13. Malignant tumors of the female reproductive system (ovary, cervix, endometrium) - clinical picture, classification, staging and complex treatment.

Approaches for treatment of common male reproductive system

Penile cancer

• Treatment is most commonly one of five types of surgery, with adjuvant radiation and chemotherapy to reduce risk of recurrence.
• In early stage penile cancer, topical chemotherapy and less invasive therapy may be used in combination.
• Treatment should also deal with underlying disease (e.g. brucellosis) to limit recurrence

Prostate cancer

• Not all prostate cancer needs to be treated, it is very slow growing and does not really metastasis. Patients are placed under expectant management which has two approaches - watchful waiting and active surveillance (the latter being more dynamic)
• Treatment can either have surgery or radiotherapy as first line, with the alternative being second line
• Aggressive, metastatic prostate cancers always involve surgery, often with adjuvant radiation therapy (brachytherapy) and/or chemotherapy (Temozolomide)
• Hormonal and chemotherapy are often reserved for when the cancer has metastasised beyond the prostate

Testicular cancer

• First line treatment is to perform an orchiectomy, often with lymph node dissection to confirm staging and ensure no metastasis.
• Adjuvant therapy in the form of chemotherapy or radiotherapy is also then given, where there is threat of distant spread, chemotherapy is generally recommended.
• Chemotherapy generally uses platinum based cisplatin and carboplatin