Treatment Option Overview
There are different types of treatment for patients with testicular cancer.
Different types of treatments are available for patients with testicular cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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Testicular tumors are divided into 3 groups, based on how well the tumors are expected to respond to treatment.
Good Prognosis
For nonseminoma, all of the following must be true:
- The tumor is found only in the testicle or in the retroperitoneum (area outside or behind the abdominal wall); and
- The tumor has not spread to organs other than the lungs; and
- The levels of all the tumor markers are slightly above normal.
For seminoma, all of the following must be true:
- The tumor has not spread to organs other than the lungs; and
- The level of alpha-fetoprotein (AFP) is normal. Beta-human chorionic gonadotropin (ß-hCG) and lactate dehydrogenase (LDH) may be at any level.
Intermediate Prognosis
For nonseminoma, all of the following must be true:
- The tumor is found in one testicle only or in the retroperitoneum (area outside or behind the abdominal wall); and
- The tumor has not spread to organs other than the lungs; and
- The level of any one of the tumor markers is more than slightly above normal.
For seminoma, all of the following must be true:
- The tumor has spread to organs other than the lungs; and
- The level of AFP is normal. ß-hCG and LDH may be at any level.
Poor Prognosis
For nonseminoma, at least one of the following must be true:
- The tumor is in the center of the chest between the lungs; or
- The tumor has spread to organs other than the lungs; or
- The level of any one of the tumor markers is high.
There is no poor prognosis grouping for seminoma testicular tumors.
Five types of standard treatment are used:
Surgery
Surgery to remove the testicle (radical inguinal orchiectomy) and some of the lymph nodes may be done at diagnosis and staging. (See the General Information and Stages sections of this summary.) Tumors that have spread to other places in the body may be partly or entirely removed by surgery.
Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
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