptorchidism, hypospadias, poor semen quality, and TGCT. These four disorders are therefore considered as one clinical entity and are linked together by epidemiological and pathophysiological relations. The relative contribution of genetics and environment in TGCT development, and the interactions between endocrine disruptors and variations in genes involved in hormonal carcinogenesis is therefore another interesting area of research.
The field of gender-specific medicine examines how normal human biology and physiology differ between men and women and how the diagnosis and treatment of disease differs as a function of gender. This revealing research covers various conditions that predominantly occur in men as well conditions that predominantly occur in women. Among the areas of greatest difference are cardiovascular disease, mood disorders, the immune system, lung cancer as a consequence of smoking, osteoporosis, diabetes, obesity, and infectious diseases. The Second Edition of Principles of Gender-Specific Medicine focuses on the essentials of gender-specific medicine and the current study of sex and gender differences in human physiology and pathophysiology. New section editors, new chapter authors, and new chapters have been added to reflect the most up-to-date clinical research and practice. - Offers insight into how the gender-specific risks of one organ system's disease affects the health of other organ systems - Outlines the sex-specific differences of normal anatomy and physiology - Illustrates the gender-specific features and quantifies "gender" and "sex" as risk factors across all major diseases - Qualifies and analyzes the results of new drug therapies designed with gender-specific differences in mind: ex, hormone therapy in men and women for the prevention and treatment of cardiovascular disease - All chapters progress translationally from the basic science to the clinical applications of gender-specific therapies, drugs, or treatments - Sections on drug metabolism, aging, and meta-analysis of data incorporated into all disease-specific chapters
An updated and revised resource to evidence-based urology information and a guide for clinical practice The revised and updated second edition of Evidence-Based Urology offers the most current information on the suitability of both medical and surgical treatment options for a broad spectrum of urological conditions based on the best evidence available. The text covers each of the main urologic areas in specific sections such as general urology, oncology, female urology, trauma/reconstruction, pediatric urology, etc. All the evidence presented is rated for quality using the respected GRADE framework. Throughout the text, the authors highlight the most patient-important, clinical questions likely to be encountered by urologists in day-to-day practice. A key title in the “Evidence-Based” series, this revised and expanded edition of Evidence-Based Urology contains new chapters on a variety of topics including: quality improvement, seminoma, nonseminomatous germ cell tumor, penile cancer, medical prophylaxis, vesicoureteral reflux disease, cryptorchidism, prenatal hydronephrosis, and myelodysplasia. This updated resource: Offers a guide that centers on 100% evidence approach to medical and surgical approaches Provides practical recommendations for the care of individual patients Includes nine new chapters on the most recently trending topics Contains information for effective patient management regimes that are supported by evidence Puts the focus on the most important patient and clinical questions that are commonly encountered in day-to-day practice Written for urologists of all levels of practice, Evidence-Based Urology offers an invaluable treasure-trove of evidence-based information that is distilled into guidance for clinical practice.
Knowledge in the field of urologic pathology is growing at an explosive pace. Today’s pathologists, specialists, and residents require a comprehensive and authoritative text that examines the full range of urological diseases and their diagnosis. Written by recognized leaders and educators in the field, the text provides readers with a detailed understanding of all diagnostic aspects of urological disease. Inside this unique resource, readers will explore a broad spectrum of practical information—including etiology, diagnostic criteria, molecular markers, differential diagnosis, ancillary tests, and clinical management. This is sure to be the new definitive text for urological pathology!
This is the first comprehensive book devoted exclusively to cancer in adolescents and young adults. It compiles medical, epidemiological, biological, psychological, and emotional issues of young adults’ oncology. The emphasis is on the differences of the "same" cancer in younger and older patients. Model programs specially designed to care for patients in the age group and surveillance of long-term adverse effects are reviewed.
Some investigators have hypothesized that estrogens and other hormonally active agents found in the environment might be involved in breast cancer increases and sperm count declines in humans as well as deformities and reproductive problems seen in wildlife. This book looks in detail at the science behind the ominous prospect of "estrogen mimics" threatening health and well-being, from the level of ecosystems and populations to individual people and animals. The committee identifies research needs and offers specific recommendations to decision-makers. This authoritative volume: Critically evaluates the literature on hormonally active agents in the environment and identifies known and suspected toxicologic mechanisms and effects of fish, wildlife, and humans. Examines whether and how exposure to hormonally active agents occursâ€"in diet, in pharmaceuticals, from industrial releases into the environmentâ€"and why the debate centers on estrogens. Identifies significant uncertainties, limitations of knowledge, and weaknesses in the scientific literature. The book presents a wealth of information and investigates a wide range of examples across the spectrum of life that might be related to these agents.
This book provides the reader with a comprehensive understanding of both the basic principles and the clinical applications of nuclear oncology imaging techniques. The authors have assembled a distinguished group of leaders in the field who provide valuable insight on the subject. The book also includes major chapters on the cancer patient and the pathophysiology of abnormal tissue, the evaluation of co-existing disease, and the diagnosis and therapy of specific tumors using functional imaging studies. Each chapter is heavily illustrated to assist the reader in understanding the clinical role of nuclear oncology in cancer disease therapy and management.
This book provides, for the first time, a detailed, up-to-date, holistic approach to the pathology and biology of germ cell tumors. The main focus is the complex histopathology of these tumors, but special considerations are also given to their morphologic variations in relation to age, gender and organ. Critical updates are provided on terminology and classification; the discussion of biology and pathogenesis includes references to many molecular genetic and immunohistochemical findings from recent stem cell research. Individual chapters are devoted to germ cell tumors at different anatomic locations, including not only the ovaries and testes but also the mediastinum and central nervous system, and pediatric tumors. All of the contributing authors are opinion leaders from universities of excellence in Europe and the United States. This monograph will be of wide interest to practitioners and researchers in many fields of medicine, including pathology, gynecology, urology, and pediatrics, as well as stem cell scientists.
