Radiotherapy for testicular cancer

Men with seminoma sometimes have radiotherapy after surgery instead of chemotherapy. You have it to the lymph nodes at the back of your tummy to reduce the risk of the cancer coming back. Men with non-seminomas rarely have this treatment.

You have radiotherapy Monday to Friday as an outpatient with a rest at weekends. Treatment for seminoma usually takes 2–3 weeks. You have a scan first to plan where the rays should be delivered and may also have some tiny marks made on your skin. Radiotherapy doesn’t make you radioactive.

You may have some side effects but these can often be controlled. They usually go away when treatment finishes. Always let your cancer team know about any side effects so they can give you advice. You may have some of the following:

  • skin changes
  • tiredness
  • feeling sick or having diarrhoea.

Radiotherapy to this area doesn’t usually make you infertile but your doctor may advise you to store sperm before treatment. You will also usually be advised not to father a child for a few months after it finishes.

Understanding radiotherapy

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 be used to treat seminomas and more rarely, non-seminomas.

If you have a stage 2 seminoma, you may have radiotherapy instead of chemotherapy. 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.


External radiotherapy

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. Treatment is 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.


Planning your radiotherapy

Radiotherapy has to be carefully planned to make sure it’s as effective as possible. It’s planned by a cancer specialist (clinical oncologist) and 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.

You may need some small marks made on your skin to help the radiographer (who gives you your treatment) 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) are usually used. These are extremely small, and will only be done with your permission. It may be a little uncomfortable while they are done.


Treatment sessions

At the beginning of each session of radiotherapy, the radiographer will position you carefully on the couch and make sure you are 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 will have to lie still for a few minutes during the treatment.


Side effects of radiotherapy

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 (nausea)

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

Radiotherapy often makes people feel tired, especially towards the end of treatment. 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. Your energy levels will then gradually improve.

Diarrhoea

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, such as fruit, vegetables, beans, pulses and wholewheat cereals.

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.


Effect on fertility

Radiotherapy to the lymph nodes in the tummy won’t affect your ability to have sex and doesn’t usually cause infertility. Your specialist may advise you to think about storing sperm before your treatment starts.


Contraception

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.

Back to Radiotherapy explained

Who might I meet?

You will meet many different specialists before, during and after radiotherapy treatment.

After treatment

It can take time for your body to recover after finishing treatment. Advice and support is always available.