The professional guide to cancer diagnosis and therapy for researchers and clinicians
In Fundamentals of Cancer Detection, Treatment, and Prevention, distinguished researcher Surya K. De delivers a concise and authoritative guide to cancer treatment, diagnosis, and prevention. The book offers a comprehensive overview of cancer in humans, from its causes, symptoms, and diagnosis to the variety of treatment options available today. Intuitively organized by cancer type, this guide provides concise information on risk factors, diagnosis, and treatment options for all commonly encountered tumors, including surgery, radiation therapy, chemotherapy, and immunotherapy.
All US FDA-approved drugs - like small molecules, peptides, monoclonal antibodies, whole antibodies, gene therapy, antibody-drug conjugates, and cell therapies - are considered, and information about their generic and brand names, clinical uses, and mechanisms of action is presented. Readers will also find: - A thorough overview of human cancers, including cancer risk factors and possible preventions - Comprehensive explorations of bladder, blood, brain, and spinal cord cancers - Practical discussions of breast, colorectal, cervical, kidney, and liver cancer - In-depth examinations of lung, skin, ovarian, vaginal, vulvar, pancreatic, and prostate cancers, as well as mesothelioma
Perfect for pharmaceutical chemists, oncologists, pharmacologists, and medicinal chemists, Fundamentals of Cancer Detection, Treatment, and Prevention is an indispensable guide for professional researchers, whether they are working in the clinic or the pharmaceutical industry.
Table of Contents
Preface xxiii
About the Book xxv
About the Author xxvii
Common Abbreviations and Acronyms xxix
1 An Overview of Cancer 1
1.1 Introduction 1
1.2 Cancer Statistics 1
1.3 Differences Between Normal Cells and Cancer Cells 2
1.4 Types of Cancer 4
1.4.1 Carcinomas 4
1.4.2 Sarcomas 4
1.4.3 Leukemias 4
1.4.4 Lymphomas 4
1.5 The Role of Genes and Chromosomes 5
1.6 Genetic Mutations 7
1.6.1 Acquired Mutations 7
1.6.2 Germline Mutations 7
1.7 Genes Connected to Cancer 7
1.7.1 Tumor Suppressor Genes 7
1.7.2 Oncogenes 8
1.7.3 DNA Repair Genes 8
1.8 Tumors and Metastasis 9
1.9 Hereditary Cancer Risk 10
1.10 Cancer Screening and Diagnosis 10
1.10.1 Colon Cancer 11
1.10.2 Lung Cancer 11
1.10.3 Breast/Cervical/Ovarian/Endometrial Cancers 11
1.10.4 Prostate Cancer 12
1.10.5 Liver Cancer 12
1.10.6 Skin Cancer 12
1.11 Cancer Treatment Options 13
1.11.1 Surgery 13
1.11.2 Radiation Therapy 13
1.11.3 Chemotherapy 14
1.11.4 Targeted Therapy 14
1.11.5 Immunotherapy 14
1.11.6 Hormone Therapy 14
1.11.7 Stem Cell Transplant 15
1.11.8 Precision Medicine 15
References 15
2 Cancer Risk Factors and Prevention 21
2.1 Introduction 21
2.2 Hormones 21
2.3 Immunosuppression and Infectious Agents 22
2.4 Chronic, Long-term, DNA-damaging Inflammation 23
2.5 Being Overweight/Obese 23
2.6 Eating to Win 24
2.6.1 Vegetables 26
2.6.2 Fruits 26
2.6.3 Grains 26
2.6.4 Proteins 26
2.6.5 Bread 26
2.6.6 Cereal 26
2.6.7 Dairy 26
2.6.8 Snacks 26
2.6.9 Beverages 26
2.6.10 Spices 27
2.7 Role of Sugar and Artificial Sweeteners on Cancer 27
