Testicular Cancer Treatments

Testicular cancer treatments may include surgery, chemotherapy or radiation therapy. If testicle tumors are diagnosed in their early stages, current treatments are very effective. In many cases of testicular cancer, radiation therapy and chemotherapy can even cure tumors that have metastasized.

Orchiectomy and Surgery

Surgery is the most common form of testicular cancer treatment. The most effective way to remove testicle tumors is to remove the entire testicle, a procedure known as an orchiectomy. Often, an orchiectomy is performed during the diagnostic biopsy.

Although surgery removes an entire testicle, if the surviving testicle is healthy, sexual function is unimpaired. The remaining testicle is sufficient for normal sexual activity, and reproduction is still possible.

Removal of Lymph Nodes

During an orchiectomy, the surgeon may also remove regional lymph nodes. Local lymph nodes may have been affected by testicular cancer. By removing lymph nodes the possibility of recurring tumors is lowered.

An additional surgery called retroperitoneal lymph node dissection (RPLND), removes all the lymph nodes in the abdomen. RPLND is not recommended for all cases of testicular cancer, but is sometimes necessary for the best outcome. This extensive lymph node removal surgery does have certain risks. Nerve damage caused by the surgical removal of lymph nodes may affect ejaculation. Surgeons are constantly looking for new ways to preserve nerves around the lymph nodes so sexual performance is not affected by surgery. Nerve damage remains, however, one of the possible side effects of lymph node removal. Patients may also suffer from lingering intestinal inactivity and will most certainly feel painful for several months following the surgery.

Radiation Therapy After Surgery

Surgery may be followed by radiation therapy to kill any remaining cancer cells. Whether to pursue radiation therapy after surgery depends on the type and stage of the cancer. Seminoma tumors are especially sensitive to radiation therapy. Non-seminoma tumors are far more resistant.

Radiation therapy can have side effects, such as fatigue, nausea, skin rashes and diarrhea. Some people experience a loss of appetite during radiation therapy.

Chemotherapy and Testicular Cancer Treatments

Chemotherapy, like radiation therapy, is a testicular cancer treatment most often used after an orchiectomy. Advanced stage testicular cancer may benefit from chemotherapy. The main medications used to treat testicular tumors are cisplatin, etoposide, and bleomycin.

Chemotherapy is a systemic treatment, meaning the drugs affect the entire body, which can cause many different side effects. Sperm production may be affected during chemotherapy. While this is usually temporary, chemotherapy’s affect on sperm can be permanent, and men should consider sperm banking before treatment.

Other chemotherapy side effects include:

  • chills
  • coughing
  • fatigue
  • fever
  • hair loss
  • mouth sores
  • nausea
  • shortness of breath
  • skin rashes
  • >vomiting.

Testicular Cancer Treatments Side Effects

Some side effects are common to both chemotherapy and radiation therapy. Both types of testicular cancer treatments can affect sex hormone production, leading to gynecomastia. Gynecomastia is characterized by breast growth and breast tenderness in men. Such side effects usually resolve when treatments end.

New Developments in Testicular Cancer Treatments

Certain types of germ cell tumors have a genetic marker on their cell surface known as an epidermal growth factor receptor (EGFR). Clinical investigations are examining the possibility of using antibodies to target tumors that contain EGFR. Similar treatments for breast cancer using the drug Herceptin® have met with some success.

Resources

Hellerstedt, B. A.