Testicular Cancer Treatment

Your cancer care team will likely include urologists, medical oncologists, surgical oncologists, radiation oncologists and other specialists working together to make sure you get the personalized care you need.

Treatment plans are created based on the type of cancer you have and its stage, as well as your overall health and preferences.

Your care team will give you detailed information about the benefits and risks of different treatment options so you can make the choice that’s best for you. Be sure to ask questions and express your concerns.

Some treatments could affect your ability to have children, so your care team will also talk to you about options such as sperm banking.

Here are some options for testicular cancer:

• Surveillance (active monitoring): For certain early-stage cases, active surveillance may be an option. It involves regular check-ups and imaging tests, with treatment only if the cancer is progressing. With active monitoring it is common to have check-ups and tests every six months for the first two years and every six to 12 months for the next three years. Surveillance is also typically done after surgery to remove the affected testicle.  In addition, your doctor may discuss other options to reduce the chance that the cancer may return.  These options may include further surgery, chemotherapy or radiation.
• Surgery: Many people undergo surgical removal of the affected testicle, called orchiectomy. The surgery is performed through an incision in your groin. If cancer is only in one testicle, removing it should not affect your sexual function, fertility or hormone production. You can talk to your provider about a testicular prosthesis if you are concerned about the appearance of your testicles after surgery.
• Radiation therapy: Radiation therapy destroys cancer cells with high-energy rays. It is often used when cancer has spread to nearby lymph nodes. It’s generally used for seminomas but not for non-seminomas.
• Chemotherapy: Chemotherapy uses drugs to kill cancer cells or keep them from growing. It may be recommended when cancer has spread beyond the testicle. Drugs such as Blenoxane (bleomycin), Etopophos or Vepesid (etoposide) and Platinol (cisplatin) are often used to treat testicular cancer. Chemotherapy may be used to treat cancer that has spread outside the testicle or to reduce the risk of spreading after surgery to remove the cancerous testicle. 
• High-dose chemotherapy and stem cell transplant: Some people need high-dose chemotherapy, followed by a stem cell transplant that helps replace the healthy cells that were destroyed during the high-dose treatment. This is typically only done in cases where the cancer has returned or failed to earlier chemotherapy treatments.
• Retroperitoneal lymph node dissection (RPLND): This surgery removes the lymph nodes in the back of your abdomen so that the cancer is less likely to spread throughout your body.

During and after treatment, your care team will watch for any signs that the cancer has returned. And they will check for any long-term side effects. They can also connect you with psychological support.

Side effects

Testicular cancer treatments may come with side effects. Be sure to communicate with your care team about the side effects you’re experiencing so they can help you minimize their impact. Here are some you might face:

• Nausea and fatigue: Chemotherapy can cause nausea and fatigue. You can manage these symptoms with rest, good nutrition and prescription medications.
• Hair loss: Some chemotherapy drugs may lead to temporary hair loss. You may want to consider wigs, hats or scarves to reduce the impact on your self-esteem.
• Nerve Damage: Some chemotherapy drugs can damage nerves leading to numbness, tingling or burning in the feet and hands (neuropathy) or problems with hearing or ringing in the ears (tinnitus).
• Fertility loss: Certain treatments may impact fertility. Before starting treatment, talk to your provider about options such as sperm banking. Fortunately, most patients treated for testicular cancer maintain their fertility after treatment.
• Long-term health considerations: Some treatments may have long-term effects. Having regular follow-up appointments with your providers is important for monitoring and addressing any health concerns. Patients treated with chemotherapy or radiation may be at higher risk for developing other cancers in the future.  There is also a higher risk of cardiovascular or metabolic diseases (such as diabetes or high cholesterol) later in life for patients treated with chemotherapy. 

Emotional changes

Coping with a cancer diagnosis and treatment may lead to emotional changes. You may have feelings of anxiety, depression or stress. Here are some options that can help you cope:

• Counseling services: Professional counselors can give you a safe space to talk about emotional challenges, fears and coping strategies.
• Support groups: Connecting with others who have experienced or are experiencing similar challenges can help you feel less alone. You can find support groups in-person or online where you can share experiences, exchange advice and build a community.
• Psycho-oncology services: These services can help you navigate the emotional challenges associated with diagnosis, treatment and life after cancer.
• Mind-body practices: Meditation, mindfulness, yoga and other practices can reduce stress, promote a sense of calm and improve your emotional well-being.
• Education: Learning about emotional and psychological well-being during cancer treatment can help you cope and feel empowered.
• Connecting with family and friends: Your loved ones can be an important source of support for you during your cancer journey.

If you’re facing emotional changes during your treatment and recovery   from testicular cancer, don’t be afraid to get help. Addressing mental health issues is an important part of your overall well-being.

Care after treatment

Completing your testicular cancer treatment is a major milestone. However, there’s a small risk that the cancer could return or could develop in the other testicle. So you’ll still need some ongoing care:

You’ll want to have regular follow-up appointments to check for any signs of cancer or long-term effects from treatment. Be sure to talk about possible long-term issues with your providers so you know what to watch for.

• You may want to continue mental health support, such as counseling or support groups.
• If you want to start or grow your family, you can talk to your providers about fertility options.
• You can support your ongoing health with a healthy lifestyle. Eat a balanced diet, get plenty of physical activity, avoid tobacco and limit alcohol.