2.8 Role of Certain Foods and Drinks on Cancer 27
2.8.1 Processed Meat and Fish 27
2.8.2 Alcohol 28
2.9 Role of Smoking or Tobacco Use on Cancer 29
2.10 Role of Radiation on Cancer 30
2.11 Role of Sunlight and UV Radiation on Cancer 31
2.12 Role of Radon on Cancer 33
2.13 Known Human Carcinogens 33
2.13.1 Arsenic, Coal Tar, Coal-tar Pitch, Diesel, Asbestos, Formaldehyde, and Air Pollutants 33
2.13.2 Certain Types of Plastic 37
2.13.3 Acrylamide 37
2.14 Possible Human Carcinogens 39
2.15 Guidelines for Early Detection of Cancer 39
References 40
Further Reading 50
3 Bladder Cancer 51
3.1 Introduction 51
3.2 Genes Associated with Bladder Cancer 51
3.3 Types of Bladder Cancer 51
3.4 Symptoms of Bladder Cancer 52
3.5 Diagnosis 52
3.6 Methods of Treatment 53
3.6.1 Surgical Transurethral Resection of Bladder Tumor (TURBT) 53
3.6.2 Radiation Therapy 53
3.6.3 Photodynamic Therapy 53
3.6.4 Chemotherapy 53
3.6.5 Targeted Therapy 53
3.6.6 Immunotherapy 53
3.7 Treatment Regimens 54
3.8 Risk Factors/Possible Prevention 57
References 57
4 Cancers of the Blood 67
4.1 Introduction 67
4.2 Genes Associated with Blood Cancer 67
4.3 Types of Blood Cancers 68
4.4 Blood Cancer Symptoms 70
4.5 Diagnosis 70
4.6 Methods of Treatment 70
4.6.1 Stem Cell Transplantation 71
4.6.2 Targeted Radiation Therapy 71
4.6.3 Chemotherapy 71
4.6.4 Targeted Drug Therapy 71
4.7 List of Drugs for Different Types of Blood Cancers 71
4.7.1 Drugs for Acute Lymphoblastic Leukemia 71
4.7.2 Drugs for Acute Myeloid Leukemia (AML) 71
4.7.3 Drugs for Chronic Lymphocytic Leukemia 72
4.7.4 Drugs for Chronic Myelogenous Leukemia (CML) 72
4.7.5 Drugs for Hairy Cell Leukemia 72
4.7.6 Drug(s) for Mast Cell Leukemia 72
4.7.7 Drug(s) for Meningeal Leukemia 72
4.7.8 Drugs for Hodgkin Lymphoma 72
4.7.9 Drugs for Non-Hodgkin Lymphoma 72
4.7.10 Drugs for Multiple Myeloma and Other Plasma Cell Neoplasms 73
4.8 Leukemia Treatment regimens 73
4.8.1 Treatment Regimens for Acute Lymphocytic (Lymphoblastic) Leukemia (ALL) 73
4.8.2 Acute Myeloid (or Myelogenous) Leukemia (AML) Treatment Regimens 76
4.8.3 Chronic Lymphocytic Leukemia Treatment Regimens 80
4.8.4 Chronic Myeloid Leukemia (CML) Treatment Regimens 83
4.8.5 Hairy Cell Leukemia Treatment Regimens 85
4.9 Hodgkin’s Lymphoma Treatment Regimens 85
4.10 Non-Hodgkin’s Lymphoma Treatment Regimens 89
4.11 Cutaneous T-Cell Lymphoma Treatment Regimens 96
4.12 Primary CNS Lymphoma Treatment Regimens 97
4.13 Multiple Myeloma Treatment Regimen 98
4.14 Risk Factors and Possible Preventions 105
References 105
5 Brain and Spinal Cord Tumors 133
5.1 Introduction 133
5.2 Genes Associated with Brain Cancer 133
5.3 Types of Primary Brain Tumors for Adults 133
5.3.1 Astrocytoma 134
5.3.2 Oligodendroglioma 135
5.3.3 Meningioma 135
5.4 Types of Brain Cancer for Children 135
5.4.1 Medulloblastoma 135
5.4.2 Grade I or II Astrocytoma 135
5.4.3 Ependymoma 135
5.4.4 Brainstem Glioma 135
5.5 Brain Tumor Symptoms 136
5.6 Diagnosis 136
5.6.1 Neurological Exam 136
5.6.2 Imaging Tests 136
5.6.3 Biopsy 137
5.7 Methods of Treatment 137
5.7.1 Surgery 137
5.7.2 Radiation Therapy 137
5.7.3 Radiosurgery 137
5.7.4 Chemotherapy 137
5.7.5 Targeted Drug Therapy 138
5.8 Treatment Regimens 138
