Testicular Cancer Treatment

Treatment for testicular cancer depends largely on the type of tumor, the stage, tumor marker levels, and your overall health. Because patients tend to be younger and in better general health than an older patient, and because testicular cancer often responds well to treatment, therapy is often highly effective, even in more advanced stages. At Rocky Mountain Cancer Centers, our oncologists develop personalized treatment plans designed to provide you with the best possible outcome, while considering your long-term health, fertility considerations, and quality of life.

While there are effective treatments already approved by the FDA available to patients with testicular cancer, RMCC also provides access to clinical research trials offering emerging new therapies. Your oncology team will carefully explain your diagnosis, review recommended treatment options, discuss potential risks and side effects, and help you understand expected outcomes. Together, you and your physician will decide on a treatment approach tailored to your needs.

In most cases, treatment begins with surgery to remove the affected testicle. After surgery, additional therapies may be recommended depending on whether the cancer has spread and how aggressive the tumor appears under the microscope.

Surgery to Remove the Affected Testicle(s)

The primary treatment for nearly all testicular cancers is a procedure called a radical inguinal orchiectomy. During this surgery, the affected testicle is removed through an incision in the groin. This approach allows physicians to remove the tumor safely while reducing the risk of spreading cancer cells. In some cases, orchiectomy is performed after imaging and blood tests strongly suggest cancer, serving both as a diagnostic and therapeutic procedure.

Once removed, the testicle is analyzed by a pathologist to determine the exact type of cancer and whether it shows high-risk features. This information plays a key role in determining whether additional treatment is necessary.

Lymph Node Testing

In certain cases, lymph nodes located at the back of the abdomen may also be removed in a procedure called retroperitoneal lymph node dissection (RPLND). This surgery helps determine whether cancer has spread beyond the testicle and may also serve as a treatment for specific types of nonseminoma tumors. Not all men require lymph node removal, and your physician will discuss whether this procedure is appropriate in your situation.

Testicle Prosthesis

After a testicle is removed, a silicone prosthetic implant can be put in place to give symmetry and self-esteem. This procedure can be performed either immediately during cancer surgery or at a later date as an outpatient procedure.

Surveillance After Orchiectomy

For some men with early-stage testicular cancer, particularly when the tumor is confined to the testicle and does not show high-risk features, active surveillance may be recommended after surgery. Surveillance, sometimes referred to as watchful waiting, involves closely monitoring the patient rather than immediately starting additional treatment.

This approach allows certain patients to avoid chemotherapy or radiation unless there is evidence that the cancer has returned. Surveillance typically involves regular follow-up visits every three to six months during the first few years, including physical exams, blood tests to measure tumor markers, and imaging studies such as CT scans. Some men may continue surveillance for up to 10 years to ensure there is no recurrence. If any signs of cancer reappear, treatment can be started promptly.

Radiation Therapy

Radiation therapy uses high-energy X-rays to destroy cancer cells. External beam radiation therapy is proven effective for testicular seminoma cancer, particularly in Stage I, IIA, and IIB. It’s often administered after surgery to destroy any unseen cancer cells in nearby lymph nodes. Seminomas are especially sensitive to radiation, making this treatment highly effective in appropriate cases.

Radiation therapy is generally not effective for nonseminoma tumors and is therefore not typically used for those cancers. However, in cases where testicular cancer has spread to distant organs and is causing symptoms, radiation may be used to relieve discomfort or control disease progression in both seminoma and nonseminoma cancers.

Chemotherapy

Chemotherapy uses powerful medications to destroy cancer cells throughout the body. It is commonly recommended when testicular cancer has spread beyond the testicle or when there is a significant risk of recurrence after surgery. Chemotherapy may also be used as a preventive (adjuvant) treatment in certain higher-risk early-stage cancers.

Treatment typically involves a combination of two or more drugs administered in cycles over several weeks. Combination regimens are used because they are more effective at eliminating cancer cells than a single drug alone. While chemotherapy can cause side effects such as fatigue, nausea, hair loss, or temporary suppression of blood cell production, it has dramatically improved survival rates for men with advanced testicular cancer.

Immunotherapy for Testicular Cancer

Immunotherapy is an emerging treatment approach that uses the body’s immune system to fight cancer. Certain cancer cells can avoid detection by turning off the body’s natural immune “checkpoints”. Immune checkpoint inhibitors are medications that block these signals and allow the immune system to recognize and destroy cancer cells.

One type of immunotherapy targets a protein known as PD-1 on immune cells called T cells. By blocking PD-1, these medications enhance the immune response against cancer.

Immunotherapy may be considered for some advanced testicular cancers, particularly if other treatments have not been effective or if tumors have specific genetic characteristics such as high microsatellite instability (MSI-H), mismatch repair deficiency (dMMR), or high tumor mutational burden (TMB-H).

High-Dose Chemotherapy With Stem Cell Transplant

Although standard chemotherapy is often highly successful, some men with recurrent or particularly aggressive testicular cancer may require high-dose chemotherapy. Higher doses can be more effective at destroying cancer cells but may also damage healthy bone marrow cells that produce blood cells.

To help manage this effect, physicians may recommend a stem cell transplant. Before high-dose chemotherapy begins, stem cells, immature blood-forming cells, are collected from the patient’s blood or bone marrow. These cells are frozen and stored. After chemotherapy is completed, the stored stem cells are infused back into the body, helping restore healthy blood cell production.

Stem cell transplants are most commonly used in cases of recurrent testicular cancer. Because this treatment is intensive, it may require a hospital stay and close monitoring.

Clinical Trials for Testicular Cancer

Ongoing research continues to improve outcomes for men with testicular cancer. Clinical trials evaluate new treatment strategies, drug combinations, and supportive care approaches. Participation in a clinical trial may provide access to innovative therapies that are not yet widely available.

At Rocky Mountain Cancer Centers, eligible patients have the opportunity to participate in clinical trials as part of their treatment plan. Your oncologist can discuss whether a clinical trial is appropriate for your diagnosis.

Testicular Cancer Treatment at Colorado’s Leading Comprehensive Cancer Center

At Rocky Mountain Cancer Centers, our testicular cancer specialists provide coordinated, evidence-based care tailored to each patient’s diagnosis. From surgery and chemotherapy to advanced therapies and survivorship planning, we are committed to delivering expert treatment close to home across Colorado.

If you have been diagnosed with testicular cancer or would like a second opinion, we encourage you to request an appointment with one of our experienced oncologists. Our team is here to guide you through every step of your treatment with expertise, clarity, and compassion.

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