If you get a diagnosis of testicular cancer, don't panic. Testicular cancer is one of the most curable cancers. If found early, over 95% of men survive 5 years or more. Even in men with cancer that's spread, the survival rate is about 75%.
Our experience and expertise at UVA means we have the tools and the team you need for your care.
Testicular Cancer Treatment Options
Your treatment options will depend on your age, health, and the stage of your cancer. Some types of testicular cancer grow slowly. Others move and grow fast.
For testicular cancer, chemotherapy works best when it includes a mix of drugs. We’ll choose these medicines to make them as effective and safe for you as possible. We’ll also figure out how much you’ll need and for how long.
Even with chemotherapy, testicular cancer can come back. If this happens, we can try different chemotherapy options.
Surgery for Testicular Cancer
We have two main types of surgery for treating cancer of the testicles.
We can surgically remove the testicle that contains cancer. In this procedure, called an orchiectomy, we take them out through your groin instead of the scrotum. This helps lower the risk of spreading any cancer.
With only one testicle removed, the healthy testicle can make enough sperm cells and hormones.
If you lose both testicles, your body won’t be able to make sperm cells or hormones. A drop in testosterone may cause hot flashes, loss of muscle mass, and a lower sex drive. Your doctor can replace your testosterone with a patch, shot, or gel.
You have the option to have prosthetic (fake) testicle. These can make your scrotum look normal. We can do this during the testicle removal or later.
Lymph Node Removal
If cancer spreads beyond the testicle, we usually find it in lymph nodes. We can remove these in a procedure called a retroperitoneal lymph node dissection (RPLND).
If a lymph node has cancer, we take it out.
We can perform this surgery two ways:
- Using an open procedure, with a cut across your abdomen
- With laparoscopy, which uses smaller cuts and tools
Treatment & Fertility Risks
Lymph node dissection can sometimes injure the nerves that control ejaculation. It causes retrograde ejaculation. This happens when your body sends semen in the wrong direction, to your bladder. This can make it hard to conceive a child.
Chemotherapy can also affect your ability to have children. Talk to your doctor before treatment about your options. We can help you find ways to save your sperm.
Symptoms of testicular cancer include:
- A painless lump or swelling in either testicle
- Enlargement or swelling of a testicle or change in the way it feels
- Feeling of heaviness in the scrotum
- A dull ache in the lower abdomen or groin
- Fluid in the scrotum that appears suddenly
- Pain or discomfort in a testicle or in the scrotum
- Lower back pain (in later stages of the cancer)
- Enlarged breasts
These symptoms don't mean you have cancer. But they do mean you should see a doctor.
Getting a Thorough Diagnosis
At UVA, we have high-tech tools for diagnosing testicular cancer. We'll want to make sure, if we find cancer, that it hasn't spread. Along with blood tests, you may have one of these tests:
- Computed tomography (CT) scan
- Positron emission tomography (PET) scan
- Magnetic resonance imaging (MRI) scan