TESTICULAR CANCER TREATMENTS

Once the diagnosis has been confirmed radiologically you will be admitted to hospital for two things:

Malignant seminomas also require radiation treatment to the glands and abdomen as there is a small risk that some cancerous cells will have escaped into this area. Radiation treatment is not necessary for non-malignant seminomas.

If the disease has spread to other areas of the body such as the abdomen or chest chemotherapy is required. Chemotherapy is a very intense treatment and most patients find it difficult. It can occasionally be life threatening but the cure rate is high, ranging from 50-95 percent, depending on how far the disease has advanced. Chemotherapy is often completed in about 16 weeks and most patients can expect to spend about one week in three as an inpatient.

Follow-up treatment includes a lot of x-rays, scans and special blood tests called alphbetaprotein and betahcg. These blood tests are extremely useful in monitoring response to treatment and they may indicate the first signs that the cancer is coming back.

If the blood tests and scans are all normal, you will receive no immediate treatment but will enter a programme of intense surveillance. This involves monthly blood tests and CAT scans every three months. The reason the programme is so intense is because in a small number of cases (3 in 10) the cancer will recur, usually within the first year and often within the first six months. The surveillance programme means that the tumour can be found when it is small and when the cure rate with chemotherapy is high.

In about 30 percent of cases a residual lump or shadow will show upon the scan. This has to be surgically removed. While this can be a huge disappointment, residual lumps are not a bad prognostic sign and do not mean that the chemotherapy has failed. For every 10 residual lumps that are removed, eight will not have cancer cells; they will either be all dead tissue or benign cells. Those that do have cancer cells will require a couple of extra courses of chemotherapy.