Testicular Cancer: Treatment Choices

You may have questions and concerns about your treatment options. You may want to know how you’ll feel, how you'll look, and how your body will work after treatment, and if you’ll have to change your normal activities.

Your healthcare provider is the best person to answer your questions. They can explain what your treatment choices are, how well treatment is expected to work, and what the risks and side effects may be.

Your healthcare provider may advise a specific treatment. Or they may offer more than one and ask you to decide which one you’d like to use. It can be hard to make this decision. It's important to take the time you need to make the best decision.

Deciding on the best plan may take some time. Talk with your healthcare provider about how much time you can take to explore your options. You may want to get a second opinion before deciding on your treatment plan. You may also want to include your partner, family, or friends in this process.

For most testicular cancers, the goal of treatment is to cure the cancer. If a cure is not possible, treatment may be used to shrink the cancer or keep it under control for as long as possible. Treatment can also improve your quality of life by helping to control symptoms of the disease. The goal of testicular cancer treatment is to do one or more of these things:

• Remove the testicle with cancer in it

• Remove or destroy tumors in other parts of the body

• Kill cancer cells or keep them from growing and spreading

• Keep the cancer from coming back or delay its return

• Ease symptoms from the cancer, such as pain or pressure on organs

Each type of treatment has a different goal. Talk with your healthcare provider about treatment goals so you know what to expect.

Treatment for cancer is either local or systemic. You may have both.

Local treatments remove, destroy, or control cancer cells in a certain place in the body. Surgery and radiation are local treatments.

Systemic treatments destroy or control cancer cells throughout the body. Chemotherapy is an example.

• Surgery. This is almost always the first treatment for testicular cancer. The goal is to remove the entire tumor along with the testicle. Sometimes lymph nodes in the lower belly (abdomen) are removed. Depending on the stage of the cancer, surgery may be the only treatment. But sometimes other treatments are needed after surgery.

• Chemotherapy.  This is the use of strong medicines to treat cancer. The goal is to kill any cancer cells still in the body after surgery to help keep the cancer from coming back. When used after surgery, this is called adjuvant chemotherapy.

• Radiation therapy.  The goal of radiation therapy is to kill cancer cells. It's mainly used to treat a type of testicular cancer called a seminoma. It might be used after surgery to treat lymph nodes in the lower back of the abdomen. When it's used after surgery, it is called adjuvant radiation therapy. In this case, the goal is to reduce the chance that the cancer will come back. Radiation can also be used to treat testicular cancer that has spread to other parts of the body, such as the brain. (This is rare.)

Researchers are always looking for new ways to treat testicular cancer. These new methods are tested in clinical trials. Taking part in a clinical trial means you get the best treatment available today, and you might also get new treatments that are thought to be even better. Before starting treatment, talk with your healthcare provider to find out if there are any clinical trials you should think about.

At first, thinking about treatment options may seem overwhelming. Talk with your healthcare providers, nurses, and loved ones. Make a list of questions. Consider the benefits and possible side effects of each option. Discuss your concerns with your healthcare provider before making a decision.