5.9 Post-Treatment Rehabilitation 141
5.10 Risk Factors/Possible Preventions 141
References 142
6 Breast Cancer 151
6.1 Introduction 151
6.2 Genes Associated with Breast Cancer (Pathophysiology) 151
6.3 Describing Breast Cancer 151
6.4 Breast Cancer Symptoms 153
6.5 Diagnosis 153
6.5.1 Breast Examination 153
6.5.2 Imaging Tests 153
6.5.3 Biopsy 153
6.6 Methods of Treatment 154
6.6.1 Surgery 154
6.6.1.1 Lumpectomy 154
6.6.1.2 Mastectomy 154
6.6.1.3 Sentinel Node Biopsy 154
6.6.1.4 Axillary Lymph Node Dissection 154
6.6.1.5 Reconstruction 154
6.6.2 Radiation Therapy 154
6.6.3 Chemotherapy 155
6.6.4 Hormone-Blocking Therapy 155
6.6.5 Targeted Therapy 155
6.6.6 Immunotherapy 155
6.6.7 Abbreviations for a Chemotherapy Combination Used to Treat Breast Cancer 156
6.6.8 Drugs to Prevent Breast Cancer 156
6.7 Drugs for Breast Cancer in Men 156
6.8 Treatment Regimens 157
6.8.1 Preoperative/Adjuvant Therapy Regimens for HER2-Negative Breast Cancer 157
6.8.2 Preoperative/Adjuvant Therapy Regimens for HER2-Positive Breast Cancer 160
6.8.3 Systemic Therapy for ER- and/or PR-Positive Recurrent or Stage IV (M1) Disease: HER2-Negative and Postmenopausal or Premenopausal Receiving Ovarian Ablation or Suppression 162
6.8.4 Systemic Therapy Regimens for Recurrent/Unresectable/Advanced/ Metastatic Stage IV Breast Cancer: Regimens for HER2-Negative Disease 165
6.8.5 Systemic Therapy for ER- and/or PR-Positive Recurrent or Stage IV (M1) Disease: Regimens for HER2-Positive Postmenopausal or Premenopausal Receiving Ovarian Ablation or Suppression 169
6.8.6 Systemic Therapy Regimens for Recurrent/Unresectable/Advanced/ Metastatic Stage IV Breast Cancer: Regimens for HER2-Positive Disease 172
6.9 Risk Factors/Possible Preventions 176
References 177
7 Colorectal Cancer 193
7.1 Introduction 193
7.2 Genes Associated with Colorectal Cancer 193
7.3 Colorectal Cancer Symptoms 193
7.4 Stages 195
7.5 Diagnosis 195
7.6 Methods of Treatment 195
7.6.1 Surgery 196
7.6.2 Radiation Therapy 196
7.6.3 Chemotherapy 196
7.6.4 Targeted Therapy 196
7.6.5 Immunotherapy 196
7.7 Drugs to Anal Cancer 197
7.8 Drugs to Prevent Anal Cancer 197
7.8.1 Treatment Regimens for Colorectal Cancer: Adjuvant/Advanced/Metastatic Disease 197
7.8.2 Systemic Therapy for Advanced or Metastatic Disease 198
7.8.3 Treatment Regimens for Anal Cancer: Regimens for Localized Stage 205
7.8.4 Treatment Regimens for Anal Cancer: Metastatic Stage 205
7.9 Risk Factors/Possible Preventions 207
References 207
8 Cervical Cancer 219
8.1 Introduction 219
8.2 Causes of Cervical Cancer 219
8.3 Symptoms of Cervical Cancer 219
8.4 Diagnosis 220
8.5 Methods of Treatment 221
8.5.1 Surgery 221
8.5.2 Radiation Therapy 221
8.5.3 Chemotherapy 221
8.5.4 Targeted Therapy 221
8.5.5 Immunotherapy 221
8.6 Vaccines to Prevent Cervical Cancer 221
8.7 Treatment Regimens: Systemic Therapy for Recurrent or Metastatic Cervical Cancer 222
8.8 Risk Factors/Possible Preventions 225
References 225
9 Kidney Cancer 233
9.1 Introduction 233
9.2 Genes Associated with Kidney Cancer 233
9.3 Types of Kidney Cancer 234
9.4 Kidney Cancer Symptoms 234
9.5 Diagnosis 234
9.5.1 Urine Tests 235
9.5.2 Blood Tests 235
9.5.3 Biopsy 235
9.5.4 Intravenous Pyelogram 235
