Testicular Cancer Treatment

Our Treatment Approach

Treatment for testicular cancer at MD Anderson focuses on the most modern techniques in surgery, chemotherapy and other therapies. We customize your treatment to include the most advanced procedures with the least impact on your body.

Our renowned team of experts considers all the options, and then choose the best course of action specifically for you. Your personalized testicular cancer treatment may include:

• Surgery by a dedicated team of urologists, vascular surgeons, and anesthesiologists with expertise in this complex cancer
• Special nerve-sparing surgical procedures to retain as much function as possible
• The most modern restoration and prosthetic techniques
• Dose-dense chemotherapy, which allows a higher level of drugs to be given and may help prevent stem cell transplant in some patients
• Stem cell transplants at one of the premier programs in the country

Experience Matters

Because MD Anderson is one of the nation’s largest cancer centers, we see a much greater number of patients with testicular cancer than do most oncologists. This is particularly important in surgery for testicular cancer, which is delicate, challenging and requires a great deal of expertise.

Studies have shown that the effectiveness of surgical treatment for testicular cancer depends a great deal on the number of procedures the surgeon has performed. MD Anderson’s skilled surgeons are among the most experienced in the country. This translates to optimal chances for your successful recovery.

And because we are a major cancer research center, we are able to offer clinical trials of new treatments for some types of testicular cancer.

Our Testicular Cancer Treatments

If you are diagnosed with testicular cancer, your doctor will discuss the best options to treat it. This depends on several factors, including the type and stage of the cancer and your general health.

One or more of the following therapies may be recommended to treat the cancer or help relieve symptoms.

Surgery

Orchiectomy: Surgery to remove the testicle. In most cases, orchiectomy is performed during testicular cancer diagnosis. The testicle is removed through an incision in the groin, and tissue samples are examined to determine the stage of the testicular cancer.

Retroperitoneal lymph node dissection (RPLND): For some patients, especially those with nonseminoma testicular cancer, surgery may also involve removal of lymph nodes in the abdominal area. This is done at the same time as the orchiectomy or in a second surgical procedure.

Nerve-sparing techniques: To preserve normal ejaculation, the surgeons at MD Anderson are skilled in surgical techniques that may avoid damage to the nerves surrounding retroperitoneal lymph nodes in some men.

Reconstructive surgery: Men who are uncomfortable with their appearance after orchiectomy can have a prosthesis implanted in the scrotum that provides the look and feel of a real testicle.

Possible side effects of testicular cancer surgery

If one testicle is removed to treat testicular cancer, most men can get erections and have sex if they are getting enough testosterone. If both testicles are removed, a man cannot father a child or make enough testosterone to have sex. In this case, testosterone needs to be taken in the form of a gel, patch or shot.

Because both surgical procedures may affect fertility, you may want to talk to your doctor about sperm banking if you want to start a family at some point. Sperm cells can be collected before cancer treatment and frozen for future use.

Radiation Therapy

Seminomas, which are the form of testicular cancer found most often, are very sensitive to radiation therapy. In fact, the treatment dosage is only about one-third of that required for prostate cancer, and the treatment cycle is only two weeks.

Radiation is performed after surgery to remove the testicle (orchiectomy). If the tumor was a seminoma, the oncologist may choose "watchful waiting" to see if the testicular cancer returns or use radiation to treat the lymph nodes along the spine, where the majority of recurrences are located.

Even if testicular cancer comes back, it is still treatable with radiation or chemotherapy. Radiation treatment has an average recurrence rate of about 5%. Radiation also can be used after chemotherapy if any cancer remains.

Other types of testicular cancer (nonseminoma) are more resistant to radiation. They are treated with orchiectomy, chemotherapy, and surgery to remove affected lymph nodes.

Chemotherapy

Chemotherapy is sometimes used in conjunction with surgical removal of the testicle to make sure all the cancer cells have been destroyed. For men with advanced tumors that have spread beyond the testicle or metastasized (spread) to distant areas of the body, chemotherapy is usually given for nine weeks or longer.

The most frequently used chemotherapy combinations for testicular cancer are:

• BEP: Blenoxane® (bleomycin), Etopophos® or Vepesid® (etoposide), and Platinol® (cisplatin)
• EP: Etopophos® or Vepesid® (etoposide) and Platinol® (cisplatin)

For men with poor-risk testicular cancer, MD Anderson uses an approach called dose-dense chemotherapy. A higher number of chemotherapy drugs are given at more-frequent intervals; this allows the cancer cells less time to recover between each treatment.

Stem Cell Transplantation

A stem cell transplant is used most often for testicular cancers that have returned after successful treatment. MD Anderson has one of the most-advanced stem cell transplant centers in the nation.

Our Testicular Cancer Clinical Trials

Since MD Anderson is one of the nation’s leading research centers, we’re able to offer a number of clinical trials (research studies) of new treatments for testicular cancer.