About this episode
Ninja Nerds! In this episode of the Ninja Nerd Podcast, Zach and Rob discuss testicular cancer, one of the most common solid tumors in young adult men. We begin with a classic clinical vignette of a young male presenting with a painless testicular mass. From there, we explore the epidemiology and key risk factors for testicular germ cell tumors, including cryptorchidism, family history, and Klinefelter syndrome (in rare cases of nonseminomatous tumors like mediastinal choriocarcinoma). We then distinguish between the two major types: seminomas and nonseminomas—breaking down their unique biological behaviors and typical age distributions. Our discussion dives deep into the pathophysiology of germ cell tumors, highlighting tumor markers like AFP, β-hCG, and LDH, and how they guide diagnosis and treatment. We walk through the classic presentations of seminomas (often β-hCG positive and radiosensitive) versus nonseminomas (associated with aggressive behavior and elevated AFP/β-hCG levels). Next, we focus on the diagnostic workup, including scrotal ultrasound, serum tumor marker analysis, and CT imaging for staging. We emphasize the importance of inguinal orchiectomy as both a diagnostic and therapeutic intervention. Finally, we cover treatment strategies based on stage and histology—ranging from surveillance and radiation therapy for early-stage seminomas to cisplatin-based chemotherapy regimens and retroperitoneal lymph node dissection (RPLND) for advanced or nonseminomatous disease. Don’t miss it—let’s get into it, Ninja Nerds! Support the show