Radiotherapy for testicular cancer
Radiotherapy uses high-energy rays to destroy cancer cells. It is sometimes used to treat testicular seminomas and more rarely, non-seminomas.
Radiotherapy is a treatment that uses high-energy rays to destroy cancer cells, while doing as little harm as possible to normal cells.
You may have radiotherapy for testicular cancer to treat a seminoma that has spread to the lymph nodes at the back of the tummy (abdomen). These are called the retroperitoneal lymph nodes. Radiotherapy aims to reduce the small risk of the cancer returning in this area of the body. You may have it after chemotherapy treatment if you have a stage 2 or 3 seminoma. We have more information on staging of testicular cancer.
If you are not able to have chemotherapy, you may have radiotherapy on its own.
If a seminoma comes back, you may have radiotherapy with chemotherapy.
More rarely, you may have radiotherapy to treat non-seminomas.
Your doctor will talk to you about what the best treatment options might be in your situation.
You usually have radiotherapy treatment in the hospital radiotherapy department. You have it as a series of short daily treatment sessions. The sessions usually happen between Monday to Friday, with a rest at the weekend. Each session takes 10 to 15 minutes. Your doctor will discuss the treatment and possible side effects with you.
A course of radiotherapy for seminoma may last about 2 to 3 weeks. You usually have treatment as an outpatient. The person who operates the machine is called a radiographer. They give you information and support during your treatment.
Radiotherapy does not make you radioactive. It is safe for you to be with other people, including children, throughout your treatment.
Temporary effects on fertility
There is no evidence that radiotherapy has any effect on children you may have (conceive) after treatment. But because radiotherapy may have a temporary effect on the sperm, you should use contraception during treatment and for 6 to 12 months after treatment. This allows time for your sperm to recover from any damage treatment may have caused.
During radiotherapy, a small dose of radiation reaches the remaining testicle. This may temporarily affect your sperm. So you will be advised to use effective contraception during treatment.
There is no evidence that radiotherapy has any effect on children you have after treatment. But you are usually advised to use contraception for 6 to 12 months after treatment. This allows time for your sperm to recover from any damage that treatment may have caused.
At the beginning of each session of radiotherapy, the radiographer will position you carefully and make sure you are comfortable. During your treatment, you will 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.
You will have a hospital appointment to plan your treatment. You will usually have a CT scan of the area to be treated. During the scan, you need to lie in the position that you will be in for your radiotherapy treatment.
Your radiotherapy team use information from this scan to plan:
- the dose of radiotherapy
- the area to be treated.
You may have some small, permanent markings made on your skin. The marks are about the size of a pinpoint. They help the radiographer make sure you are in the correct position for each session of radiotherapy.
These marks will only be made with your permission. If you are worried about them, talk to your radiographer.
Radiotherapy to your tummy 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.
It is important to let your doctor know if you are having any problems with side effects. Most side effects are mild, and you can have medicines to treat them successfully.
If you have fair skin, the treated area may become red. If you have black or brown skin, it may become darker. But after your treatment finishes, these changes should go away. Your doctor can advise you how to look after your skin and prescribe cream if your skin is sore.
Feeling sick (nausea)
Radiotherapy to the tummy area may make you feel sick. Your doctor can prescribe anti-sickness medicine to prevent or stop this. Let your doctor know if the tablets are not working for you. There are other medicines they can prescribe.
Radiotherapy often makes people feel tired, especially towards the end of treatment. Try to pace yourself and avoid doing anything that you do not really need to do. Gentle exercise, such as short walks, can help to improve tiredness. It is good to balance this with plenty of rest.
Sometimes, tiredness can last about 8 weeks or longer after treatment finishes. Your energy levels should then slowly improve.
You might get diarrhoea, but your doctor can prescribe you medicines to control this. Let your doctor know if you have diarrhoea. It is important to drink plenty of fluids. Try to eat fewer high-fibre foods, such as fruit, vegetables, beans, pulses and wholewheat cereals.
Effects on the heart
Radiotherapy to the lymph nodes at the back of the tummy may have an effect on your heart many years after treatment has finished. This is called a late effect. This is because these lymph nodes are positioned near to the heart. You may have regular follow-up appointments to check your heart health after cancer treatment. The benefits of having treatment will usually far outweigh this risk. Your specialist doctor can tell you more about this.
Radiotherapy may slightly increase the risk of developing another cancer later. This does not mean that you will definitely develop another cancer. The benefits of having treatment will usually far outweigh this risk. Talk to your specialist doctor if you have any concerns about this.
Below is a sample of the sources used in our testicular cancer information. If you would like more information about the sources we use, please contact us at email@example.com
The British Association of Urological Surgeons (BAUS) Guidelines on Testicular Cancer. March 2015. Available from: https://www.baus.org.uk/professionals/sections/testicular_cancer.aspx (accessed April 2022).
European Association of Urology (EAU) Guidelines on Testicular Cancer 2022. Available from: https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Testicular-Cancer-2022.pdf (accessed April 2022).
European Society for Medical Oncology (ESMO). Testicular seminoma and non-seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Last updated 2022.
European Society for Medical Oncology (ESMO). Testicular seminoma and non-seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Last updated 2022. Available from: https://www.annalsofoncology.org/article/S0923-7534(22)00007-2/fulltext (accessed April 2022).
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.
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