What Impact Did an Undescended Testicle Have on This Young Man’s Risk for Developing Testicular Cancer?
Men with undescended testicles are at increased risk of developing testicular cancer. If the undescended testicle is not in the groin but in the abdomen, the risk is even higher (Cheng et al., 2018). Surgical repair of undescended testicles can reduce, but not eliminate, the risk of future testicular cancer. Thus, an undescended testicle at an early age was the reason behind the increased risk of testicular cancer.
What Might be the Side Effects of Cytotoxic Chemotherapy?
All cytostatics used for chemotherapy are substances with high biological activity. The lack of a selective effect on the tumor leads to the effect of the drug on many normal organs and tissues, primarily those that are characterized by a high pool of rapidly renewing cells. The latter include bone marrow, gastrointestinal mucosa, hair follicles, and others (NHS Lothian Joint Formulary, n.d.). The most characteristic and inherent side effect of most cytostatics is the inhibition of hematopoiesis, manifested by leukopenia (neutropenia), thrombocytopenia, and anemia (NHS Lothian Joint Formulary, n.d.).
Myelosuppression, which is the primary dose-limiting factor for many anticancer drugs, is due to the antiproliferative effect on hematopoietic cells, leading to their death and blocking proliferation and maturation. Typical for almost all cytostatics are toxic effects from the gastrointestinal tract (nausea, vomiting, stomatitis, diarrhea) (NHS Lothian Joint Formulary, n.d.). Stomatitis, a frequent manifestation of the toxic effect of many cytostatics, is also the result of the drugs on the oral mucosa’s intensively proliferating cells.
Common skin changes during cytotoxic chemotherapy include rash, redness, itching, and dry skin. In addition, hair loss is common with certain medications. Some chemotherapy drugs cause darkening or other discoloration of the skin, nails, or hair. Damaged skin often becomes discolored; for example, the patient may have dark streaks at the site of itching. Detachment of nails from the nail bed on the fingers and toes can sometimes be observed.
Neurotoxicity can manifest itself in various parts of the nervous system. Symptoms most often include disturbances in attention, memory, emotional disorders, and a decrease in general tone. Hallucinations and excitement should be considered serious complications. Peripheral neurotoxicity manifests itself in the form of a slight tingling sensation in the fingers, dysfunction of the upper and lower extremities, bloating, and impairment of vision and hearing.
Several cytostatics have a significant local irritating effect. This type of chemotherapy is also accompanied by developing the so-called flu-like syndrome (fever, headache, chills, myalgia, asthenia), which usually develops a few hours after the drug is administered and lasts up to two days (NHS Lothian Joint Formulary, n.d.). Almost all cytostatics are potent immunosuppressants, which is associated with a cytotoxic effect on immunocompetent cells. When treating with cytostatics, it is possible to suppress various immune systems with the ensuing consequences. Most anticancer drugs have mutagenic, teratogenic, and carcinogenic properties, and therefore, their use is not recommended for pregnant women and during breastfeeding.
What was the Purpose of Preserving His Sperm Before Chemotherapy?
During chemotherapy, it is necessary to use reliable mechanical contraception (condoms). Importantly, men planning to conceive children after completion of treatment are advised to store sperm in a special bank (Cheng et al., 2018). The process must be done before starting treatment. Thus, preserving his sperm before chemotherapy was done with the purpose to provide the patient an opportunity to conceive children after the treatment.
Is This Young Man’s Age Typical for the Development of Testicular Carcinoma?
This young man’s age is typical for testicular carcinoma development since one of the major risk groups for this diagnosis is men aged 14-40 years (Cheng et al., 2018). The proportion of testicular tumors is from 1 to 1.5% in the structure of the overall cancer incidence among men and 5% of all tumors of the genitourinary system (Cheng et al., 2018). The incidence of testicular cancer does not increase with age, but peaks between the ages of 25-and 34.
References
Cheng, L., Albers, P., Berney, D. M., Feldman, D. R., Daugaard, G., Gilligan, T., & Looijenga, L. H. (2018). Testicular cancer. Nature Reviews Disease Primers, 4(1), 1-24.
NHS Lothian Joint Formulary (n.d.). Cytotoxics. Web.