9.5.5 Ultrasound 235
9.5.6 Computed Tomography Scan 235
9.5.7 Magnetic Resonance Imaging 235
9.5.8 Renal Arteriogram 235
9.6 Kidney Cancer Stages 236
9.7 Methods of Treatment 236
9.7.1 Simple Nephrectomy 236
9.7.2 Partial Nephrectomy 236
9.7.3 Radical Nephrectomy 237
9.7.4 Radiofrequency Ablation 237
9.7.5 Arterial Embolization 237
9.7.6 Cryotherapy 237
9.7.7 Radiation Therapy 237
9.7.8 Chemotherapy 237
9.7.9 Targeted Drug Therapy 237
9.7.10 Immunotherapy 237
9.7.11 Complementary or Alternative Treatment 238
9.7.12 Drugs for Upper Tract Urothelial Cancer 238
9.7.13 Drugs for Wilms’ Tumor and Other Childhood Kidney Cancers 238
9.8 Treatment Regimens 238
9.9 Risk Factors/Possible Preventions 240
References 241
10 Liver (Hepatocellular) Cancer 247
10.1 Introduction 247
10.2 Gene Associated with Liver Cancer and Role of Hepatitis Infection 247
10.3 Liver Cancer Symptoms 247
10.4 Diagnosis 248
10.5 Methods of Treatment 249
10.5.1 Surgery 249
10.5.2 Liver Transplant 249
10.5.3 Ablation Therapies 249
10.5.4 Embolization 249
10.5.5 Radiation Therapy 249
10.5.6 Chemotherapy 249
10.5.7 Targeted Therapy 249
10.5.8 Immunotherapy 250
10.6 Treatment Regimens 250
10.7 Liver (Hepatocellular) Cancer Risk Factors/Possible Preventions 252
References 252
11 Lung Cancer 259
11.1 Introduction 259
11.2 Genes Associated with Lung Cancer 259
11.3 Types of Lung Cancer 260
11.4 Symptoms of Lung Cancer 260
11.5 Diagnosis 261
11.5.1 Imaging Tests 261
11.5.2 Sputum Cytology 262
11.5.3 Tissue Biopsy 262
11.6 Methods of Treatment 262
11.6.1 Surgery 262
11.6.2 Radiation Therapy 262
11.6.3 Chemotherapy 262
11.6.4 Targeted Drug Therapy 262
11.6.5 Immunotherapy 263
11.6.6 Drugs by Types of Lung Cancer 263
11.6.6.1 Drugs for Non-Small Cell Lung Cancer 263
11.6.6.2 Drugs for Small Cell Lung Cancer 263
11.7 Treatment Regimens 264
11.7.1 Treatment Regimens for Non-Small Cell Lung Cancer 264
11.7.2 Treatment Regimens for Small Cell Lung Cancer 270
11.8 Risk Factors and Possible Preventions 273
References 273
12 Melanoma (Skin Cancer) 285
12.1 Introduction 285
12.2 Genes Associated with Melanoma 285
12.3 Types of Melanoma 285
12.3.1 Superficial Spreading Melanoma 285
12.3.2 Nodular Melanoma 286
12.3.3 Lentigo Maligna Melanoma 286
12.3.4 Acral Lentiginous Melanoma 286
12.4 Stages of Malignant Melanoma 286
12.5 Symptoms of Melanoma Cancer 287
12.6 Diagnosis 287
12.6.1 Asymmetric 287
12.6.2 Border 287
12.6.3 Color 287
12.6.4 Diameter 288
12.6.5 Evolving 288
12.7 Methods of Treatment 288
12.7.1 Surgery 288
12.7.2 Radiation 288
12.7.3 Chemotherapy 288
12.7.4 Targeted Therapy 289
12.7.5 Immunotherapy 289
12.7.6 Photodynamic Therapy 289
12.8 Drugs for Other Types of Skin Cancer 289
12.8.1 Drugs for Basal Cell Carcinoma 289
12.8.2 Drugs for Cutaneous Squamous Cell Carcinoma 289
12.8.3 Drugs for Merkel Cell Carcinoma 289
12.8.4 Drugs for Kaposi Sarcoma 290
12.9 Treatment Regimens 290
12.10 Melanoma Risk Factors 293
12.11 Possible Prevention 294
12.11.1 Sun Protection Tips 294
12.11.2 What about Vitamin D? 295
References 295
13 Mesothelioma 305
13.1 Introduction 305
13.2 Genes Associated with Mesothelioma 305
13.3 Types of Mesothelioma Cancers 305
