There is a range of treatment options that can successfully cure or manage testicular cancer. These include surgery, chemotherapy, high-dose chemotherapy with stem cell transplants, hormone therapy and radiation therapy. You and your doctor will determine which approach is best for you.
Surgery
Because most patients diagnosed with testicular cancer are young and otherwise in good health, surgery is typically the first form of treatment. In a radical inguinal orchiectomy the entire testicle in removed from an incision made in the groin. If the lymph nodes behind the abdomen are affected, then they will be removed in a second procedure. This can be done laparoscopically through small incisions in the abdomen or using a traditional open incision technique.
Chemotherapy
Chemotherapy uses drugs circulated through the blood stream to destroy cancer cells. It is used if the cancer has spread outside the testicle. It can also be used after surgery if the tumor was not confined to the testicle, to destroy any cancerous cells left behind and prevent recurrence of the cancer. Most chemotherapy for testicular cancer is injected intravenously.
Stem Cell or Bone Marrow Transplant
Testicular cancer typically responds well to chemotherapy, but in some cases the cancer returns. Higher doses of chemotherapy could be more effective to treat the recurrence, but can damage the bone marrow where red blood cells are formed. This can lead to problems such as infections and bleeding. In a process called leukapheresis, blood and/or marrow are collected and the blood forming stem cells are separated out. The blood is then returned to the body and the stem cells are frozen. The tumor is then subjected to high-dose chemotherapy to destroy all of the cancer cells in the testicle. The stem cells are then intravenously returned to the body. You may undergo one or two high-dose chemotherapy stem cell transplants six to 12 months apart.
Radiation Therapy
Your doctor may recommend External Beam Radiation Therapy (EBRT) as the primary treatment for seminoma germ cell tumors or in conjunction with surgery such as an orchiectomy, where the testicle is removed. Seminoma germ cell tumors are very sensitive to radiation therapy and this helps to prevent recurrence of the cancer. EBRT is not commonly used for non-seminoma germ cell tumors because they are not sensitive to radiation. Radiation can also be used if the cancer has spread beyond the testicle to treat the area of the lymph nodes.