Treatment of cancer of the testicle depends on the stage and cell type of the disease, and the patient's age and overall condition. There are treatments for all patients with cancer of the testicle, and most patients can be cured with available treatments. Four kinds of treatment are used: surgery (taking out the cancer in an operation); radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells); chemotherapy (using drugs to kill cancer cells); and bone marrow transplantation.
Surgery is the initial treatment of most stages of cancer of the testicle. A doctor may take out the cancer by removing one or both testicles through an incision (cut) in the groin. This is called a radical inguinal orchiectomy. It is essential that this be done by experienced urologic surgeons to avoid tumor spillage. For early stage testis cancer, Stage I or Stage II, the lymph nodes in the abdomen are also commonly removed (RPLND-retroperitoneal lymph node dissection). This complicated operation requires experienced surgeons and experienced hospital staff who perform this procedure commonly. Technical skill and experience are essential in providing a cancer cure while maintaining an excellent quality of life. This procedure is not commonly performed outside of major cancer centers. Dr. Joseph A. Smith, Jr., Dr. Michael S. Cookson, and Dr. Sam S. Chang, Dr. Rodney Davis, and Dr. Peter E. Clark have had years of specialized training in this procedure and routinely perform this operation.
Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation therapy for testicular cancer usually comes from a machine outside the body (external-beam radiation). Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein. Chemotherapy is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells outside the testicle. Bone marrow transplantation is a newer type of treatment. For autologous bone marrow transplant, bone marrow is taken from the patient and treated with drugs to kill any cancer cells. The marrow is then frozen and the patient is then given high-dose chemotherapy with or without radiation therapy to destroy all of the remaining marrow. The marrow that was taken out is then thawed and given back to the patient through a needle in a vein to replace the marrow that was destroyed. This complicated therapy is almost exclusively offered only at major cancer centers such as the Vanderbilt-Ingram Cancer Center.