Being treated for testicular cancer
Treatment for testicular cancer can be very successful. Surgery and chemotherapy are the two main types of treatment. Often people have both treatments.
To make sure you have the right treatment, your specialist needs to know what stage the cancer is. The stage of a cancer describes the tumour and whether it has spread outside the testicle. You may need some more tests to confirm what stage you are at. 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 can be really successful. Most young men 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 to remove the testicle is one of the main treatments for testicular cancer. The operation is called an orchidectomy. It can be done as a day patient or during a short stay in hospital.
You may 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.
The surgeon makes a small cut (incision) through your lower abdomen (tummy) in the groin on the affected side. The testicle is pushed up from the scrotum and removed through the cut.
During the operation the surgeon can put a false testicle into your scrotum so that you’ll look the same as before. Your surgeon will explain this to you before the op, or you can ask them about it. If this wasn’t done at the time of the operation, but now you think you would like this, talk to your doctor or nurse. It is a small operation to put this in later on.
After the operation
You'll have a small dressing where the cut was made. 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 about a week. You can expect to make a quick recovery after this operation.
If you want to know more about what happens before and after an operation, there’s lots more information in our surgery section.
If one of your testicles is removed, you will still be able to have sex and make someone pregnant. Your other testicle should produce enough of the hormone testosterone and sperm.
It isn't common to have both testicles removed. If you’ve had this done then you’ll be prescribed testosterone so you'll still be able to have sex. But you won't be making sperm now, so you won’t be able to make someone pregnant through sex. Your doctor will talk to you about sperm banking before your surgery. Storing your sperm before the operation can help you to become a dad in the future. Our sections on sex and relationships and fertility have more information as well as ways of coping.
If after surgery the chance of the cancer coming back is very low, your doctor might suggest you have surveillance. 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 treatment. At each clinic appointment, your doctor will examine you and you may have blood tests and chest x-rays.
Going to all your surveillance appointments is really important - so don’t forget. You could put a reminder in your phone.
Chemo is when you’re given anti-cancer drugs to destroy the cancer cells.
You might be given chemo:
- after the operation to remove your testicle, to reduce the chance of the cancer coming back
- to destroy cancer cells that have already spread outside the testicle
- if the cancer comes back
- occasionally before surgery, if the cancer has spread.
Chemotherapy can affect your fertility. Before your chemo starts, your doctor will talk to you about storing some of your sperm. This is called sperm banking. We have more information about fertility issues.
Chemo is given into a vein as injections or drips. You have your chemo through one of the following:
- a fine tube called a cannula
- a line into a vein in the chest (called a central line)
- a line into the arm (PICC line) that leads into a vein in the chest.
Find out more about how chemo is given.
The amount of chemo you have depends on the stage of the cancer. If the stage is low then you will have 1 to 2 cycles (sessions) of chemo. If the stage is higher, or if the cancer comes back during surveillance, you’ll usually have 3 to 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.
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. If you have BEP, you’ll usually spend 3 to 5 days of the first 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 a week later, and again the following week.
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.
Different chemotherapy drugs cause different side effects. You will probably have a few side effects, but it's hard to know exactly how it's going to be you. Your doctor will do everything they can to treat any side effects you have.
Most side effects are short-term and gradually disappear once treatment stops. The most common temporary side effects are:
- hair loss
- feeling sick or being sick (which can be controlled with medicines)
- being more at risk of getting an infection.
There’s lots more information in the chemotherapy section.
Sometimes side effects can be long-term. For example, although chemo usually only affects fertility for a year or so, sometimes it’s permanent. See our fertility section for more information.
There may be other late effects of treatment and your specialist can talk to you about this.
If the lymph nodes (glands) at the back of your tummy area are still swollen after chemo, they’re usually removed with an .
If the lymph nodes 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 will 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.
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 scar but it’ll gradually fade until it ends up looking like a fine line.
Sometimes you have surgery 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 painkillers to take regularly. Your staples (like metal stitches) are removed 7 to 10 days after the operation.
It might take a few months to get back to the level of fitness you had before.
This operation can affect your fertility, because the nerves that control the release of sperm (ejaculation) may be damaged by surgery. Surgeons use 'nerve-sparing’ techniques to try to stop this happening. The operation doesn’t usually stop you getting an erection or having an orgasm.
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If you're looking for information about testicular cancer in men of all ages, please see our general testicular cancer section.