Treatment and Prevention
The first line of treatment for testicular cancer is surgery to remove the affected testicle. This is then followed up with radiotherapy, chemotherapy, or a combination of the 2. The oncologist (a doctor who specializes in treating cancer) will often decide after surgery what follow-up treatment is best based on the type of cancer and the stage of the disease.
Seminomas in the early stage are often treated with surgery and radiotherapy. Non-seminomatouos germ cell tumors (NSGCT) are often treated with more extensive surgery such as radical retroperitoneal lymph node dissection (the removal of some lymph nodes behind the abdomen) followed by watchful waiting or chemotherapy. Often, the use of chemotherapy or surgery depends on an estimate of the risk (low, intermediate, or high) of the cancer worsening or spreading. Various factors, such as the type and stage of the cancer and your overall health, may indicate one treatment is more suitable than another.
For more advanced disease, such as bulky tumors or metastatic disease, treatment with chemotherapy can still be highly effective. There is a still a significant cure-rate even for testicular cancer that has moved to other parts of the body. Sometimes for high-risk disease, though most often for a recurring cancer, high-dose chemotherapy with autologous stem cell support (a bone marrow transplant from the patient's own stem cells after high-dose chemotherapy) can be successful in long-term remission or even cure.
Side effects for radiation therapy can include:
- decreased appetite
- diarrhea
- fatigue
- nausea
- red, dry skin at the radiation site
Radiation can affect fertility, but any reduction in sperm production is usually temporary.
Because chemotherapy circulates throughout the body, more of the body systems are affected by the treatment. Side effects from chemotherapy include:
- chills
- coughing
- diarrhea
- fatigue
- hair loss
- mouth sores
- nausea and vomiting
- shortness of breath
Some chemotherapy can cause sterility so this should be discussed before treatment starts. Those who want to be able to father children in the future should speak to their doctors regarding storing sperm.
Following cancer treatment, doctors usually recommend blood tests and chest X-rays every month for one year and every 2 months for the second year.
The outlook for testicular cancer is good; the earlier the cancer is detected, the better the expected outcome. Recurrences of the cancer are possible, however, so those who have had it treated must be watchful for any signs of the cancer returning. Statistics show that most recurrences happen within the first year following treatment.
Since there are no known causes for testicular cancer, prevention lies in early detection. Monthly testicular examinations are the best way to discover the cancer in the earliest of stages - and early discovery offers the best chance for a cure.