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Treatment of Testis Cancer



Treatment for testicular cancer depends on the stage of the disease. Surgery to remove the testicle is sometimes combined with radiation and/or chemotherapy. Some patients choose to store frozen sperm in a sperm bank before treatment to ensure fertility.

Surgery

Radical inguinal orchidectomy is the surgical removal of the testicle and the spermatic cord through an incision in the groin. Surgery is performed under general anaesthetic and takes approximately 45 minutes. Most patients are able to go home on the same day; however, a few patients may require an overnight stay in hospital.

Men who have had an orchidectomy may choose to have a testicular prosthesis surgically implanted into the scrotum. This can be performed at the time of removal of the cancerous testicle or deferred to a later date. The prosthesis is filled with saline and is made to look and feel natural.

If CT scan indicates that testicular cancer has metastasised to the lymph nodes, retroperitoneal lymph node dissection is often performed. All of the lymph nodes connected to the affected testicle are removed in this procedure. Such dissection is usually done at a later date.

Retroperitoneal lymph node dissection is performed under general anaesthesia and requires a large incision, and usually takes 2 to 4 hours.

Complications associated with surgery include the following:
  • Adverse reaction to anaesthesia
  • Bowel obstruction and inactivity
  • Damage to surrounding organs, blood vessels, and nerves
  • Infection
  • Infertility (caused by nerve damage which results in retrograde ejaculation)
  • Lymph-filled cyst (lymphocele)


  • Following surgery, patients are usually encouraged to get up as soon as possible. Pain at the incision site and numbness in the area surrounding the incision are common, and pain relievers are often prescribed. Driving and heavy lifting should be avoided for several weeks.

    Radiation

    Radiation uses high energy x-rays to destroy cancer cells. In testicular seminoma, external beam radiation (from a machine outside of the body) is primarily used after orchidectomy (called adjuvant therapy) to destroy cancer cells that have spread (metastasised) to lymph nodes. Testicular seminoma typically requires a lower dose of radiation than other types of cancer. During treatment, a shield is placed over the remaining testicle to preserve fertility.

    Side effects of radiation include the following:
    • Diarrhoea, Fatigue ,Nausea and Skin irritation that resembles sunburn


    Chemotherapy

    Chemotherapy is a systemic (i.e., circulates throughout the body via the bloodstream) cancer treatment that uses toxic drugs to destroy cancer cells. In testicular cancer cases, it is used to destroy cancer cells that remain after surgery. Chemotherapy may be administered intravenously (IV), taken in pill form, or injected into muscle.

    Side effects of chemotherapy are often severe and include gastrointestinal disturbances, low blood count, skin disorders, and neurological disorders.

    Prognosis

    Prognosis for testicular cancer depends on the stage of the disease at diagnosis. More than 95% of cases are treated successfully.

    Prevention

    Testicular cancer cannot be prevented. Regular self examination and awareness of the condition may aid early detection of testis cancer.