What Is the Treatment for Testicular Cancer?

Testicular cancer is highly survivable, but getting the right treatment early on is crucial. Learn what options are available for treating testicular cancer at every stage.

Testicular cancer is rare (about 1% of all male cancers globally), but it’s one of the most common cancers in people aged 15-29. While it has a high survivability rate (at an average of 95%) and a high cure rate (average of 90%), it can be deadly if it has a chance to spread.

The key is to catch the disease as early as possible.

“The majority of the time, the most common presenting symptom of testicular cancer is a painless mass, so it’s really important for young people and the parents of teenagers to pay attention to this and seek medical advice for any abnormalities in the testicles,” says Hooman Djaladat, MD, a urologic oncologist with USC Urology, part of Keck Medicine of USC.

For those diagnosed with testicular cancer, treatment options vary according to the cancer’s stage — whether the cancer has spread, and if so, how far. Dr. Djaladat explains what patients and their loved ones can expect at every step of the journey.

Stage 1 testicular cancer treatment

“At any stage, the standard treatment when a patient has a cancerous mass is to remove the testicle,” Dr. Djaladat says. “This surgery is called an orchiectomy.”

In Stage 1, the cancer has not spread from the testicle. Following orchiectomy, doctors will keep an eye on the patient’s condition through active surveillance, which includes ongoing blood tests, imaging and symptom checks.

Stage 2 testicular cancer treatment

By Stage 2, the cancer has spread through the retroperitoneum — the space behind the peritoneum, which is the tissue that lines the abdominal wall.

“In early Stage 2 testicular cancer cases, patients may benefit from a surgery called a retroperitoneal lymph node dissection, which removes lymph nodes from the abdomen in order to clear out all possible disease,” Dr. Djaladat says. “This is a procedure we may offer robotically — a minimally invasive technique.”

In higher levels of Stage 2 testicular cancer, the lymph nodes in the retroperitoneum may be larger than two to five centimeters across. When this is the case, or if certain tumor biomarkers are elevated, the patient may need systemic chemotherapy.

However, this chemotherapy can often shrink the tumors. When this happens, a patient may or may not need retroperitoneal lymph node dissection.

Stage 3 testicular cancer treatment

At this stage, the cancer has spread beyond the retroperitoneal area.

“Most of the time, treatment for Stage 3 testicular cancer is systemic chemotherapy,” Dr. Djaladat says. The patient may or may not need lymph node dissection.

Testicular cancer is a rare disease

Because testicular cancer is rare, with an average of 8,000-10,000 diagnoses in the United States per year, doctors don’t see it as often as they see other types of cancer.

In order to get care from a well-seasoned expert in testicular cancer, Dr. Djaladat recommends that patients seek care at a comprehensive cancer center with expert urologic oncologists on staff. Here, a patient can benefit from the use of microRNA to analyze a patient’s type of cancer and the best way to manage it, advanced surgical techniques, a robust active surveillance protocol and surgical procedures beyond orchiectomy or retroperitoneal lymph node dissection.

“One surgical approach we use at the USC Norris Comprehensive Cancer Center at Keck Medicine is called robotic-assisted retroperitoneal lymph node dissection, a minimally invasive technique which not a lot of centers on the West Coast offer,” Dr. Djaladat says. “And our experience is very robust in this approach.”

Robotic surgery drastically reduces the length and difficulty of the recovery period. While this surgery used to involve long incisions and require a hospital stay for up to a week, the robotic procedure is on the cusp of becoming an outpatient procedure. Very recently, a few patients who have qualified for the procedure have been able to go home the same day, Dr. Djaladat says.

That said, all treatments for testicular cancer are likely to be more effective when cancer is caught early, so if a person notices any abnormalities in their testicles, it’s crucial that they get to see a doctor right away to ensure to best outcome possible.

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