Radiotherapy for testicular cancer
Radiotherapy treats cancer by using high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells.
Radiotherapy may sometimes be given to treat seminoma and NSGCTs.
It may be given as an alternative to chemotherapy or surveillance in men who have stage 1 seminoma. In this situation, the aim of treatment is to reduce the small risk of the cancer coming back in the lymph nodes at the back of the abdomen.
If an NSGCT has spread outside the testicle, radiotherapy may sometimes be used to treat cancer that has spread elsewhere in the body. Radiotherapy is usually given in addition to chemotherapy treatment.
The treatment is normally given in the hospital radiotherapy department as a series of short daily sessions. The treatments are usually given from Monday-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 2-3 weeks. It’s usually given as an outpatient. Radiotherapy doesn’t make you radioactive, and it’s perfectly safe for you to be with other people, including children, throughout your treatment.
Our section on radiotherapy gives more detailed information about this treatment and its side effects.
Planning your radiotherapy
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To make sure radiotherapy is as effective as possible, it has to be carefully planned by a clinical oncologist (a doctor who specialises in radiotherapy treatment for cancer).
Your treatment will be planned on your first visit to the radiotherapy department. Usually, you’ll have a CT scan of the area to be treated. The radiographer may draw tiny marks on your skin. These marks must stay visible throughout your treatment, and permanent marks (like tiny tattoos) may be used. These are extremely small, and will only be done with your permission. It may be a little uncomfortable while they are done.
The radiographer will position you carefully on the couch at the beginning of each radiotherapy session, and make sure you’re comfortable. During your treatment you’ll be 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 have to lie still for a few minutes during the treatment.
Radiotherapy to the tummy (abdomen) can cause side effects, but these can usually be controlled 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.
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 (nausea)
Radiotherapy to the tummy area may make you feel a bit sick. Your doctor will prescribe medicine (anti-emetics) to prevent or stop this. You’ll probably be advised to take these medicines regularly during treatment.
Let your doctor know if the tablets aren’t working for you as there are other medicines they can prescribe.
You’re likely to become tired and will 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 might get some diarrhoea but this can usually be controlled with medicines, which your doctor can prescribe. Let your doctor know if this is a problem and make sure you drink plenty of fluids and cut down on foods that are high in fibre.
It’s important to let your doctor know if you’re having any problems with side effects. Most of the side effects are mild and can be treated successfully with medicines.
Radiotherapy to the lymph nodes in the abdomen won’t affect your ability to have sex and doesn’t usually cause infertility. But your specialist may advise you to think about storing sperm before your treatment starts.
You can find out more about how treatment for testicular cancer might affect your fertility and sex life.
During radiotherapy, a small dose of radiation reaches the remaining testicle. This may affect your sperm, so it’s advisable to use effective contraception during your treatment. There’s no evidence that radiotherapy has any effect on children fathered after 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.