What Are the Treatments for Testicular Cancer?

Testicular cancer refers to cancer that originates in the testicles. With advances in modern science, testicular cancer has become a manageable and treatable disease. As of 2009, Sloan Kettering reports that statistics show up to 90 percent of testicular cancers are curable, especially if the cancer is identified early and the patient is given timely treatment.

Stages & Treatment

• Testicular cancer treatment depends on the type of tumor and the stage of the cancer. There are 2 types of tumors: seminoma tumors or nonseminoma tumors. Staging is done using the American Joint Committee on Cancer Staging Protocol, referred to as AJCC or TNM System. It is based on three factors: the "T" factor which corresponds with the size of the tumor, the "N" factor which corresponds with lymph node involvement and the "M" factor which addresses whether there is metastasis. Possible treatments for testicular cancer, depending on the type and stage of the tumor, include surgery, radiation, chemotherapy or monitoring.

Stage I-IIA Seminoma Treatments

• For patients with early Stage (Stage I) testicular cancer, surgery may be sufficient. A surgery, called a radical orchiectomy, involves removal of the affected testicle. Following the surgery, no additional treatment may be needed although the patient may be monitored closely for a set period of time or for life. Fertility is not affected by orchiectomy and patients may chose to have a cosmetic procedure involving the insertion of a prosthesis. Approximately 15 percent of patients treated with an orchiectomy experience a relapse of testicular cancer.

  If the cancer has spread beyond the testicle but is still locally contained, external beam radiation therapy targeted to lymph nodes in the abdomen and pelvis is recommended. The combination of surgery and targeted radiotherapy is successful in the vast majority of cases, but followup treatment is needed to monitor the side effects of the radiation and to ensure that the patient does not develop a new cancer at the site of radiation.

Stage I-IIB Nonseminoma Treatments

• Treatment for early stage nonseminoma tumors still involves the orchiectomy to remove the testicle. Cancer cells may also be present in the lymph nodes of the retroperitoneum, in which case an additional surgery is performed called a retroperitoneal lymph node dissection. The removal of these lymph nodes surgically can allow patients to avoid the need for chemotherapy. However, infertility may result as a side effect of the lymph node removal.

Advanced Testicular Cancer (Stages IS, IIB to III)

• Chemotherapy is recommended for treatment for advanced testicular cancer which has spread or metastasized. The most commonly used chemotherapy agents include a combination called EP (made from etoposide and cisplatin) or a combination called BEP (which adds bleomycin). Of patients who are treated with one of these chemotherapy combinations, 90 percent are cured.

Treatment and Fertility

• While testicular cancer itself does not affect fertility, radiation and chemotherapy can interfere with the production of viable sperm. Doctors at Sloan Kettering recommend freezing and storing sperm prior to treatment for patients who may wish to conceive a child.