Diagnosing Testicular Cancer
In order to reach a diagnosis of testicular cancer, a physician will conduct a number of tests, including blood tests, imaging tests (such as ultrasound, CT scan, or MRI), and an excisional biopsy. If such tests suggest the presence of testicular cancer, surgery can be performed to confirm the diagnosis (in some cases, the same surgical procedure can be used to diagnose then remove the cancer). This range of diagnostic tests is used not only to determine if testicular cancer is present, but also its stage (stage I, II, or III) and its type (seminoma or nonseminoma).
Treatments for Testicular Cancer
There are four basic treatment approaches that play a key role in testicular cancer. The course of treatment is determined by a number of factors, such as whether the testicular cancer is a seminoma or nonseminoma, as well as the stage of the cancer. The choice of treatment is a shared medical decision made by the patient and physician based on the differing risk profiles of the therapies versus the risk of the cancer itself.
- Surgery: Surgery to remove cancerous tissue plays a role for nearly every patient with testicular cancer. For some patients, the surgery can be both a diagnostic and therapeutic procedure; for example, if an ultrasound detects testicular cancer, subsequent surgery can both prove the finding and act as the definitive treatment by removing it. Some patients will not need treatment beyond surgery.
- Radiation therapy: Radiation therapy is the use of high-energy radiation to eradicate cancer cells. It plays a role in treating the subset of testicular cancers called seminomas.
- Chemotherapy: Chemotherapy is the use of a regimen of drugs to treat cancer. It can be used in the treatment of either seminoma or nonseminoma.
- Surveillance: Surveillance is the close monitoring of a patient who doesn’t need active treatment at the time but is at higher risk of the cancer returning. Such monitoring may consist of frequent CT scans and blood tests. If the cancer returns, another course of treatment will be initiated.
Treatments by Stage and Type of Cancer
While treatment courses will vary from one patient to the next, the basic treatment of testicular cancer based on the stage and type of cancer is as follows:
- Stage I Nonseminoma: This group of patients will first undergo surgery to diagnose the cancer. For some patients this surgery can also be used to remove the cancer and may be the only treatment required. Other patients considered to be at higher risk have three options: An additional surgery called retroperitoneal lymph node dissection (removal of the lymph nodes at the back of the abdomen), an abbreviated course of chemotherapy, and then surveillance.
- Stage I Seminoma: This group of patients will also undergo surgery to diagnose (and potentially remove) the cancer. Patients considered to be at higher risk have three options: Radiation therapy, an abbreviated course of chemotherapy, and then surveillance.
- Stage II Nonseminoma: This group of patients will undergo surgery then will have the options of additional surgery (retroperitoneal lymph node dissection) or a longer course of chemotherapy.
- Stage II Seminoma: This group of patients will undergo surgery then will have the options of radiation therapy or a longer course of chemotherapy.
- Stage III: For this group of patients the primary treatment will be chemotherapy regardless of whether the cancer is classified as seminoma or nonseminoma.
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