Testicular Cancer New Insights On The Origin Genetics Treatment Fertility General Health Quality Of Life And Sexual Function

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.

This book provides andrologists and other practitioners with reliable, up-to-date information on all aspects of male infertility and is designed to assist in the clinical management of patients. Clear guidance is offered on classification of infertility, sperm analysis interpretation and diagnosis. The full range of types and causes of male infertility are then discussed in depth. Particular attention is devoted to poorly understood conditions such as unexplained couple infertility and idiopathic male infertility, but the roles of diverse disorders, health and lifestyle factors and environmental pollution are also fully explored. Research considered stimulating for the reader is highlighted, reflecting the fascinating and controversial nature of the field. International treatment guidelines are presented and the role of diet and dietary supplements is discussed in view of their increasing importance. Clinicians will find that the book’s straightforward approach ensures that it can be easily and rapidly consulted.

Written by international authorities, this book is aimed at clinicians dealing with male patients rendered infertile by cancer therapy.

It's obvious why only men develop prostate cancer and why only women get ovarian cancer. But it is not obvious why women are more likely to recover language ability after a stroke than men or why women are more apt to develop autoimmune diseases such as lupus. Sex differences in health throughout the lifespan have been documented. Exploring the Biological Contributions to Human Health begins to snap the pieces of the puzzle into place so that this knowledge can be used to improve health for both sexes. From behavior and cognition to metabolism and response to chemicals and infectious organisms, this book explores the health impact of sex (being male or female, according to reproductive organs and chromosomes) and gender (one's sense of self as male or female in society). Exploring the Biological Contributions to Human Health discusses basic biochemical differences in the cells of males and females and health variability between the sexes from conception throughout life. The book identifies key research needs and opportunities and addresses barriers to research. Exploring the Biological Contributions to Human Health will be important to health policy makers, basic, applied, and clinical researchers, educators, providers, and journalists-while being very accessible to interested lay readers.

In the past, pregnancy after cancer was largely unheard of. Today, it is increasingly a possibility. Oncofertility has emerged as an interdisciplinary field bridging biomedical and social sciences, and examining issues regarding an individual’s fertility options, choice and goals in light of cancer diagnosis, treatment and survivorship. Written by leaders in this evolving field, the volume covers various aspects: medical, ethical and social.

Immunoregulation is one of the areas which has witnessed the most explosive advances of immunology during the past decade. It is in this area that the current view of the immune system has arisen and developed. There is indeed little doubt that immune reactions are primarily determined by messages which are genera ted within the immune system and passed among different types of immunologie cells. This cell communication not only determines the type, intensity and duration of the response after perturbation of the immune system by exogenous antigens, but it is also essential for preventing autoimmune reactions and their clinical conse quences. In order to assure aperfect balance within the enormous com plexity of the immune system, it is not surprising that multiple self-regulatory mechanisms are organized at different levels, such as antibody feedback, idiotypic-anti-idiotypic responses, suppres sor and helper T cells, lymphokine signals and genetic require ments. A nu mb er of observations in recent years have, however, demonstrated that consistent contributions to the immunological homeostasis are given also by signals generated outside of the immune system, namely,in the central and autonomous nervous system as weIl as in the endocrine apparatus. Furthermore, the interactions between the immune system and the other body homestatic mechanisms seem to be bidirectional: if immunological cells may be targets of neuroendocrinological factors, immunological products seem in turn to contribute to the neuro endocrine homeostasis.

From the basic science underpinnings to the most recent developments in medical and surgical care, Campbell-Walsh-Wein Urology offers a depth and breadth of coverage you won’t find in any other urology reference. Now in three manageable volumes, the revised 12th Edition is a must-have text for students, residents, and seasoned practitioners, with authoritative, up-to-date content in an intuitively organized, easy-to-read format featuring key points, quick-reference tables, and handy algorithms throughout. Features shorter, more practical chapters that help you find key information quickly. Includes new chapters on Urinary Tract Imaging: Basic Principles of Nuclear Medicine · Ethics and Informed Consent · Incisions and Access · Complications of Urologic Surgery · Urologic Considerations in Pregnancy · Intraoperative Consultation · Special Urologic Considerations in Transgender Individuals · and more. Covers hot topics such as minimally invasive and robotic surgery; advancements in urologic oncology, including innovative therapeutics for personalized medicine; new approaches to male infertility; technological advances for the treatment of stones; and advances in imaging modalities. Incorporates current AUA/EAU guidelines in each chapter as appropriate Updates all chapters with new content, new advances, and current references and best practices. Extensively updated chapters include Urological Immunotherapy, Minimally Invasive Urinary Diversion, and Updated Focal Therapy for Prostate Cancer. Features more than 175 video clips, including all-new videos on perineal ultrasound, abdominoplasty in prune belly syndrome, partial penectomy, low dose rate brachytherapy, and many more. Written and edited by key opinion leaders, reflecting essential changes and controversies in the field.