About testicular cancer treatment

The 3 main treatments for testicular cancer are:

You usually have surgery to diagnose and remove the cancer. This is called an orchidectomy. After this, your doctors and other members of the multidisciplinary team will talk to you about the treatment options. They will explain what might be best for your situation.

They may talk to you about surveillance. This is the option of monitoring you regularly in clinic. Or they may suggest having chemotherapy after surgery. Occasionally, they may suggest radiotherapy. Treatment options depend on:

  • the stage of the cancer
  • whether it is a non-seminoma or seminoma (see below)
  • the risk of it coming back.

If testicular cancer comes back, it can usually be treated successfully.

If you are aged between 16 and 24, you should have the option of having your treatment at a Principal Treatment Centre (PTC). These centres provide cancer services for teenagers and young adults (TYA).

We understand that having treatment can be a difficult time for people. We're here to support you. If you want to talk, you can:

How your treatment is planned

After your test results, you and your doctor start to talk about your treatment. Your doctor usually meets with other specialists to get their opinions too.

Multidisciplinary team (MDT) meeting

A team of specialists meet to talk about the best treatment for you. They are called a multidisciplinary team (MDT).

A multidisciplinary team looks at national treatment guidelines or the latest evidence for the type of cancer someone has. If you have any treatment preferences, your doctor will tell them about this.

The MDT for testicular cancer will usually include the following professionals:

  • a surgeon (urologist) – a doctor who treats problems with the kidneys, bladder and male reproductive system
  • an oncologist – a doctor who treats people who have cancer
  • a specialist urology nurse – a nurse who gives you information and support. They are sometimes called Macmillan specialist urology nurses
  • a radiologist – a doctor who looks at scans and x-rays to diagnose problems
  • a pathologist – a doctor who looks at cells or body tissue under a microscope to diagnose cancer.

The MDT may also include other healthcare professionals such as dietitians, physiotherapists, occupational therapists, psychologists or counsellors.

After the meeting, your specialist doctor and nurse will talk to you about your treatment options.

The MDT will look at several factors when advising you on the best course of treatment. These may include:

  • your general health
  • the type and size of the tumour
  • whether it has begun to spread.

They will explain different treatments and their advantages and disadvantages (see below).

We have more information about making treatment decisions.

Treating stage 1 testicular cancer

Stage 1 testicular cancer is cancer that has not spread outside the testicle.

Surgery to remove the testicle (orchidectomy) may be the only treatment you need.

After surgery, your doctor will ask you to go to the clinic for regular physical examinations and have blood tests, including a test to check your tumour marker levels. You may also have CT or MRI scans at the clinic. This is called monitoring (surveillance). If the cancer comes back, the surveillance tests help to find it at the earliest stage. Further treatment can usually cure the cancer.

Your doctor may offer you chemotherapy treatment after surgery. This is called adjuvant treatment. You have it to reduce the risk of the cancer coming back.

Your doctor will explain why they have suggested adjuvant treatment. After talking to your doctor, you may feel you do not want treatment that might not be necessary. You may decide not to have treatment, and to have surveillance instead.

And if you have the option of surveillance, you may decide to have chemotherapy treatment instead.

You can talk about the benefits and disadvantages of the treatment with your doctor.

Seminoma stage 1

If you have a stage 1 seminoma, your doctor may suggest you have surveillance (monitoring). This is if there is a low risk of the cancer coming back. You usually need to have regular clinic appointments for several years.

Your doctors may also offer you a single dose of adjuvant chemotherapy, with a drug called carboplatin.

Your doctors will decide whether you will benefit from adjuvant treatment based on:

Non-seminoma stage 1

If you have a stage 1 non-seminoma, your doctor may suggest you have surveillance if there is a low risk of the cancer coming back. After a few years, you may only need to have regular blood tests, if scans show no signs of the cancer.

Your doctors may also offer you the option of adjuvant treatment. The chemotherapy drugs usually used for non-seminoma testicular cancer are bleomycin, etoposide and cisplatin. This combination of chemotherapy drugs is also called BEP chemotherapy. You usually have 1 session of treatment.

