Treatments

Recent studies show that people with advanced testicular cancer fare better when they get care at a major medical center where the entire team has extensive experience treating this disease, as we do. Your testicular cancer care team at Columbia Cancer will help you navigate your treatment options for testicular cancer. 

Your doctor may recommend surgery, chemotherapy, or radiation, or a combination. Your treatment plan will be created with your specific cancer and personal considerations in mind. You can also access our male fertility team to discuss your ability to have children after treatment.

Surgery

Surgery may be the only treatment you need if you have early testicular cancer. Often, you’ll go home the same day you have the operation.

The most common surgery for testicular cancer is called a radical orchiectomy. It diagnoses and treats cancer by removing the primary tumor. Your surgeon will remove your testicle and the sperm cord through a small incision in your groin. You might opt to have a prosthetic testicle inserted to maintain a natural appearance. Men are able to go home the same day they have surgery.

If your surgeon removes one testicle, you will still be able to have a normal erections, sexual function, and fertility, if your other testicle is normal.

For men who are at risk for sexual dysfunction or infertility as a result of orchiectomy or other testicular cancer treatments, we partner with male fertility specialists to help you preserve sperm if you want to have children in the future and support hormonal function.

Sometimes, your surgeon will also remove your abdominal lymph nodes during this operation. A pathologist will check if cancer has spread to your lymphatic system. This operation is called a retroperitoneal lymph node dissection and is particularly important for men whose cancer has spread and who have been treated with chemotherapy. It also helps establish its exact stage and type and determine if the cancer has spread outside your testicles.

You may have a large incision from your breastbone to just below your navel. Or, you might be eligible for a minimally invasive operation with smaller incisions and shorter recovery.

This surgery does not interfere with your ability to get an erection, but it can damage the nerves that control ejaculation. We are skilled and experienced in a nerve-sparing technique that can preserve ejaculation.

Active Surveillance

Many men with low-stage testicular cancer are cured by radical orchiectomy alone. Patients with normal imaging and blood tests may be eligible for close surveillance with periodic imaging and blood tests. Active surveillance for testicular cancer has over a 99% survival rate for properly selected patients.

Medication Treatments

We use chemotherapy to cure testicular cancer that has spread beyond your testicles or to keep it from coming back after your testicle has been removed.

Chemotherapy is systemic therapy, meaning that the drug travels throughout the body to attack the cancer cells. You can have chemo through an IV in our comfortable infusion center. You’ll have chemotherapy in three- or four-week cycles with a rest period in between. We often use a combination of several drugs over nine weeks if cancer has spread.

Radiation Therapy

Some men with seminoma may benefit from radiation. Radiation treatment for testicular cancer is a lower dose than what’s given for other cancers. It is sometimes given after radical orchiectomy when cancer is seen in other parts of your body during a CT scan or to treat cancer that doesn’t show up on imaging tests. The radiation beam targets lymph nodes in the back of your abdomen.

Radiation therapy causes cancer cells to break or die by targeting the DNA with high-energy X-ray particles. Radiation oncology specialists direct these particles to the tumor site from outside of your body to precisely target cancer cells, often sparing nearby tissue.

The most common type of radiation we use is called external beam radiation therapy (EBRT). It’s painless, similar to getting an X-ray but with more intense radiation. Our radiation oncology specialists take precise measurements to target only the effective area. They also figure out the exact dose of radiation you need.

During radiation treatment, a shield is employed to keep radiation from reaching the healthy testicle and to prevent infertility.