Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Cancer, Testicle(s)


Related Terms

  • Malignant Tumor of the Testicle
  • Testicular Cancer
  • Testicular Choriocarcinoma
  • Testicular Embryonal Carcinoma
  • Testicular Seminoma
  • Testicular Yolk Sac Tumor

Differential Diagnosis

Specialists

  • Oncologist
  • Psychiatrist
  • Radiology Oncologist
  • Urologist

Comorbid Conditions

  • Immune system disorders

Factors Influencing Duration

Duration of disability may be influenced by the type of tumor, the size of the tumor, the stage of disease (evidence of metastasis to other parts of the body), and the method of treatment. Adjuvant chemotherapy or radiation therapy is common. Complications from this treatment (such as nausea, vomiting, or fatigue) will lengthen disability.

Medical Codes

ICD-9-CM:
186.9 - Malignant Neoplasm of Testis; Other and Unspecified Testis; Testis: NOS, Descended, Scrotal
233.6 - Carcinoma in Situ of Other and Unspecified Male Genital Organs
236.4 - Neoplasm of Uncertain Behavior of Genitourinary Organs, Testis

Overview

© Reed Group
Testicular cancer is a malignant tumor of the testes. The most common types of testicular cancers are seminomas and nonseminomas (teratoma, choriocarcinoma, embryonal carcinoma, or yolk sac tumor), which develop from the cells. Each type grows, spreads, and is treated differently. Seminomas contain just one type of cell and develop from the cells that produce sperm (germ cells). Nonseminomas usually consist of a mixture of different types of cells. Tumors that develop from supportive and hormone-producing tissue of the testicles (stromal tumors) are rare, as are tumors that develop because cancer has spread (metastasized) from another part of the body.

Many testicular cancers are found in the early stages, because tumors produce lumps, swelling, or discomfort in the testes that motivate men to seek medical care. Treatment for testicular cancer has a high success rate, with more than a 90% cure rate for all stages combined.

Incidence and Prevalence: In the US, the American Cancer Society estimates that in 2004 approximately 9,000 men will be diagnosed with testicular cancer, and about 360 men will die from the disease; although worldwide incidence rates are not available, men living in the US and Europe have a higher risk of developing the disease than men living in Asia or Africa ("Testicular Cancer").

Source: Medical Disability Advisor



Causation and Known Risk Factors

Although the causes are unknown, both acquired factors and those present at birth (congenital) are associated with development of testicular tumor. Most testicular cancers occur in men between the ages of 15 and 40. Testicular cancer is 5 to 10 times more common in white Americans than in blacks and twice as common in white Americans as in Asian Americans; for no clear reason, the rate of testicular cancer has doubled in the past 40 years for white Americans while remaining steady for blacks ("Testicular Cancer").

Approximately 14% of cases of testicular cancer develop in men who were born with an undescended testicle (cryptorchidism) ("Testicular Cancer"). This risk remains even after surgery to relocate the testes to the scrotum. Other acquired factors associated with testicular cancer include trauma or injury to the testes and HIV/AIDS infection. Also, men who have had cancer in one testicle have about a 4% higher risk of developing cancer in the other testicle ("Testicular Cancer").

Source: Medical Disability Advisor



Diagnosis

History: The most common symptom men report is a firm swelling or lump in one testicle that may or may not be uncomfortable. The lump usually is about the size of a pea but can be as large as a marble or even an egg. Other abnormalities that are occasionally present include an enlarged testicle, a feeling of heaviness or sudden collection of fluid in the scrotum (hydrocele), pain and discomfort in a testicle or the scrotum, a dull ache in the lower abdomen, tender breasts, or enlarged breast tissue (gynecomastia).

Most men discover testicular cancer themselves either unintentionally or during a self-examination. Self-examination during or directly after a shower or bath, when the skin of the scrotum is relaxed, increases the chances of finding testicular cancer early.

Physical exam: The physical exam usually reveals a mass or lump in the testicle or swollen scrotal skin. Enlarged abdominal lymph nodes may be felt. Occasionally, breast enlargement is seen.

Tests: A definite diagnosis of testicular cancer can only be confirmed by the surgical removal of the testis (orchiectomy) and microscopic examination of the testicular tissue. This not only confirms the presence of cancer but also identifies the type of cancer, which is an important part of treatment. Biopsy of the tumor without removal of the testicle is rarely done, but if it is, a special clamp is used to avoid possible spillage and the resulting spread of cells if they prove to be cancerous.

Ultrasound of the testis is useful to help determine whether the mass is solid or fluid filled. If testicular cancer is confirmed by pathology, a chest x-ray is done to determine whether the cancer has spread (metastasized) to the lungs. Blood tests (human chorionic gonadotropin, alpha-fetoprotein, and lactate dehydrogenase [LDH] levels) and CT and MRI of the abdomen and pelvic region help with diagnosis and treatment. These scans also help detect any spread of cancer to other parts of the body (metastasis), a factor in determining the stage of the tumor. Lymphangiography may also help visualize the lymph nodes on an x-ray. If they appear to be involved, they may need to be removed surgically and examined under a microscope.

