Testicular Cancer: Radiation Therapy

Radiation therapy is a treatment for cancer that uses beams of energy, often X-rays, to kill cancer cells and shrink tumors.

Your healthcare provider and treatment team will work with you to decide what is the best treatment plan for you. Testicular cancer is most often first treated with surgery. Chemotherapy and radiation therapy can also be involved in the treatment Treatment depends on the type and stage of testicular cancer. Many times, more than one kind of treatment is used.

When radiation is used, it is most often used to treat the type of testicular cancer called seminoma.

Your healthcare provider may suggest this treatment for one of these reasons:

• To try to kill any cancer cells left after surgery. Radiation therapy is mainly used to kill testicular cancer cells that may have spread to lymph nodes. It might be used after an orchiectomy (surgery to remove the testicle). The goal is to treat the lymph nodes in the back of your pelvis and belly (abdomen). This is to make sure all the cancer cells are gone, even those that can't be seen on scans.

• To treat areas of cancer spread. Radiation might be used to treat cancer that has spread to other parts of your body, such as the brain.

To plan your treatment, you'll meet with a team of cancer specialists. This might include a surgeon, radiation oncologist, and medical oncologist.

A healthcare provider who specializes in treating cancer with radiation is called a radiation oncologist. This provider works with you to decide the kind of radiation you need. They also figure out the dose and how long you need treatment.

Radiation is often given once a day, 5 days a week, for several weeks. You can often drive yourself to and from therapy.

Before your first radiation treatment, you will have a planning session called simulation. This is done to find out exactly where the radiation beams need to be aimed. This session may take up to 2 hours.

You will need imaging scans. They are used to clearly outline the size and shape of the tumor. The radiation beams are controlled and formed to fit a field in your body that has the highest chance of having cancer. This helps limit damage to nearby healthy tissue.

You’ll lie still on a table while a radiation therapist uses a machine to define your treatment field. The field is the exact area on your body where the radiation will be aimed. Sometimes it’s called your port. A mold or cast might be made so that you're in the exact same position and stay still for each treatment. Permanent ink marks (tiny tattoos) might be put on your skin. This is so the radiation will be aimed at the exact same place each time.

On the days you get radiation treatment, you’ll lie on a table attached to the radiation machine. You may have to wear a hospital gown. The treatment is a lot like getting an X-ray, but it takes longer. The whole thing takes about 15 to 30 minutes to complete. But the radiation treatment itself is only a few minutes.

At the start of the treatment session, a radiation therapist helps you get into position. They may use blocks or special shields to protect parts of your body from exposure to radiation. The therapist may also place a a shield around the scrotum to protect the remaining testicle. The therapist then lines up lights on the machine with the marks on your skin. This is done so the radiation is directed to the right spot. When you’re ready, the therapist leaves the room and turns the machine on. You may hear whirring or clicking noises as the machine moves during radiation. This may sound like a vacuum cleaner. The machine won't touch you.

During the session, you'll be able to talk to the therapist over an intercom. You can’t feel radiation, so the process won't hurt. You won't be radioactive afterward.

Radiation affects normal cells as well as cancer cells. So you may have some side effects. The side effects from radiation are normally limited to the area being treated. Some people have few or no side effects. Sometimes, if you do have them, your healthcare provider may change the dose of your radiation or how often you get treatments. Or treatment may be stopped until the side effects clear up. Tell your healthcare team about the side effects you have right away. It's important to treat them before they get worse.

Common short-term side effects include:

• Nausea or vomiting. This is common and can usually be easily treated with medicine.

• Diarrhea

• Hair loss in the treated area (this can be permanent)

• Severe tiredness (fatigue)

• Skin irritation, redness, or blistering and peeling at the treatment port

• Secondary cancer. These are cancers unrelated to the original one that occur in the area that was radiated. These tend to develop many years after treatment.
• Decrease in fertility. This could mean it is harder to have children in the future.
• Kidney damage

Many of these side effects can be controlled with medicine. Some can even be prevented. They may not start until you're a few weeks into treatment. They can get worse as treatment goes on. Talk with your healthcare team about what to watch for, how to deal with side effects, and how to know when they become serious.

Most side effects go away over time after treatment ends. But some long-term side effects may not show up until many years later. For instance, radiation could also increase your risk for gastrointestinal or heart problems. Also, before starting your treatment, make sure to discuss if sperm banking is a choice for you. Ask your provider about long-term side effects before starting radiation treatment.