Testicular Cancer (cont.)
In this Article
- What is testicular cancer?
- What are testicular cancer risk factors and causes?
- How is testicular cancer detected? What are testicular cancer symptoms and warning signs?
- How is testicular cancer diagnosed?
- How is testicular cancer treated? What are the side effects of treatment for testicular cancer?
- Is follow-up treatment necessary for testicular cancer? What does it involve?
- Are clinical trials (research studies) available for men with testicular cancer?
- Testicular Cancer At A Glance
- Find a local Oncologist in your town
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.
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 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.
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