Treatment Options
After a confirmed diagnosis of testicular cancer has been made, your doctor will discuss the treatment options that are available to you. The type and stage of your cancer, your overall health, and your preferences all influence your course of treatment. There are 3 primary treatments for testicular cancer:
In addition, you may want to talk with your doctor about participating in a clinical trial in which a new treatment is being studied.
Surgery
For most testicular cancers, your doctor will recommend surgery. The type of surgery you have will depend on how advanced your cancer is.
- Radical Inguinal Orchiectomy
Most men will have the affected testicle removed. This procedure is called a radical inguinal orchiectomy. The surgeon makes an incision in your groin and removes the entire testicle and spermatic cord. Because the spermatic cord can serve as a pathway for cancer cells to quickly travel to other parts of the body, it is tied off during surgery. - Retroperitoneal Lymph Node Dissection
In more advanced stages of testicular cancer, surgery to remove lymph nodes in the groin and abdomen will be performed. This procedure is called retroperitoneal lymph node dissection and usually involves making a large incision in your abdomen.
Damage to the nerves that control ejaculation can occur during removal of some lymph nodes, resulting in infertility. Your ability to have an erection is not affected, but the sperm travel into the bladder rather than leaving the body. - Nerve Sparing Surgery
A newer surgical technique called nerve-sparing surgery may be an option for you. This surgery is designed to limit the damage to the nerves surrounding the lymph nodes and to protect your ability to ejaculate.
Radiation Therapy
Radiation therapy uses focused high-energy radiation to kill cancer cells. Usually lower doses of radiation can be used to treat testicular cancer than are used for other cancers. The radiation therapist designs a specific course of radiation for your individual cancer. Before treatment, lead blocks are designed to protect surrounding healthy tissue.
Radiation therapy doesn’t hurt, but you may experience some common side effects:
- fatigue
- diarrhea and/or nausea
- loss of hair at the site of radiation
- skin redness
These unpleasant side effects resolve within a few months of treatment.
Some men experience infertility as a result of radiation therapy. Individual results vary, but fertility may return after healing of the treated areas.
For patients with seminoma-type testicular cancer, radiation therapy may be used to kill cancer cells that have spread to the lymph nodes.
Chemotherapy
Chemotherapy uses high-potency drugs to kill cancer cells. The drugs are taken by mouth or intravenously. Chemotherapy is regularly used to treat testicular cancer that has spread beyond the testicles. Often a combination of drugs is used to attack the cancer cells. Your doctors will design a chemotherapy program that is most effective for your individual needs.
Before beginning treatment, your doctor will explain what to expect from chemotherapy. The following short-term side effects usually resolve within a few months of treatment:
- tiredness
- nausea and vomiting
- hair loss (from the head and body)
- mouth sores
- loss of appetite
- diarrhea or constipation
- increased risk of infection
- easy bruising or bleeding
- kidney damage
- damage to small blood vessels, increasing sensitivity to cold
- nerve damage, causing numbness and tingling sensations
- hearing loss
- heart disease
- lung damage, causing shortness of breath
- developing a secondary cancer, usually leukemia—occurs in less than 1% of patients
Stem Cell Transplantation
Chemotherapy is highly effective at killing cancer cells, but at the same time it kills healthy cells too. One promising new development in the treatment of advanced testicular cancer is stem cell transplantation. In this procedure, the patient receives drugs to coax their own blood-forming stem cells from the bone marrow into the blood stream. The stem cells are then filtered from the bloodstream and frozen for transplantation back into the body after high-dose chemotherapy treatment.
Stem cell transplantation gives the body back its own bone marrow cells, replenishing those that were destroyed during chemotherapy treatment. With the ability to preserve vital bone marrow–producing red blood cells, oncologists can use higher doses of chemotherapy to attack resistant cancer cells, potentially increasing the cure rate.
New Treatments
One of the major goals of the SCCA is to move the latest diagnostic tools and techniques from the research setting to patient care as quickly as possible. Our medical teams are dedicated to providing each patient with the best possible treatment available.
- DNA
Studies are ongoing to determine the cause of testicular cancer. Scientists believe that a better understanding of genetic changes will lead to the creation of better and more individualized treatments. - New Drugs and Drug Combinations
Testing of new drugs, dosages, and drug combinations are continually being refined to increase effectiveness and decrease adverse side effects. - Alternative Therapies
Sources offering treatment for cancer are abundant: from your neighbor’s cousin to your coworkers; magazine articles; and best/worst of all—the Internet. These sources recommend vitamins, herbs, massage therapy, acupuncture, and more. While some of the suggestions may be helpful, others may interfere with your treatment or cause harm.
Researching your cancer as much as possible is a good idea. You want to be a knowledgeable patient. But be cautious and discuss what you learn with your doctor.
Infertility
Treatment for testicular cancer can cause infertility. The specific treatment you receive will determine whether you can still father children.
- Sometimes the surgery to remove the testicle and spermatic cord results in the sperm traveling into the bladder and not being released through ejaculation.
- Radiation therapy can result in infertility that may be reversed after the effects of treatment wear off.
- Chemotherapy can cause permanent infertility.
- If only one testicle is removed you should remain fertile.
Whether or not you are considering having children, you may want to consider the option of sperm banking. This process allows you to have your healthy sperm frozen and stored for later use.