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Testicular Cancer Treatment Options by Staging

Treatment Options by Stage

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Stage I Testicular Cancer

Treatment of stage I testicular cancer depends on whether the cancer is a seminoma or a nonseminoma.

Treatment of seminoma may include the following:

Treatment of nonseminoma may include the following:

  • Surgery to remove the testicle and lymph nodes in the abdomen, with lifelong follow-up.
  • Surgery to remove the testicle, with lifelong follow-up.
  • Surgery followed by chemotherapy for patients at high risk of recurrence, with lifelong follow-up.

Check for U.S. clinical trials from NCI’s PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I malignant testicular germ cell tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Stage II Testicular Cancer

Treatment of stage II testicular cancer depends on whether the cancer is a seminoma or a nonseminoma.

Treatment of seminoma may include the following:

Treatment of nonseminoma may include the following:

  • Surgery to remove the testicle and lymph nodes, with lifelong follow-up.
  • Surgery to remove the testicle and lymph nodes, followed by combination chemotherapy and lifelong follow-up.
  • Surgery to remove the testicle followed by combination chemotherapy and a second surgery if cancer remains, with lifelong follow-up.
  • Combination chemotherapy before surgery to remove the testicle, for cancer that has spread and is thought to be life-threatening.
  • A clinical trial of combination chemotherapy instead of removing the lymph nodes.

Check for U.S. clinical trials from NCI’s PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II malignant testicular germ cell tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Stage III Testicular Cancer

Treatment of stage III testicular cancer depends on whether the cancer is a seminoma or a nonseminoma.

Treatment of seminoma may include the following:

Treatment of nonseminoma may include the following:

  • Surgery to remove the testicle, followed by combination chemotherapy.
  • Combination chemotherapy followed by surgery to remove any remaining tumor. Additional chemotherapy may be given if the tumor tissue removed contains cancer cells that are growing.
  • Combination chemotherapy combined with radiation therapy to the brain for cancer that has spread to the brain.
  • Combination chemotherapy before surgery to remove the testicle, for cancer that has spread and is thought to be life-threatening.
  • A clinical trial of a new therapy.
  • A clinical trial of high-dose chemotherapy with bone marrow transplant.

Check for U.S. clinical trials from NCI’s PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III malignant testicular germ cell tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Treatment Options for Recurrent Testicular Cancer

Treatment of recurrent testicular cancer may include the following:

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Testicular Cancer – General Information

Testicular cancer is a disease in which malignant (cancer) cells form in the tissues of one or both testicles.

The testicles are 2 egg-shaped glands located inside the scrotum (a sac of loose skin that lies directly below the penis). The testicles are held within the scrotum by the spermatic cord, which also contains the vas deferens and vessels and nerves of the testicles.

testicular cancer

testicular cancer

Anatomy of the male reproductive and urinary systems, showing the testicles, prostate, bladder, and other organs.

The testicles are the male sex glands and produce testosterone and sperm. Germ cells within the testicles produce immature sperm that travel through a network of tubules (tiny tubes) and larger tubes into the epididymis (a long coiled tube next to the testicles) where the sperm mature and are stored.

Almost all testicular cancers start in the germ cells. The two main types of testicular germ cell tumors are seminomas and nonseminomas. These 2 types grow and spread differently and are treated differently. Nonseminomas tend to grow and spread more quickly than seminomas. Seminomas are more sensitive to radiation. A testicular tumor that contains both seminoma and nonseminoma cells is treated as a nonseminoma.

Testicular cancer is the most common cancer in men 20 to 35 years old.

Health history can affect the risk of developing testicular cancer.

Anything that increases the chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors for testicular cancer include:

Possible signs of testicular cancer include swelling or discomfort in the scrotum.

These and other symptoms may be caused by testicular cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:

  • A painless lump or swelling in either testicle.
  • A change in how the testicle feels.
  • A dull ache in the lower abdomen or the groin.
  • A sudden build-up of fluid in the scrotum.
  • Pain or discomfort in a testicle or in the scrotum.

Tests that examine the testicles and blood are used to detect (find) and diagnose testicular cancer.

The following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. The testicles will be examined to check for lumps, swelling, or pain. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
  • Serum tumor marker test: A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers. The following 3 tumor markers are used to detect testicular cancer:

    Tumor marker levels are measured before radical inguinal orchiectomy and biopsy, to help diagnose testicular cancer.

  • Radical inguinal orchiectomy and biopsy: A procedure to remove the entire testicle through an incision in the groin. A tissue sample from the testicle is then viewed under a microscope to check for cancer cells. (The surgeon does not cut through the scrotum into the testicle to remove a sample of tissue for biopsy, because if cancer is present, this procedure could cause it to spread into the scrotum and lymph nodes.) If cancer is found, the cell type (seminoma or nonseminoma) is determined in order to help plan treatment.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

  • Stage of the cancer (whether it is in or near the testicle or has spread to other places in the body, and blood levels of AFP, β-hCG, and LDH).
  • Type of cancer.
  • Size of the tumor.
  • Number and size of retroperitoneal lymph nodes.

Testicular cancer is often curable.

Treatment for testicular cancer can cause infertility.

Certain treatments for testicular cancer can cause infertility that may be permanent. Patients who may wish to have children should consider sperm banking before having treatment. Sperm banking is the process of freezing sperm and storing it for later use.

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Testicular Cancer Treatment Options by Staging

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

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