When a tumor is found, the testicle is removed to determine the type of cancer cells that make up the tumor. The tumor is also staged. Staging is used to find out how far the cancer has spread. In addition to tests used to diagnose testicular cancer, imaging tests and blood tests are also used to determine the stage. The stage of your cancer is very important in planning your treatment.
Treatment for Testicular Cancer - There are 3 types of treatment for testicular cancer. Which treatment you choose depends on the type of cancer and stage at diagnosis. The three treatments are:
Surgery to remove the affected testicle is called a radical inguinal orchiectomy. Men may be concerned that losing a testicle will affect their ability to have sex or father children. A man with one testicle can still have normal erections and produce sperm. Depending on the type and stage of your testicular cancer, the surgeon may remove lymph nodes from the back of the abdomen. This procedure is called a retroperitoneal lymph node dissection, and is an area of great expertise at UCLA Urology. We perform this procedure through an incision or with robotic-assisted laparoscopy. Removal of these lymph nodes has been known, in some cases, to cause fertility problems, though a nerve sparing surgical technique can potentially avoid this result. Some men are concerned about how their body will look after having a testicle removed. We can place testicular prostheses or artificial testicles in your scrotum to replace the one that was removed during your surgery. The prosthesis makes your scrotum look like it did before surgery. Some men want to have a prosthesis, and others do not. You should discuss your wishes with your surgeon before surgery.
Radiation therapy uses high energy beams, such as x-rays, to kill cancer cells in your scrotum and stop them from spreading. When treating testicular cancer, men receive external beam radiation. With external beam radiation therapy, a machine directs the high-energy rays at your tumor and a small amount of healthy tissue around it. The most common type of machine used to give you external radiation therapy is called a linear accelerator. External radiation therapy is usually given to you during outpatient visits to a hospital or treatment center. Outpatient visits are when you do not need to stay overnight in the hospital or treatment center. Radiation therapy is mainly used for patients with seminoma, which is very sensitive to radiation. It may be used after surgery and is directed at the lymph nodes at the back of the abdomen. This is to kill any cancer in those lymph nodes that can't be seen.
Radiation therapy can affect health cells as well as cancer cells. This can cause you to have side effects. Side effects are different from person to person, and may be different from one treatment to the next. Some people have no or very mild side effects. The good news is that there are ways to deal with most of the side effects. The side effects that you have depend on the radiation dose you get during your cancer treatment, and your general health. Common side effects include fatigue, changes in skin at the radiation site, loss of appetite, nausea, and diarrhea. Radiation therapy can also interfere with sperm production. Many patients regain their fertility 1 to 2 years after treatment. If you are concerned with fertility speak, with your doctor about your options.
Chemotherapy for testicular cancer is the use of powerful anticancer medicines that kill many of the cancer cells. Chemotherapy treats your whole body, not just one area, like surgery or radiation therapy. The chemotherapy medicines you are given travel throughout your whole body. You can get chemotherapy in two different ways. Some of the anticancer medicines are given to you intravenously. This means that the medicines go into your body through a needle in your vein. Other chemotherapy medicines can be taken by mouth or orally. Sometimes two or more chemotherapy medicines will be given to you at the same time.
The strong anticancer medicines used in chemotherapy are made to kill cells in your body that grow and divide very quickly. This is why you may have side effects with chemotherapy. Along with your cancer cells, chemotherapy also kills healthy cells in your body that grow and divide very quickly. However, most of the side effects slowly go away after you finish your chemotherapy. There are ways to make the side effects easier to deal with while you are having chemotherapy. Common side effects include nausea, hair loss, fatigue, vomiting, fever, chills, coughing/shortness of breath, mouth sores, or skin rash. Other side effects include dizziness, numbness, loss of reflexes, or difficulty hearing.
Men with one healthy testicle still achieve normal erections and produce sperm, and in most cases fertility is also preserved. Because of the possibility that men who have lymph node removal, radiation, or chemotherapy will no longer be fertile, patients may opt to freeze and store sperm prior to treatment. Given the risk of recurrence, regular follow-up exams are important for men who have been treated.
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