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Testicular cancer
Treatment
Generally, doctors use four kinds of treatments for testicular cancer.
They are:
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Radical
inguinal orchiectomy.
This surgical procedure involves removing one or both testicles
through a cut in the groin. Lymph nodes in the abdomen also may be
removed (lymph node dissection). If just one cancerous testicle is
removed, there's a small chance that the other will become cancerous
at some point. As a result, your doctor will likely recommend
regular follow-up exams with a urologist.
-
External beam
radiation therapy.
This treatment uses high-dose X-rays or other high-energy radiation
to kill cancer cells. Seminomas are highly sensitive to radiation
therapy, but nonseminomas are not.
-
Chemotherapy.
Chemotherapy is used to kill cancer cells outside the testicle. This
drug therapy is usually given by infusions into your veins
(intravenous), typically in the hospital several days each month. In
some cases, chemotherapy may be given by intramuscular injection or
in pill form.
-
Bone marrow
transplant.
In this procedure, bone marrow is taken from you, treated with drugs
to kill any cancer cells and then frozen. You then undergo
chemotherapy, with or without radiation, to destroy the remaining
cancer cells in your body. The chemotherapy also destroys your
remaining bone marrow. The frozen marrow is then thawed and injected
back into you through a needle in a vein. This relatively new
treatment for testicular cancer has shown some promising initial
results. Yet doctors don't routinely recommend it because
traditional chemotherapy treatments are typically very successful.
Surgery may be in combination with radiation therapy or chemotherapy or
both. It depends on the type and the stage of your cancer. Your age and
overall health also are factors in choosing treatment options.
You may wonder how treatment for testicular cancer will affect your
appearance and sex life. Keep the following in mind:
-
Artificial
implants.
After the surgical removal of a testicle, you can have an artificial
testicle (prosthesis) placed inside your scrotum. The artificial
implant has the weight and feel of a normal testicle.
-
Surgery and
your sex life.
The surgical removal of lymph nodes won't affect your ability to
achieve an erection or an orgasm. However, this surgery may cause
sterility by interfering with ejaculation. Some men recover the
ability to ejaculate without treatment; medication may help others.
If you undergo surgery, ask about special techniques that may
protect your ability to ejaculate.
-
Radiation
therapy and your sex life.
Radiation therapy probably won't change your ability to have sex.
However, radiation does interfere with sperm production. The effect
is usually temporary, and most men regain their fertility within a
few months. As a precaution, many men store sperm at a special
facility (sperm bank) before treatment, where it can be preserved
for later use.
-
Chemotherapy
and your sex life.
Chemotherapy doesn't have to interfere with a normal sex life. The
fatigue caused by chemotherapy, however, may decrease your interest
in sexual activity during the months of treatment. Some anti-cancer
drugs affect sperm production. Although the effect can be permanent,
many men regain their fertility later. Men concerned about their
fertility can have their sperm frozen and preserved (cryopreserved)
before chemotherapy.
Prevention
A
simple procedure called testicular self-examination (TSE) can improve
your chances of finding a tumor. Beginning in your mid-teenage years,
and throughout your life, examine your testicles regularly.
A
good time to examine your testicles is after a warm bath or shower. The
heat from the water relaxes your scrotum, making it easier for you to
find anything unusual. Do this once a month.
To do this examination, follow these steps:
-
Stand in front
of a mirror.
Look for any swelling on the skin of the scrotum.
-
Examine each
testicle with both hands.
Place the index
and middle fingers under the testicle while placing your thumbs on
the top.
-
Gently roll the
testicle between the thumbs and the fingers.
Remember that the testicles are usually smooth, oval shaped and
somewhat firm. It's normal for one testicle to be slightly larger
than the other. Also, the cord leading upward from the top of the
testicle (epididymis) is a normal part of the scrotum. By regularly
performing this exam, you will become more familiar with your
testicles and aware of any changes that might be of concern.
-
If you find a
lump,
call your doctor as soon as possible. Testicular cancer is
highly treatable, especially when identified early.
Regular self-examination is an important health habit. But it can't
substitute for a doctor's examination. Your doctor should check your
testicles whenever you have a physical exam. If you have an undescended
testicle — less than two testicles in your scrotum — be sure to tell
your doctor, who may refer you to a urologist for treatment or a more
specialized exam.
Testicular cancer
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