In most cases of testicular cancer, whether the cancer is local or has spread, your doctor will recommend a radical inguinal orchiectomy to remove the affected testicle. It is a minimally invasive procedure, done via a small incision in your groin. The procedure removes the tumor along with the entire testicle and the spermatic cord. Early in the surgery, blood and lymph vessels that might allow the cancer to travel to other parts of the body are tied off to prevent any potential spread to other parts of the body.
Your doctor may also recommend a procedure to remove nearby lymph nodes, though this is not necessary in every case of testicular cancer. The procedure, called a retroperitoneal lymph node dissection (RPLND), is a more complex procedure than an orchiectomy and is either done open through an incision in your abdomen or, in some cases, laparoscopically. After removal, the lymph nodes are tested for cancerous cells. If you undergo a laparoscopic lymph node removal and cancer is detected in those lymph nodes, your doctor will likely recommend chemotherapy as a follow-up to the procedure.
In radiation therapy, a high-energy beam is directed at precise points on your body to kill cancer cells. This beam could be made of gamma rays, X-rays, or particles such as electrons, protons or neutrons. If you have testicular cancer, radiation is most often used to kill cancer cells that have spread to your lymph nodes. It is used most frequently in patients with the seminoma type of testicular cancer, which is especially sensitive to radiation. It can also be used to treat testicular cancer that has spread to other parts of the body.
Another name for radiation therapy is external beam radiation. Before you begin treatment, your team will determine the exact points where the beam needs to be aimed and calculate the proper angles for the beam as well as the correct dosage of radiation for your specific case. Learn more about our services by visiting our Radiation Oncology website.
Chemotherapy can be delivered in one of two forms: either orally in pill form or injected into a vein or muscle. For testicular cancer, chemotherapy is most often delivered intravenously and treats cancer that spread outside the testicle, including when cancerous cells spread to lymph nodes or other organs.
Chemotherapy drugs travel throughout your body seeking and destroying cancer cells and are referred to as a systemic therapy. Treatment is delivered in cycles between three and four weeks, with time for your body to rest in between. Some chemotherapy drugs may cause infertility in some men, so if this is of concern to you, talk to your doctor about preserving your sperm before you begin treatment.