Source: Medical Disability Advisor



Treatment

Treatment is based on staging of the tumor. A general summary of the stages of testicular cancer goes as follows: stage 0, which involves noninvasive cancer cells (called cancer in situ); stage I, in which cancer has not spread to the lymph nodes; stage II, in which cancer has spread only to the nodes located in the rear of the body below the diaphragm (retroperitoneal lymph nodes); stage III, in which cancer has spread to distant lymph nodes and/or organs (e.g., lungs, liver) and in which metastases are larger than in stage II; and recurrent, in which treated cancer has returned.

No one treatment works for all testicular cancers. Each type responds differently to radiation and has different patterns of spread (metastases). Surgery to remove the testis (orchiectomy) has a high rate of success in curing testicular cancer in its early stage. The testicle is usually removed through the groin to avoid the risk of spreading the cancer through contact with the loose skin of the scrotum. Since the chance of developing testicular cancer in the other testis is low, the testicle without the tumor is usually left intact. Regional lymph node removal (lymphadenectomy) may also be necessary and should be followed by monthly monitoring and chest x-rays for the first year.

Surgery may be followed either by radiation therapy, administration of anticancer drugs (chemotherapy), or both, depending upon the type of cancer and its stage. Radiation therapy is carefully targeted to the affected area to preserve the fertility of the remaining testis. Radiation is normally done only on individuals with seminomas, and it is used mainly to treat the lymph nodes of the abdomen. Nonseminomas rarely respond to radiation therapy, so it is not used for that type of tumor.

Psychological counseling may be needed, especially for men who become infertile.

Source: Medical Disability Advisor



Prognosis

The prognosis varies according to the type of cancer and how far advanced it was when discovered, but testicular carcinoma is one of the most curable forms of cancer. Most individuals recover completely. The 5-year survival rate (individuals living at least 5 years after diagnosis) is 99% for tumors detected in stage I, 95% in stage II, and 70% in stage III ("Testicular Cancer").

Source: Medical Disability Advisor



Complications

Testicular cancer can metastasize to other parts of the body, most commonly the lungs, liver, or intestines. Temporary or permanent infertility may also develop.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Work leave for treatment and recovery will be required. Cancer drugs (chemotherapy) can cause nausea, vomiting, dehydration, loss of appetite, fatigue, lowered resistance to infections, and hair loss. Individuals who undergo radiation therapy may experience fatigue, lowered blood counts, and lowered resistance to infections. As a result, individuals with physically demanding jobs may require a reduced workload, possibly with reduced hours, and reassignment to more sedentary duties.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Does individual report a firm swelling or painful or nonpainful lump in one testicle?
  • Does individual feel heaviness or sudden collection of fluid in the scrotum (hydrocele)?
  • Is there pain and discomfort in a testicle or the scrotum?
  • Does individual note a dull ache in the lower abdomen, tender breasts, or enlarged breast tissue (gynecomastia)?
  • Was diagnosis confirmed by the surgical removal of the testis (orchiectomy) and microscopic examination of the tissue?
  • Was the tumor surgically removed?
  • Was ultrasound done to exclude other causes of scrotal masses?
  • Were chest x-ray, blood tests, and CT of the abdomen and pelvic region done to detect evidence of spread of cancer to other parts of the body (metastasis)?

Regarding treatment:

  • Is additional treatment such as radiation and/or chemotherapy required, or has the doctor elected to postpone these treatments until individual has a recurrence?
  • If no additional treatment is given, is individual being monitored closely, keeping all follow-up appointments, and doing regular testicular self-examination?
  • Was regional lymph node removal required?
  • If individual does not respond to treatment, would individual benefit from experimental treatment?

Regarding prognosis:

  • Did individual have early stage testicular cancer, or was the disease advanced?
  • Did individual undergo orchiectomy? Was the surgery successful in removing the tumor?
  • Did individual require lymphadenectomy? Does the physician believe all affected lymph nodes were removed?
  • Has the cancer spread to other parts of the body, and if so, what parts are involved?
  • Does individual have secondary effects from radiation therapy or chemotherapy? If so, what are they, and how will they be treated?
  • Would individual benefit from psychological counseling because of the disease or treatments for the disease?

Source: Medical Disability Advisor



References

Cited

"Testicular Cancer." American Cancer Society. Apr. 2004. 2 Oct. 2004 <http://www.cancer.org/docroot/CRI/CRI_2x.asp?sitearea=&dt=41>.

Source: Medical Disability Advisor






Feedback
Send us comments, suggestions, corrections, or anything you would like us to hear. If you are not logged in, you must include your email address, in order for us to respond. We cannot, unfortunately, respond to every comment. If you are seeking medical advice, please contact your physician. Thank you!
Send this comment to:
Sales Customer Support Content Development
 
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is published with the understanding that the author, editors, and publisher are not engaged in rendering medical, legal, accounting or other professional service. If medical, legal, or other expert assistance is required, the service of a competent professional should be sought. We are unable to respond to requests for advice. Any Sales inquiries should include an email address or other means of communication.