By Dr Ananya Mandal, MD
When detected and treated in the early stages, testicular cancer is one of the most curable cancers to affect men.
Depending on the type of testicular cancer a patient has, their care after treatment may include monitoring alone, chemotherapy, radiotherapy, further surgery or different combinations of these.
Some of the approaches to managing patients after they have been treated for testicular cancer are described below.
- The primary approach to all cases of testicular cancer, irrespective of cancer stage, is surgical removal of the affected testicle, a procedure called orchidectomy. In cases of stage one non-seminoma, only close patient monitoring or a short chemotherapy course may be required after the procedure. For those who had stage one seminoma, only a single dose of chemotherapy is usually required to prevent recurrence, although a short radiotherapy course may also be advised for some individuals.
- After orchidectomy for stage three and four cancers, several rounds of chemotherapy are usually administered and any affected lymph nodes are also surgically removed.
- Stage four cancers often require a similar approach to stage two and three cancers, but additional surgery may also be needed to remove tumors that are growing in other parts of the body.
- In the majority of testicular cancer cases, only one testicle needs to be removed. However, in some cases, both testicles are removed in a bilateral orchidectomy procedure. Men with one remaining testicle suffer few lasting effects and do not experience a loss of libido or a reduction in fertility. However, those who undergo bilateral orchidectomy lose their ability to produce sperm and testosterone. These patients may wish to bank their sperm before orchidectomy if they wish to father children in the future. To address the loss of testosterone, testosterone replacement therapy is administered to increase sex drive and restore sexual function. Testosterone is usually administered as an injection or in the form of skin patches.
- Smoking is a known risk factor for testicular and other forms of cancer. Patients should therefore be encouraged to stop smoking after their cancer has been treated.
After a man has been treated for testicular cancer, there is still a risk of cancer recurrence. Around one quarter of patients experience recurrence of the cancer within two years of treatment finishing. Patients therefore need to be regularly monitored using physical examinations, blood tests to check for certain cancer markers, chest X-rays and computed tomography (CT) scans.
Follow-up checks are performed frequently within the first two years of treatment finishing and may continue for up to five years. Even if the cancer does return, it is usually possible to cure it again using chemotherpay or radiotherpay if it is detected in the early stages.
Reviewed by Sally Robertson, BSc
Last Updated: Sep 16, 2014