13.4 Mesothelioma Cancer Symptoms 305
13.4.1 Symptoms for Pleural Mesothelioma 305
13.4.2 Symptoms for Peritoneal Mesothelioma 307
13.4.3 Symptoms for Pericardial Mesothelioma 307
13.4.4 Symptoms for Testicular Mesothelioma 307
13.5 Diagnosis 307
13.6 Methods of Treatment 307
13.6.1 Surgery 307
13.6.2 Radiation Therapy 308
13.6.3 Chemotherapy 308
13.6.4 Targeted Therapy 308
13.6.5 Immunotherapy 308
13.7 Treatment Regimens 308
13.8 Possible Prevention 310
13.9 Occupational Exposure Prevention 310
13.9.1 Employer Responsibilities 310
13.9.2 Employee Responsibilities 311
13.10 Household Exposure Prevention 311
References 311
14 Ovarian, Vaginal, and Vulvar Cancer 317
14.1 Introduction 317
14.2 Genes Associated with Ovarian, Vaginal, and Vulvar Cancer 318
14.3 Symptoms of Ovarian, Vaginal, and Vulvar Cancer 318
14.4 Diagnosis 319
14.5 Methods of Treatment 320
14.5.1 Surgery 320
14.5.2 Radiation Therapy 320
14.5.3 Chemotherapy 320
14.5.4 Hormone Therapy 320
14.5.5 Targeted Therapy 320
14.6 Drugs for Vaginal Cancer 320
14.7 Drugs to Prevent Vaginal Cancer 321
14.8 Drugs to Treat Vulvar Cancer 321
14.9 Drugs to Prevent Vulvar Cancer 321
14.10 Treatment Regimens 321
14.10.1 Treatment Regimens for Germ Cell Ovarian Cancer 327
14.11 Risk Factors/Possible Preventions 328
References 328
15 Pancreatic Cancer 341
15.1 Introduction 341
15.2 Genes Associated with Pancreatic Cancer 341
15.3 Symptoms of Pancreatic Cancer 342
15.4 Diagnosis 342
15.5 Methods of Treatment 342
15.5.1 Surgery 343
15.5.2 Radiation Therapy 343
15.5.3 Chemotherapy 343
15.5.4 Targeted Therapy 343
15.5.5 Immunotherapy 343
15.5.6 Drugs for Gastroenteropancreatic Neuroendocrine Tumors 343
15.6 Treatment Regimens for Pancreatic Cancer 344
15.7 Risk Factors and Possible Preventions 346
References 347
16 Prostate Cancer 355
16.1 Introduction 355
16.2 Genes Associated with Prostate Cancer 355
16.3 Symptoms of Prostate Cancer 356
16.4 Diagnosis 356
16.5 Methods of Treatment 357
16.5.1 Surgery 357
16.5.2 Radiation Therapy 357
16.5.3 Cryotherapy 357
16.5.4 Chemotherapy 358
16.5.5 Targeted Therapy 358
16.5.6 Immunotherapy 358
16.5.7 Hormone Therapy 358
16.6 Treatment Regimens 358
16.7 Risk Factors/Possible Preventions 362
References 363
17 Stomach (Gastric) Cancer 371
17.1 Introduction 371
17.2 Genes Associated with Stomach Cancer 371
17.3 Symptoms of Stomach Cancer 372
17.4 Stages of Stomach Cancer 373
17.5 Diagnosis 374
17.6 Methods of Treatment 375
17.6.1 Surgery 375
17.6.2 Endoluminal Stent Placement 375
17.6.3 Endoluminal Laser Therapy 375
17.6.4 Gastrojejunostomy 375
17.7 Radiation Therapy 376
17.8 Chemotherapy 376
17.9 Targeted Medications 376
17.10 Immunotherapy 376
17.11 Treatment Regimens for Stomach Cancer 376
17.12 Risk Factors 383
17.12.1 Certain Medical Conditions 383
17.12.2 Smoking 383
17.12.3 Helicobacter Pylori Infection 383
17.12.4 Family History 384
17.12.5 Foods Containing Aflatoxins 384
17.12.6 Diet 384
17.12.7 Age 384
17.12.8 Gender 384
17.12.9 Previous or Existing Cancers 384
17.12.10 Some Surgical Procedures 384
17.13 Possible Preventions 384
References 385
18 Thyroid Cancer 395
18.1 Introduction 395
18.2 Genes Associated with Thyroid Cancer 395
18.3 Types of Thyroid Cancer 395
