Basics of Testicular Cancer
Chemotherapy, radiotherapy and surgery are the 3 main treatments for testicular cancer. Your recommended treatment plan will depend on:
- the type of testicular cancer you have – whether it's a seminoma or a non-seminoma
- the stage of your testicular cancer
An orchidectomy is a surgical procedure to remove a testicle. If you have Testicular Cancer, the whole of the affected testicle will need to be removed because only removing the tumour may lead to the cancer spreading. By removing the entire testicle, your chances of making a full recovery are greatly improved. Your sex life and ability to father children will not be affected. About 1 in 50 people will get a second new Testicular Cancer in their remaining testicle. If testicular cancer is detected in its very early stages, an orchidectomy may be the only treatment you require. An orchidectomy is not carried out through the scrotum. It's done by making a cut in your groin that the testicle is removed through, along with all the tubes and blood vessels attached to the testicle that pass through the groin into the tummy. The operation is carried out under general anaesthetic. You can have an artificial (prosthetic) testicle inserted into your scrotum, so the appearance of your testicles is not greatly affected. The artificial testicle is usually made of silicone, a soft type of plastic. It probably will not be exactly like your old testicle or the one you still have. It may be slightly different in size or texture.
Most people are still fertile after having 1 testicle removed. But some treatments for Testicular Cancer can cause infertility. Some people with Testicular Cancer may have low sperm counts because of changes that occur in the testicles before the cancer develops. For some treatments, such as chemotherapy, infertility may occur, but standard chemotherapies have a less than 50% chance of causing infertility if the remaining testicle is normal. In people who need to have post-chemotherapy removal of lumps at the back of the abdomen, known as retroperitoneal lymph node dissection (RPLND), the ability to ejaculate may be affected, even though the remaining testicle can still produce sperm. Before your treatment begins, you may want to consider sperm banking.
Chemotherapy uses powerful medicines to kill the malignant (cancerous) cells in your body or stop them multiplying. You may require chemotherapy if you have advanced testicular cancer or it's spread within your body. It's also used to help prevent the cancer returning. Chemotherapy is commonly used to treat seminomas and non-seminoma tumours. Chemotherapy medicines for testicular cancer are usually injected into a vein.
Radiotherapy uses high-energy beams of radiation to help destroy cancer cells. Sometimes seminomas may require radiotherapy after surgery to help prevent the cancer returning. It may also be needed in advanced cases where someone is unable to tolerate the complex chemotherapies usually used to treat stage 2 and 3 Testicular Cancer. If testicular cancer has spread to your lymph nodes, you may require radiotherapy after a course of chemotherapy.