Testicular Cancer (cont.)
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.
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 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
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Testicular Cancer - Symptoms
Question: What were the symptoms and signs associated with testicular cancer in you or your partner?
Testicular Cancer - Treatments
Question: What kinds of treatment, surgery, or therapy did you or your partner receive for testicular cancer?