Testicular Cancer Management

By Dr. Ananya Mandal, MDReviewed by Sally Robertson, B.Sc.

Testicular cancer is more likely to be successfully treated if the condition is detected in the early stages of disease. The recommended treatment approach will then depend on the following:

• Stage of the cancer
• Whether the cancer is a seminoma or a non-seminoma

Steps to manage testicular cancer

• The primary approach to all cases of testicular cancer, irrespective of cancer stage, is surgical removal of the affected testicle, a procedure called orchidectomy.
• After orchidectomy for stage one seminoma, only a single dose of chemotherapy is usually required to prevent recurrence. On some occasions, a short radiotherapy course may also be advised.
• After orchidectomy for stage one non-seminoma, close monitoring or a short course of chemotherapy may be advised.
• After orchidectomy for stage three and four cancers, several rounds of chemotherapy are usually administered and any affected lymph nodes are also surgically removed.
• Stage four cancers often require a similar approach to stage two and three cancers, but additional surgery may also be needed to remove tumors that are growing in other parts of the body.
• After orchidectomy, a patient needs to stay in hospital for a few days. Most patients only need to have one testicle removed and do not experience any long-lasting effects such as sexual dysfunction or infertility. Rarely, however, both testicles are removed in a bilateral orchidectomy.
• However, those who undergo bilateral orchidectomy will lose their ability to produce sperm. These patients may wish to bank their sperm beforehand if they wish to father children in the future.
• The removal of both testicles also means the male sex hormone testosterone is no longer produced, which can lower libido and cause sexual dysfunction. These patients can take testosterone replacement therapy to make up for the lack of naturally produced testosterone. Testosterone is usually administered as an injection or skin patches. This will allow a man to increase his sex drive and achieve and maintain erections.

Further Reading

• All Testicular Cancer Content
• What is Testicular Cancer?
• Testicular Cancer Diagnosis
• Testicular Cancer Classification
• After Testicular Cancer Treatment