18.3.1 Papillary Thyroid Cancer 395
18.3.2 Follicular Thyroid Cancer 395
18.3.3 Medullary Cancer 396
18.3.4 Anaplastic Thyroid Cancer 396
18.4 Thyroid Cancer Symptoms 396
18.5 Diagnosis 397
18.6 Staging of Thyroid Cancer 397
18.6.1 Papillary or Follicular Thyroid Cancer Patients under the Age of 45 397
18.6.2 Papillary or Follicular Thyroid Cancer Patient Aged 45 Years and Older 397
18.6.3 Medullary Thyroid Cancer 398
18.6.4 Anaplastic Thyroid Cancer 398
18.7 Methods of Treatment 399
18.7.1 Surgery 399
18.7.2 Radioactive Iodine Ablation 399
18.7.3 External Beam Radiation 399
18.7.4 Thyroid Hormone Therapy 399
18.7.5 Chemotherapy 399
18.7.6 Targeted Therapy 399
18.8 Treatment Regimens 400
18.9 Possible Preventions 402
References 402
19 Endometrial Cancer 407
19.1 Introduction 407
19.2 Genes Associated with Endometrial Cancer 407
19.3 Symptoms 407
19.4 Endometrial Cancer Diagnosis 408
19.4.1 Internal Pelvic Exam 408
19.4.2 Pap Test (also called Pap Smear) 408
19.4.3 Endometrial Biopsy 408
19.4.4 Dilation and Curettage (Also Called D&C) 409
19.4.5 Transvaginal Ultrasound 409
19.5 Stages 409
19.6 Methods of Treatment 409
19.6.1 Surgery 409
19.6.1.1 Hysterectomy 410
19.6.1.2 Salpingo-oophorectomy 410
19.6.1.3 Pelvic Lymph Node Dissection 410
19.6.1.4 Para-aortic Lymphadenectomy 410
19.6.1.5 Laparoscopic Lymph Node Sampling 410
19.6.1.6 Sentinel Lymph Node Mapping 410
19.6.2 Radiation Therapy 410
19.6.2.1 External Radiation Therapy 410
19.6.2.2 Internal Radiation Therapy 410
19.6.3 Chemotherapy 410
19.6.4 Targeted Therapy 411
19.6.5 Immunotherapy 411
19.6.6 Hormone Therapy 411
19.7 Treatment Regimens 411
19.8 Risk Factors of Endometrial Cancer 415
19.9 Prevention 415
References 416
20 Penile Cancer 423
20.1 Introduction 423
20.2 Symptoms of Penile Cancer 423
20.3 Penile Cancer Diagnosis 424
20.3.1 Biopsy 424
20.3.2 Imaging Tests 424
20.4 Methods of Penile Cancer Treatment 424
20.4.1 Surgery 424
20.4.1.1 Circumcision 424
20.4.1.2 Other Surgical Procedures 425
20.4.2 Local Treatments (Other than Surgery) for Penile Cancer 425
20.4.2.1 Laser Ablation 425
20.4.2.2 Cryosurgery/Cryotherapy 425
20.4.2.3 Photodynamic Therapy (PDT) 425
20.4.3 Radiation Therapy 425
20.4.4 Chemotherapy 425
20.4.4.1 Topical Chemotherapy 425
20.4.4.2 Systemic Chemotherapy 425
20.5 Treatment Regimens for Penile Cancer 425
20.6 Risk Factors of Penile Cancer 427
20.7 Penile Cancer Prevention 427
References 428
21 Testicular Cancer 431
21.1 Introduction 431
21.2 Symptoms of Testicular Cancer 431
21.3 Diagnosis 432
21.3.1 Ultrasound 432
21.3.2 A Physical Exam and Medical History 432
21.3.3 Blood Tests for Tumor Markers 432
21.3.3.1 Biopsy 433
21.3.4 CT Scan and X-ray 433
21.4 Methods of Treatment 433
21.4.1 Surgical Treatment 433
21.4.2 Radiation Therapy 433
21.4.3 Chemotherapy 433
21.5 Treatment Regimens for Testicular Cancer 433
21.6 Risk Factors 435
21.6.1 An Undescended Testicle 435
21.6.2 Family History of Testicular Cancer 436
21.6.3 HIV Infection 436
21.6.4 Race 436
21.6.5 Infertility 436
21.6.6 Certain Activities 436
21.6.7 Reducing Exposure to Chemical Toxins 436
21.7 Prevention 436
21.8 Self-Exam of Testicular Cancer 437
References 437
Index 443
