Men who've been diagnosed with testicular cancer have a number of treatment options depending on the type and stage. The oncologist’s recommendation for one patient may be different for another based on these factors.
Most men will start with surgery to remove the testicle. After determining whether the cancer has spread and the type of testicular cancer it is, one or more of the following treatments may be recommended by the urologist or oncologist:
Surveillance (Watchful Waiting)
High-dose chemotherapy with stem cell transplant
After the doctor removes the testicle, the tumor will be evaluated to determine what types of testicular cancer it is and to see if it has spread. Some men will have the lymph nodes 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.
Side effects of surgery may include the following:
Most men experience some pain after surgery, but that can be eased with pain medication.
Short-term effects include bleeding, reaction to anesthesia, infections, and blood clots.
A man may experience no effects on his ability to get an erection or have sex after losing one testicle. When both testicles are removed, though, he cannot make sperm, and he becomes infertile.
Loss of muscle mass and fatigue could also become problems, but with testosterone supplements, such side effects can be controlled.
Your doctor will weigh many factors before recommending treatment. After a discussion regarding the risks and side effects of treatment, you may decide that active surveillance, or watchful waiting, is the right option for you. 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 doctor could also recommend surveillance if he feels your age or other health concerns might undermine the effectiveness of treatment.
If your testicular cancer has not spread beyond the testicles, it is possible for your oncologist to closely monitor your status for up to 10 years. Regular three to six-month checks, that include image testing, by your doctor should follow your initial decision for surveillance. If these tests do not cancer has spread beyond the testicles, no further treatment is needed. However, if the cancer has spread beyond the testicles radiation and/or chemotherapy may be 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. It's not typically used to treat cancer that's only in the testicle.
External radiation therapy is typically used to treat testicular cancer that has spread to lymph nodes or to distant organs like the brain. External radiation is most common, 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
Testicular cancer can often be treated successfully with chemo, but sometimes a stronger dose is needed. Each situation is different, but doctors normally do not give a higher dose of chemo because it can harm the body's bone marrow. Bone marrow makes the body's blood cells. If this area is damaged, it can cause serious health problems related to low blood cell counts.
Doctors can now use stem cell transplant to counter higher doses of chemo. According to cancer.gov, high doses of chemotherapy are given, kills both cancer cells and healthy cells, including blood-forming cells. A stem cell transplant is then given after the cells are destroyed. This replenishes 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. The patient might need to stay in the hospital for a period of time during this treatment.
Clinical Trials for Testicular Cancer
A clinical trial could be another alternative that you may want to discuss with your doctor. Taking part in a clinical trial may be the best treatment option for you. Virginia Oncology Associates is a research destination that is "dedicated to testing the safety and efficiency of new or modified treatments."
Visit our Clinical Trials section to learn more about research trials, including any that are available through Virginia Oncology Associates.