Radiotherapy for testicular cancer

Radiotherapy is a very effective treatment for seminoma| but it isn’t usually used to treat teratoma|.

The most likely place for seminoma to come back in or to spread to is the lymph nodes at the back of the abdomen (retroperitoneal nodes)|. You may need radiotherapy to this area either to:

• reduce the risk of the cancer coming back (known as adjuvant radiotherapy) if you have seminoma which hasn’t spread outside the testicle
• get rid of the cancer if it has already spread to these lymph nodes.

Occasionally radiotherapy may be used to treat testicular cancer that has spread to other parts of the body.

External radiotherapy Back to top

The treatment is normally given in the hospital radiotherapy department as a series of short daily sessions. The treatments are usually given from Monday to Friday, with a rest at the weekend. Each treatment takes 10–15 minutes. Your doctor will discuss the treatment and possible side effects with you.

A course of radiotherapy for seminoma may last from two to three weeks. It’s usually given as an outpatient.

Planning radiotherapy

Radiotherapy has to be carefully planned to make sure that it is as effective as possible. It may take a few visits. On your first visit to the radiotherapy department, you’ll be asked to have a CT scan| or lie under a machine called a simulator, which takes x-rays of the area to be treated.

The treatment is planned by a cancer specialist (clinical oncologist). Marks are usually drawn on your skin to help the radiographer (who gives you your treatment) to position you accurately and to show where the rays will be directed.

These marks must stay visible throughout your treatment, and permanent marks (like tiny tattoos) may be used. These are tiny, and will only be done with your permission. It may be a little uncomfortable while being done.

Treatment sessions

At the beginning of each session, the radiographer will position you carefully on the couch, and make sure you are comfortable. During your treatment you’ll be left alone in the room but you can talk to the radiographer who will watch you from the next room. Radiotherapy is not painful but you do have to lie still for a few minutes during the treatment.

Side effects Back to top

Radiotherapy to the tummy (abdomen) can cause side effects, but these can usually be controlled well with medicines. Your doctor or specialist nurse will tell you more about what to expect. These side effects usually disappear gradually once your course of treatment has finished.

Skin changes

The skin in the area being treated may become red (if you have white skin) or darken (if you have black or brown skin), but this will improve after your treatment finishes. You’ll be given advice on looking after your skin and your specialist can prescribe cream if your skin is uncomfortable.

Feeling sick

Radiotherapy to the tummy area may make you feel a bit sick|. Your doctor will prescribe medicine to prevent or stop this (anti-emetics). You’ll probably be advised to take these regularly during treatment. Let your doctor know if the tablets aren’t working for you as there are other medicines they can prescribe.

Tiredness

You’re likely to become tired and need to take things more slowly. Try to pace yourself and avoid doing things that don’t really need to be done. Gentle exercise, such as short walks, can help to improve tiredness. It’s good to balance this with plenty of rest.

Sometimes tiredness can last up to eight weeks or longer after treatment finishes. You may find it helpful to read our information on coping with fatigue|.

Diarrhoea

You might get some diarrhoea| but this can usually be controlled with medicines, which your doctor can prescribe. Let them know if this is a problem and make sure you drink plenty of fluids and cut down on foods that are high in fibre.

Effect on fertility

Radiotherapy to the nodes at the back of the abdomen doesn’t usually cause infertility. Your specialist may advise you to think about storing sperm| before your treatment starts.

Contraception

A small dose of radiation reaches the remaining testicle. The radiotherapy may affect your sperm, so it’s advisable during treatment to use effective contraception.

There’s no evidence that radiotherapy has any effect on children fathered after the treatment, but you’re usually advised to use contraception for 6–12 months afterwards. You can talk this over with your doctor or specialist nurse.