How is testicular cancer treated? What are the side effects of treatment?
Although the incidence of testicular cancer has risen in recent years, more
than 95 percent of cases can be cured. Treatment is more likely to be successful
when testicular cancer is found early. In addition, treatment can often be less
aggressive and may cause fewer side effects.
Most men with testicular cancer can be cured with surgery, radiation therapy,
and/or chemotherapy. The side effects depend on the type of treatment and may be
different for each person.
Seminomas and nonseminomas grow and spread differently and are treated
differently. Nonseminomas tend to grow and spread more quickly; seminomas are
more sensitive to radiation. If the tumor contains both seminoma and nonseminoma
cells, it is treated as a nonseminoma. Treatment also depends on the stage of
the cancer, the patient's age and general health, and other factors. Treatment
is often provided by a team of specialists, which may include a surgeon, a
medical oncologist, and a radiation oncologist.
The three types of standard treatment are described below.
Surgery to remove the
testicle through an incision in the groin is called a radical inguinal
orchiectomy. Men may be concerned that losing a testicle will affect their
ability to have sexual intercourse or make them sterile (unable to produce
children). However, a man with one healthy testicle can still have a normal
erection and produce sperm. Therefore, an operation to remove one testicle
does not make a man impotent
(unable to have an erection) and seldom
interferes with fertility (the ability to produce children). For cosmetic
purposes, men can have a prosthesis (an artificial testicle) placed in the
scrotum at the time of their orchiectomy or at any time afterward.
Some
of the lymph nodes located deep in the abdomen may also be removed (lymph node
dissection). This type of surgery does not usually change a man's ability to
have an erection or an orgasm, but it can cause problems with fertility if it
interferes with ejaculation. Patients may wish to talk with their doctor about
the possibility of removing the lymph nodes using a special nerve-sparing
surgical technique that may preserve the ability to ejaculate normally.
Radiation therapy (also called radiotherapy) uses high-energy rays to kill
cancer cells and shrink tumors. It is a local therapy, meaning that it affects
cancer cells only in the treated areas. External radiation (from a machine
outside the body), aimed at the lymph nodes in the abdomen, is used to treat
seminomas. It is usually given after surgery. Because nonseminomas are less
sensitive to radiation, men with this type of cancer usually do not undergo
radiation therapy.
Radiation therapy affects normal
as well as cancerous cells. The side effects of radiation therapy depend
mainly on the treatment dose. Common side effects include fatigue, skin
changes at the site where the treatment is given, loss of appetite, nausea,
and diarrhea. Radiation
therapy interferes with sperm production, but many patients regain their
fertility over a period of 1 to 2 years.
Chemotherapy is the use of anticancer drugs to kill cancer cells. When
chemotherapy is given to testicular cancer patients, it is usually given as
adjuvant therapy (after surgery) to destroy cancerous cells that may remain in
the body. Chemotherapy may also be the initial treatment if the cancer is
advanced; that is, if it has spread outside the testicle at the time of the
diagnosis. Most anticancer drugs are given by injection into a vein.
Chemotherapy is a systemic therapy, meaning drugs travel through the
bloodstream and affect normal as well as cancerous cells throughout the body.
The side effects depend largely on the specific drugs and the doses. Common side
effects include nausea, hair loss, fatigue,
diarrhea, vomiting, fever,chills,
coughing/shortness of breath, mouth sores, or skin rash. Other side effects
include dizziness, numbness, loss of reflexes, or difficulty hearing. Some
anticancer drugs also interfere with sperm production. Although the reduction in
sperm count is permanent for some patients, many others recover their fertility.
Some men with advanced or recurrent testicular cancer may undergo treatment
with very high doses of chemotherapy. These high doses of chemotherapy kill
cancer cells, but they also destroy the bone marrow, which makes and stores
blood cells. Such treatment can be given only if patients undergo a bone marrow
transplant. In a transplant, bone marrow stem cells are removed from the patient
before chemotherapy is administered. These cells are frozen temporarily and then
thawed and returned to the patient through a needle (like a blood transfusion)
after the high-dose chemotherapy has been administered.
Men with testicular cancer should discuss their concerns about sexual
function and fertility with their doctor. It is important to know that men with
testicular cancer often have fertility problems even before their cancer is
treated. If a man has pre-existing fertility problems, or if he is to have
treatment that might lead to infertility, he may want to ask the doctor about
sperm banking (freezing sperm before treatment for use in the future). This
procedure allows some men to have children even if the treatment causes loss of
fertility.
A hernia is an opening or weakness in the muscular structure of the wall of the abdomen. This defect causes a bulging of the abdominal wall. Symptoms of a hernia include pain or discomfort and a localized swelling somewhere on the surface of the abdomen or in the groin area.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Testicular pain, or pain in the testicle or testicles are caused by a variety of diseases or conditions such as testicular trauma, testicular torsion, testicular cancer, epididymitis, and orchitis. Common symptoms of pain in the testicle or testicles are abdominal pain, urinary pain or incontinence, fever, nausea, vomiting, and pain in the scrotum or testicle. Treatment depends on the cause of the testicular pain or pain in the testicles.
Gynecomastia, an enlargement of the gland tissue in the male breast is the caused by an imbalance of hormones. Certain medical conditions may also lead to gynecomastia such as cirrhosis, malnutrition, disorders of the male sex organs, kidney failure, thyroid disorders, and medications. Gynecomastia is generally treated with medication, and if necessary surgery.
Hydrocele is a collection of clear fluid in a thin walled sack that also contains the testicle. Hydroceles are more common in males than females. There are two types of hydroceles: 1) communicating and 2)non-communicating. Hydroceles present at birth may resolve on their own. Hydroceles that appear in the teen or adult years may require surgery.
Though it's difficult to say why some people develop cancer while others don't, research shows that certain risk factors increase a person's odds of developing cancer. These risk factors include growing older, family history of cancer, diet, alcohol and tobacco use, and exposure to sunlight, ionizing radiation, certain chemicals, and some viruses and bacteria.
Men's health is an important component to a happy lifestyle and healthy relationships. Eating healthy, exercise, managing stress, and knowing when to have medical tests for a particular age is key to disease prevention in men.
Most often, caregivers take care of other adults who are ill or disabled. Less often, caregivers are grandparents raising their grandchildren. The majority of caregivers are middle-aged women. Caregiving can be very stressful, so it's important to recognize when it's putting to much strain on you and to take steps to prevent/relieve stress.
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