Doctors will offer treatment depending on:

  • how the cancer looks under a microscope
  • if it has spread to nearby blood vessels
  • the size of the tumour
  • the tumour marker levels (if present).

Treating stages 2 to 3 testicular cancer

Treatment will depend on the type and the stage of the cancer. Your doctors will talk to you about the treatment they feel is best for you.

If the cancer has spread outside your testicle, you will be offered chemotherapy after your orchidectomy. Occasionally, radiotherapy may be offered.

If testicular cancer has spread to other areas in the body and tumour markers are high, you may be offered chemotherapy before having surgery. This aims to reduce the size of the tumour before the operation or any other treatment.

Treatment for a non-seminoma

If you have a non-seminoma that has spread, you may need 3 or 4 sessions of chemotherapy. You may need more intensive chemotherapy. This will depend on the stage of cancer, certain risk factors and how you respond to the standard chemotherapy.

If you have chemotherapy, you may also need surgery to remove the retroperitoneal lymph nodes. You may need this if the lymph nodes are still enlarged after chemotherapy treatment.

Treatment for a seminoma

If you have a seminoma that has spread, your doctor may offer you 3 or 4 courses of chemotherapy. You may have radiotherapy and chemotherapy treatment. If you are not able to have chemotherapy, you may have radiotherapy on its own. Your doctor will talk to you about the treatment they think is best.

If testicular cancer comes back

If testicular cancer comes back, treatment can usually cure it. This is even if the cancer has spread to other parts of the body. Treatment will depend on the type of testicular cancer, the areas affected and previous treatment.

You may be offered some treatments as part of a clinical trial.

Current research

Although current treatments for testicular cancer are very effective, different trials are being carried out to see if there are ways to improve them. For example, trials are looking at which genes may increase the risk of developing testicular cancer. Your doctors will be able to tell you about any trials that may be suitable for you.

Effects of treatment on sex life and fertility

Treatments for testicular cancer may affect your ability to make someone pregnant. You are usually advised to store sperm before having an orchidectomy. You can also do this after surgery if you need further treatment.

We have more information about testicular cancer, sex and fertility.

Benefits and disadvantages of testicular cancer treatment

With early-stage testicular cancer, surgery alone may cure the cancer. Adjuvant chemotherapy may be offered to reduce the risk of the cancer coming back. Or your doctors may ask you to choose what you want to do. They may ask whether you want to have adjuvant treatment or surveillance. Sometimes people find it hard to make a decision like this.

You may be worried about having adjuvant treatment because it is treatment you may not need, and it has side effects. Or you may prefer to have any treatment that might reduce the risk of the cancer coming back.

You can talk about the benefits and disadvantages of treatment with your doctor. It is important that you have all the information you need to make the right choice for you. Your doctor and nurse will talk to you about:

  • the risk of the cancer coming back
  • the benefits and side effects of the treatment
  • ways to cope with side effects.

If early-stage testicular cancer comes back, the aim of treatment is still usually to cure it.

If the cancer is very advanced or comes back after initial treatment, you may need intensive chemotherapy. But the aim will also usually still be to cure the cancer.

Rarely, very advanced testicular cancer may not respond well to treatment. Or it may continue to come back despite treatment. In this case, you can have treatment to help control the cancer and improve symptoms. Occasionally, the treatment may not control the cancer or improve symptoms. This means you would have side effects without the benefit of treatment. In this case, you may decide not to continue the treatment.

Making decisions about treatment can be difficult. You may need to talk about it with your doctor and family or friends. If you choose not to have treatment for the cancer, you can still have treatment to control any symptoms.

Giving your permission

Doctors need your permission (consent) before you have any treatment. They will give you all the information you need to make your decision. You will usually need to sign a form to say that you agree.

Second opinion

A second opinion is an opinion from a different doctor about your treatment. If you think you want a second opinion, talk to your specialist doctor or GP first. Tell them your concerns or ask them to explain anything you do not understand. If you still want a second opinion, you can ask your specialist doctor or GP to arrange it.

About our information

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Ursula McGovern, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

  • use plain English
  • explain medical words
  • use short sentences
  • use illustrations to explain text
  • structure the information clearly
  • make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.

Date reviewed

Reviewed: 01 May 2022
Next review: 01 May 2025
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.