Being treated for testicular cancer

Before you have treatment, the doctors need to find out if the cancer has spread outside the testicle to any other parts of your body. This is called the stage of the cancer. Waiting to hear about the stage of the cancer can be worrying. But this information is important because it helps your doctors plan the right treatment.

Treatment for testicular cancer is usually really successful. Most guys with testicular cancer are cured, even if the cancer has spread. If you have any questions about your treatment, don't be afraid to ask your doctor or nurse.

Surgery Back to top

Surgery| to remove the testicle is one of the main treatments for testicular cancer. The medical name for the operation is orchidectomy. Sometimes it’s the only treatment that’s needed to cure the cancer. It’s a small operation, so it can be done as a day patient or during a short stay in hospital.

You’ll probably feel shocked and scared at the thought of having this done. Your doctor and nurse will tell you more about it so that you know what to expect and feel less worried. Most guys only need surgery to remove one testicle, and they quickly make a full recovery.

The surgeon makes a small cut (incision) through your lower tummy (abdomen) in the groin on the affected side. The testicle is pushed up from the scrotum and removed through the cut in your tummy. 

During the operation the surgeon can put a false testicle (testicular prosthesis) into your scrotum so that you’ll look the same as before. Your surgeon will usually explain this to you before the op, or you can ask them about it.

After the operation

You'll have a small dressing where the cut was made, but this can usually be removed a day or so after the op. The stitches in the wound will dissolve by themselves over the next few months.

You'll probably feel a bit sore and you’ll be given painkillers to take regularly. Let your nurse or doctor know if they’re not controlling the pain. Wearing fitted briefs or shorts that support you and loose trousers like jogging bottoms can feel more comfortable after your op. 

You’ll probably feel tired and need to take things easy for the first week or so. But you can expect to make a quick recovery after this op.

If you want to know more about what happens before and after an operation, there’s lots more information in our surgery section.

If you’ve had one testicle removed, you’ll still be able to have sex and have children in the future. If your other testicle is working okay, it will produce enough of the hormone testosterone.

It isn't common to have both testicles removed, but if you’ve had this done then you’ll be prescribed testosterone so you'll still be able to have sex. However, because you won't be making sperm, you won’t be able to make someone pregnant through sex. But having your sperm stored before the operation can help you to become a dad in the future. Our section on fertility has more information as well as ways of coping.

Surveillance Back to top

If after surgery the chance of the cancer coming back is very low, your doctor might suggest surveillance (monitoring) instead of chemo. This means having regular checks to look for signs of the cancer coming back. If it does come back and it’s picked up very early, then it’s easy to cure. If the cancer doesn’t come back then you’ve avoided having unnecessary chemo. At each clinic appointment, your doctor will examine you and you’ll have blood tests and sometimes other tests, such as chest x-rays.

Going to all your surveillance appointments is really important - so don’t forget. You could put a reminder in your phone.

Chemotherapy Back to top

Chemo| is when you’re given anti-cancer drugs to destroy the cancer cells.

You might be given chemo after the op where your testicle’s removed. It’s given to reduce the chance of the cancer coming back - this is called adjuvant chemo. Chemo is also given to destroy cancer cells that have already spread outside the testicle, and if the cancer comes back.

Occasionally chemo is given before surgery, if the cancer has spread to other parts of the body. Then the operation to remove the testicle is done later.  

Before your chemo starts, your doctor will talk to you about storing some of your sperm. This is called sperm banking.

Chemo is given into a vein (intravenously) as injections or drips. You’ll usually have this through a fine tube called a cannula. Occasionally some guys have it through a line into a vein in the chest (called a central line), or through a line into the arm (PICC line) that leads into a vein in the chest. Find out more about how chemo is given here.

The amount of chemo you have depends on whether the cancer has spread outside the testicle or not. If it hasn’t spread, you’ll usually have two cycles (sessions) of chemo. If it has spread outside the testicle, or if it comes back during surveillance (monitoring), you’ll usually have 3-4 cycles of chemo.

The drugs most often used to treat testicular cancer are cisplatin, etoposide and bleomycin. Giving these drugs together is called BEP.  

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We have more information about BEP chemotherapy|. This info is written for anyone who's looking for information about BEP chemotherapy, not just for young adults.

 

Chemo is given in cycles of treatment. A cycle usually takes three weeks. You’ll usually spend 3-5 days each week having your chemo as a day patient, or you might need to stay in hospital overnight. After this you’ll come back to the clinic for another injection of chemo once a week, then you’ll usually have no chemo for the last week of each cycle.

If the cancer has spread to other parts of the body, or if it isn’t going away completely with BEP, then different chemotherapy drugs can be given.

Side effects

Different chemo drugs cause different side effects. Some guys just have a few side effects and others have more. It's hard to know how it's going to be for you, as everyone’s different.

Most side effects are short-term (temporary) and gradually disappear once treatment stops. The most common temporary side effects are hair loss, tiredness, sickness (which can be controlled) and being more at risk of getting an infection.

There’s lots more information in the chemotherapy section and the deal with it section.

Sometimes side effects can be long-term. For example, although chemo usually only affects fertility short-term, sometimes it’s permanent. But you’ll usually have stored your sperm before treatment starts - see our fertility section|.

There may be other late effects of treatment and your specialist can talk to you about this. 

Further surgery Back to top

If the lymph nodes (glands) at the back of your tummy area are still swollen after chemo, they’re usually removed with an operation|. Lymph nodes are part of the body's immune system and help fight infection. The lymph nodes in the tummy are called the retroperitoneal lymph nodes, so the operation is called a 'retroperitoneal lymph node dissection'. The operation can only be done by experienced surgeons in specialist centres.

The lymph nodes might contain cells that could become cancerous in the future, so having them removed is the only certain way to find this out.

It’s quite a big operation and you might be in hospital for up to 10 days. The surgeon usually makes a cut from the top of your tummy (near your breastbone) to below your belly button. This leaves you with a long scar but it’ll gradually fade until it ends up looking like a fine line. Sometimes surgery’s also done to remove any abnormal cells in areas like the lung or the lymph nodes in the chest.

After the operation

You’ll have a drip in your arm to give you fluids until you’re able to eat and drink normally. You’ll also have drainage tubes from the wound to stop any extra fluid collecting. The nurses will keep a check on the dressing over your wound and change it when needed. You’ll be given pain killers to take regularly. Your staples (like metal stitches) are removed 7-10 days after the operation.

This is quite a big operation, so it might take a few months to get back to the level of fitness you had before.  

This operation can affect your fertility (being able to father a child), because the nerves that control the release of sperm (ejaculation) may be damaged by surgery. Surgeons use 'nerve-sparing’ techniques to try to prevent this happening. The op doesn’t usually stop you getting an erection or having an orgasm.