The main treatment approach to testicular cancer is surgical removal of the affected testicle, a procedure called orchidectomy.
Depending on the type of testicular cancer the patient has, further treatment may involve chemotherapy, radiotherapy and additional surgery to remove tumors that have spread to any other parts of the body. Testicular cancer is one of the most treatable forms of cancer, with a cure rate of more than 96% among men with early-stage disease. The cure rate is also high (80%) among those with more advanced disease that has spread to tissue outside of the testicles.
The recommended treatment approach to testicular cancer will then depend on the following:
- Stage of the cancer
- Whether the cancer is a seminoma or a non-seminoma
- After orchidectomy for stage one seminoma, only a single dose of chemotherapy is usually required to prevent recurrence. On some occasions, a short radiotherapy course may also be advised.
- After orchidectomy for stage one non-seminoma, close monitoring or a short course of chemotherapy may be advised.
- 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.
- After orchidectomy, a patient needs to stay in hospital for a few days. Most patients only need to have one testicle removed and do not experience any long-lasting effects such as sexual dysfunction or infertility. Rarely, however, both testicles are removed in a bilateral orchidectomy and the patient is no longer able to produce sperm.
- Men due to undergo a bilateral orchidectomy may wish to bank their sperm beforehand if they wish to father children in the future.
- The removal of both testicles also means the male sex hormone testosterone is no longer produced, which can lower libido and cause sexual dysfunction. These patients can take testosterone replacement therapy, which is usually administered as an injection or skin patches. This will allow a man to increase his sex drive and achieve and maintain erections.
Reviewed by Sally Robertson, BSc