What are the treatment options for testicular cancer?

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There are several goals of testicular cancer treatment. These include managing a person’s symptoms and improving their quality of life. However, the main goal of testicular cancer treatment is to cure the disease.

Testicular cancer is often curable: The cure rate for testicular cancer is roughly 90%.

The National Cancer Institute (NCI) details the main elements of testicular cancer treatment. These include the following five standard treatment options:

• Surveillance: This is when doctors monitor a person’s condition with regular tests and exams. The purpose is to detect any significant changes in their condition.
• Surgery: Surgery is when doctors remove one or both testicles and possibly some nearby lymph nodes. The purpose is to remove the cancer within these organs. Surgery to remove one or both testicles is called an orchiectomy.
• Chemotherapy: Chemotherapy involves specific anticancer drugs. These drugs slow cancer growth by killing cancer cells or preventing their division.
• Radiation therapy: Radiation therapy is when doctors use special machines to aim radiation at cancer cells to kill them.
• High dose chemotherapy with stem cell transplant: This combined approach begins with high doses of chemotherapy to kill cancer cells. Doctors then provide the person with a stem cell transplant to help the healthy cells recover from the shock of chemotherapy.

Sometimes, doctors may recommend a combination of these treatment options at once.

Several factors can affect a person’s testicular cancer treatment plan. For instance, someone’s overall state of health is relevant. Factors such as having certain health conditions other than cancer may make some treatment options unsuitable. Other factors include a person’s outlook at diagnosis and the stage of their cancer.

Another important factor determining treatment is the type of testicular cancer.

There are two main types of testicular cancer: seminomas and nonseminomas. Seminomas begin in the germ cells. Most testicular cancers are seminomas.

Nonseminomas begin in the cells that form sperm. They have the potential to spread faster than seminomas.

According to the NCI, treatment of stage 0 testicular cancer could involve:

• surveillance
• radiation therapy
• surgical removal of the testicle

Radiation therapy is an effective treatment for stage 0 testicular cancer, with a 2.5% risk of relapse.

According to the NCI, doctors can treat stage 1 seminomas with the following:

• surgical removal of the testicle plus surveillance
• surgical removal of the testicle plus chemotherapy

Doctors can treat stage 1 nonseminomas with the following:

• surgical removal of the testicle
• surgical removal of the testicle and nearby lymph nodes
• surgical removal of the testicle plus chemotherapy for people at high risk of relapse

Doctors also recommend long-term follow-ups.

Efficacy

According to the NCI, surgical removal of the testicle alone has a nearly 100% cure rate for stage 1 seminoma.

For stage 1 nonseminoma, removal of the testicles can cure about 70% of cases. The remaining 30% of cases require additional treatment.

However, stage 1 seminoma is highly curable, with a cure rate of over 99%.

According to the NCI, if the tumor is no more than 5 centimeters (cm) in diameter, doctors can treat stage 2 seminomas with the following:

• surgical removal of the testicle plus radiation therapy to nearby lymph nodes
• combination chemotherapy
• surgical removal of the testicle and nearby lymph nodes

If the stage 2 seminoma is greater than 5 cm, doctors recommend:

• surgical removal of the testicle
• long-term follow-ups
• radiation therapy or combination chemotherapy

Doctors can treat stage 2 nonseminomas with the following:

• surgical removal of the testicle and nearby lymph nodes
• surgical removal of the testicle plus combination chemotherapy, with a possible second surgery

Doctors also recommend long-term follow-ups.

Efficacy

According to the NCI, stage 2 seminoma can have a cure rate as high as 95%. For stage 2 nonseminoma, the cure rate can be over 95%.

According to the NCI, doctors can treat stage 3 seminoma with the following:

• surgical removal of the testicle plus combination chemotherapy
• a chemotherapy trial

Doctors can treat stage 3 nonseminoma with the following:

• surgical removal of the testicle plus combination chemotherapy
• combination chemotherapy plus surgical removal of the testicle and any other tumors

Efficacy

According to the NCI, the 5-year progression-free survival rate for stage 3 seminoma and nonseminoma is roughly 82%. The cancer is curable, although it is harder to estimate how often this occurs.

Sometimes, testicular cancer keeps coming back, even after treatment. As the NCI explains, doctors have several ways to treat recurrent testicular cancer:

• combination chemotherapy
• high dose chemotherapy plus stem cell transplant
• surgery
• taking part in a clinical trial

There is no set duration for testicular cancer treatment.

As the American Cancer Society (ACS) explains, this treatment can take weeks, months, or even years. It all depends on how the cancer responds to treatment, the treatment type, and whether the cancer returns.

The 5-year relative survival rate for testicular cancer is positive.

A relative survival rate helps give an idea of how long a person with a particular condition will live after receiving a diagnosis compared with people without the condition.

For example, if the 5-year relative survival rate is 70%, it means a person with the condition is 70% as likely to live for 5 years as someone without the condition.

These figures are just estimates. A person can consult a healthcare professional about how their condition will affect them.

The ACS provides the following survival rates:

This data comes from people who received a testicular cancer diagnosis between 2011 and 2017.

The following are answers to some frequently asked questions about treatment for testicular cancer.

What is the best treatment for testicular cancer?

The best treatment for testicular cancer depends on many factors, such as the person’s overall health and the type and stage of the cancer.

However, surgical removal of the testicle has a nearly 100% cure rate.

Is it possible to treat testicular cancer without removing a testicle?

According to the National Health Service (NHS), removing the affected testicle is the first treatment option for all cases of testicular cancer.

Standard treatment options for testicular cancer include surveillance, surgery, and chemotherapy. Treatment plans depend on factors such as overall health, cancer stage, and type of testicular cancer.

The stage of cancer determines treatment options and can make a huge difference in survival and cure rates. For example, surgery often cures stage 1 testicular cancer. Other treatments, including chemotherapy and radiation, can treat later stage cancers.