Treatment Overview

If you are diagnosed with testicular cancer, your doctor will explain what type of cancer you have, whether it has spread beyond the testicle (metastasized), and the potential for curing it. You and your doctor will discuss your treatment options and possible outcomes of those treatments. Testicular cancer is considered a highly curable disease, especially when diagnosed at an early stage.

Initial treatment

Treatment for testicular cancer begins with a radical inguinal orchiectomy, which is surgery to remove the affected testicle(s). After surgery, depending on which type of cancer cells are present and whether your cancer has spread to other areas of your body (stage), you may need only surveillance. Or you may need further treatment with chemotherapy, radiation therapy, or surgery to remove lymph nodes (RPLND).

If your cancer was found early, you may have a choice regarding further treatment. Talk with your doctor about the risks and possible side effects of each treatment option. For more information, see:

Testicular Cancer: Which Treatment Should I Have for Stage I Seminoma Testicular Cancer After My Surgery?

Testicular Cancer: Which Treatment Should I Have for Stage I Nonseminoma Testicular Cancer After My Surgery?

If testicular cancer is not found and treated during its early stages, it may spread (metastasize) to the lymph nodes and to the lungs, liver, brain, and bones. But often testicular cancer that has spread can still be treated successfully.

Ongoing treatment

Regardless of the therapy you choose to treat your testicular cancer, it is important to receive follow-up care, which may lead to early identification and management of recurrent cancer (cancer that comes back). Your regular follow-up program may include:

• Physical exams.
• Imaging tests, including X-rays, CT scans, and MRIs.
• Blood tests, to check tumor marker levels. Stable or increasing tumor marker levels after treatment may mean that your cancer is still present or has returned and that further treatment is needed.

A diagnosis of testicular cancer means that you will be seeing your doctor regularly for years to come, so it's a good idea to develop a relationship based on trust and the sharing of information. Your doctor may give you some advice on changes to make in your life to help treatment be successful.

Treatment if the condition gets worse

Testicular cancer that has come back (recurred) may be discovered during a physical exam, through an imaging test, or as a result of increasing tumor marker levels. In some cases, treatment for recurrent testicular cancer may be successful, especially if the cancer has spread only to the lymph nodes in the pelvis, abdomen, or lower back and pelvis (retroperitoneum).

Recurrent testicular cancer may be treated with chemotherapy, surgery to remove lymph nodes, or radiation. Sometimes high doses of chemotherapy are needed. If these treatments don't work, then high-dose chemotherapy with autologous stem cell transplant may be tried.

In many cases of recurrent testicular cancer, chemotherapy treatment is followed by surgery to remove any remaining cancer as well as tissue damaged as a result of the chemotherapy.

What to think about

When you first find out that you have cancer, you may feel scared or angry. Or you may feel very calm. It is normal to have a wide range of feelings and for those feelings to change quickly. Some people find that it helps to talk about their feelings with their family and friends.

If your emotional reaction to cancer interferes with your ability to make decisions about your health, it is important to talk with your doctor. Your cancer treatment center may offer psychological or financial services. You can also contact your local chapter of the American Cancer Society to help you find a support group.

Infertility. Some cancer treatments raise your risk of infertility. Unless you are sure you won't want to father a child in the future, talk to your doctor about sperm banking before any treatment for testicular cancer.

Palliative care

Cancer treatment has two main goals: curing cancer and making your quality of life as good as possible. Your quality of life may be improved by having palliative care to manage your symptoms.

Testicular cancer has a very good cure rate, especially if it is found early. For some people who have advanced-stage cancer, a time comes when more treatment to cure cancer no longer seems like a good choice. This can be because the side effects, time, and costs of treatment are greater than the promise of cure or relief. But this isn't the end of treatment. You and your doctor can decide when you may be ready for hospice care.

It can be hard to decide when to stop treatment aimed at prolonging your life and shift the focus to end-of-life care. For more information, see the topics:

Palliative Care.

Hospice Care.

Care at the End of Life.

For more information about testicular cancer, see the following topics:

• Testicular Cancer Treatment (PDQ) - Health Professional Information
• Testicular Cancer Treatment (PDQ) - Patient Information