Testicular Cancer Treatment
Patients with testicular cancer have different types of treatment options available to them. Some treatments are standard (the most commonly used treatment across all oncologists), and some are being tested in clinical trials. Keep in mind that what your RMCC oncologist recommends for you might be different for someone else based on factors such as type and stage.
In most cases, treatment will begin with surgery to remove the testicle. After determining whether the cancer has spread and the type of testicular cancer it is, one or more treatments such as surveillance, chemotherapy, radiation therapy, and high-dose chemotherapy with stem cell transplant, may be recommended by the urologist or oncologist.
Surgery to Remove the Testicle
After an orchiectomy is performed to remove the testicle, the tumor will be evaluated to determine what type of testicular cancer it is and to see if it has spread. Lymph nodes may also be removed in the groin area during the initial surgery or in a follow-up surgery to help determine whether it’s spread beyond the testicle.
Testicular surgery can result in short-term or long-term side effects depending on whether one or both testicles was removed. These could include:
- Pain or tenderness around the incision site
- Bleeding, reaction to anesthesia, infections, and blood clots
- Loss of sex drive and inability to get or maintain an erection
- Depression or other mood changes
- Decreased muscle mass
If there are no changes in test results after surgery, your oncologist might suggest closely following your condition rather than giving any other treatment. This “watchful waiting” is known as surveillance. Some considerations for choosing surveillance instead of an aggressive treatment plan might include the fact that your testicular cancer is slow growing and in an early stage of development. Your oncologist could also recommend surveillance if he or she feels your age or other health concerns might undermine the effectiveness of treatment.
Some men might be closely monitored for up to 10 years as long as their testicular cancer has not spread beyond the testicles. After the initial decision for surveillance, you will need to see your doctor regularly every 3 to 6 months for checkups. Only if these tests confirm that cancer has not spread beyond the testicles, no further treatment is needed.
Chemotherapy is most often used for patients whose cancer has spread outside the testicle. It’s also used to help decrease the risk of cancer coming back after the testicle is removed. Typically, it is not used to treat cancer that’s only in the testicle. When chemotherapy is used, it is given directly into a vein so that it enters the bloodstream and reaches cancer cells throughout the body.
Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. It affects cancer cells only in the treated area.
There are different types of radiation therapy, however, external radiation therapy is most commonly used to treat testicular cancer that has spread to lymph nodes or to distant organs like the brain. External radiation is administered using a beam of radiation focused typically at the back of the abdomen (the retroperitoneal lymph nodes). Radiation therapy is able to kill any tiny bits of cancer in those lymph nodes that can’t be seen. It can also be used to treat small amounts of seminoma that have spread to the nodes (based on changes seen on images that are taken such as CT Scans or PET Scans).
High-dose Chemotherapy With Stem Cell Transplant
While testicular cancer can often be treated successfully with chemo, there are times a stronger dose is needed— especially if the cancer has returned. To counter those higher doses of chemo, doctors are able to use stem cell transplant. According to cancer.gov, high doses of chemotherapy are given, killing both cancer cells and healthy cells, including blood-forming cells. A stem cell transplant is then given after the cells are destroyed to replenish the blood-forming cells. A stem cell transplant takes stem cells (immature blood cells) from the blood or bone marrow of the patient (before treatment began) or a donor during the weeks leading up to the surgery. The cells are frozen and stored, and used as the patient needs.
The stored stem cells are thawed and given back to the patient through an infusion. Once the cells return to the bone marrow, they can begin to make new blood cells.
Stem cell transplants are usually used to treat recurring testicular cancer. If you are the recipient of stem cells, you may need to stay in the hospital for a period of time during this treatment.
Clinical Trials for Testicular Cancer
Researchers are discovering more ways to treat testicular cancer through carefully run clinical trials. These could be an option for you, so if you would like to learn more, your RMCC oncologist would be more than happy to talk with you. You can also gather additional information by visiting US Oncology Clinical Trials, ClinicalTrials.Gov, or the National Cancer Institute.