Treatment for testicular cancer

The main treatments for testicular cancer are surgery and chemotherapy. The treatment you have depends on the stage of the cancer. Treatment can usually cure the cancer.

You may have a type of surgery called an orchidectomy. The surgeon removes the testicle through a small cut through your lower abdomen (tummy). The surgeon can put in a false testicle so you look the same as before.

If the chance of the cancer coming back after surgery is low, you may not need further treatment. But your doctor may recommend that you have regular checks to look for signs of cancer (surveillance).

Chemotherapy (anti-cancer drugs) might be given after surgery to help stop the cancer coming back, destroy any cancer cells that have spread or if the cancer comes back. It is also sometimes given before surgery if the cancer has spread. It can cause some side effects  but these usually go away when treatment stops.

Some people need further surgery to remove swollen lymph nodes at the back of the tummy.

Having treatment for testicular cancer

Treatment for testicular cancer can be very successful. Most young men with testicular cancer are cured, even if the cancer has spread. Treatment includes:

  • surgery
  • surveillance
  • chemotherapy.

Rarely, some teenagers and young men have a type of testicular cancer called seminoma. We have more about treating seminoma in our general information about testicular cancer. This information is for all age groups.

To make sure you have the right treatment, your specialist needs to know what stage the cancer is. The stage of a cancer describes its size and whether it has spread outside the testicle. You may need more tests to confirm the stage of the cancer. Waiting to hear about the stage can be worrying. But this information is important because it helps your doctors plan the best treatment.

If you have any questions about your treatment, ask your doctor or nurse.

You may be offered the chance to take part in a clinical trial. If your doctor thinks there is a trial that is suitable for you, they will discuss this with you. You will be able to talk things over with your specialist and family before you decide what to do. It will be your decision whether or not to take part in a trial.


Surgery

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 about having surgery. 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 side of the affected testicle. 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 will look the same as before. You can talk to your surgeon about this before the operation. You don’t have to make your mind up about this straight away. You can have a small operation to put a false testicle in at another time.

After the operation

You will have a small dressing where the cut was made. You can usually remove this a day or two after the operation. The stitches in the wound will dissolve by themselves over a few weeks.

You will probably feel a bit sore, but your doctor or nurse will give you painkillers to take regularly. Let your nurse or doctor know if you are still in pain. Wearing fitted briefs or shorts that support you and loose trousers like jogging bottoms can feel more comfortable after your operation.

You will probably also feel tired and need to take things easy for about a week. Most people make a quick recovery after the operation.

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

If one of your testicles is removed, you will still be able to get an erection and make someone pregnant. Your other testicle will still produce the hormone testosterone and make sperm.

It is not common to have both testicles removed. If you have had both your testicles removed, your doctor can prescribe testosterone so you will still be able to have sex. But you will no longer be making sperm, so you won’t be able to make someone pregnant through sex.

Storing your sperm before the operation can help you to become a parent in the future. Your doctor will talk to you about sperm banking before your surgery. You can find more information about preserving your fertility in our section on fertility.


Surveillance

This means having regular checks to look for signs of the cancer coming back Your doctor might suggest this if the chance of the cancer coming back is low.

If it does come back and it is found very early, then it can still be cured. If the cancer does not come back, you have avoided having unnecessary treatment. At each clinic appointment, your doctor will examine you and you may have blood tests, chest x-rays and ultrasound scans.

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


Chemotherapy

Chemotherapy uses anti-cancer drugs to destroy the cancer cells.

You might be given chemotherapy:

  • after an operation to remove your testicle – this is 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
  • sometimes before surgery, if the cancer has spread.

Chemotherapy can affect your fertility. Before your treatment starts, your doctor will talk to you about storing some of your sperm. This is called sperm banking. We have more information about cancer treatment and fertility.

Your nurse will give the chemotherapy as an injection or drip into a vein. You have it 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 (called a PICC line) that leads into a vein in the chest.

Find out more about how chemotherapy is given.

The amount of chemotherapy you have may depend on the stage of the cancer. Chemotherapy is given in cycles of treatment. A cycle usually takes three weeks. If the stage is low, then you will usually have one or two cycles (sessions) of chemotherapy. If the stage is higher, or if the cancer comes back during surveillance, you will usually have three or four cycles.

The drugs most often used to treat testicular cancer are cisplatin, etoposide and bleomycin. Giving these drugs together is called BEP. Carboplatin is sometimes used if the cancer is a seminoma.

If you have BEP, you will usually spend 3 to 5 days of the first week having your chemotherapy as a day patient. Or you might need to stay in hospital overnight. After this, you will come back to the clinic for another injection of chemotherapy a week later, and again the following week.

We have more information about BEP chemotherapy. This information is written for all age groups.

If the cancer has spread to other parts of the body, or if it hasn’t gone away completely with BEP, your doctor can give you different chemotherapy drugs.

At the time of writing this information, there is a clinical trial called UKP3BEP. It is looking at different ways of giving chemotherapy if a cancer has spread. Your doctor can tell you more about this.

Side effects of chemotherapy

Different chemotherapy drugs cause different side effects. These can usually be well controlled with medicines. They usually go away once treatment has finished. You can talk to your doctor or nurse about what to expect.

The most common side effects are:

  • hair loss
  • tiredness
  • feeling sick or being sick (which can be controlled with medicines)
  • being more at risk of getting an infection.

Sometimes side effects can be long-term. There is lots more information about side effects in the chemotherapy section.


Further surgery after chemotherapy

If the lymph nodes at the back of your tummy are still swollen after chemotherapy, you usually have an operation to remove them. 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. Having them removed is the only certain way to find this out.

You might be in hospital for up to seven 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 will slowly fade to look like a fine line.

Sometimes you have surgery to remove any abnormal cells in the lungs or the lymph nodes in the chest.

After the operation

You will have a drip in your arm to give you fluids until you are able to eat and drink normally. You will also have drainage tubes from the wound to stop any extra fluid collecting. The nurses will check the dressing over your wound and change it when needed. You will 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 damage the nerves that control the release of sperm (ejaculation). This may affect your fertility. 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.

Back to Testicular cancer

The testicles

Understanding more about what the testicles do might make it easier for you to talk about them.

Having tests

You may have tests to help your doctors see whether you have testicular cancer.

Life after treatment

Being diagnosed with testicular cancer can have a big impact on your life, even after you have finished treatment.