Diagnosis and Treatments

The symptoms of testicular cancer can also indicate other conditions. We conduct a series of tests to diagnose the disease as well as determine the stage and type. These include blood tests, imaging tests (such as ultrasound, computerized tomography (CT), and magnetic resonance imaging, as well as excisional biopsy.

Treatment

We individualize your treatment plan based on the type and stage of cancer as well as any other conditions or preferences you may have. We work with you to consider your feelings about the differing risk profiles of the therapies versus the risk of the cancer itself. There are four basic treatments for testicular cancer.

• Surgery plays a role for nearly everyone with testicular cancer. Sometimes, the procedure can be both diagnostic and therapeutic; 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 this surgery. We also offer advanced surgical procedures, including retroperitoneal lymph node dissection (surgical removal of the lymph nodes at the back of the abdomen).
• Radiation therapy is the use of high-energy radiation to eradicate cancer cells. We use this most often in treating the type of testicular cancer called seminoma.
• Chemotherapy is the use of a regimen of drugs to treat cancer. We use this for both seminoma and nonseminoma cancers.
• Surveillance is the close monitoring of a patient who does not need active treatment immediately, but is at risk of the cancer returning. Such monitoring may consist of frequent CT scans and blood tests. If the cancer returns, we will likely initiate another course of treatment.

We strive to minimize the risk of long-term complications from therapy. For instance, with chemotherapy, we create a schedule that minimizes the effect on your work and daily activities. If you worry about the possible impact of treatment on fertility, we offer counseling to discuss options such as sperm banking.

Treatment by Stage and Type of Cancer

Precise treatment plans vary from one patient to the next, but there are some general trends, based on the stage and type of cancer. Stages I and II start with surgery to diagnose the cancer.

• Stage I Nonseminoma.  We may remove the cancer during the diagnostic procedure and this may be the only treatment you require. You might also need further treatment, such as 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 surveillance.
• Stage I Seminoma. We may remove the cancer during your diagnostic procedure. If you are at higher risk, we may also provide radiation therapy, an abbreviated course of chemotherapy, and then surveillance.
• Stage II Nonseminoma. After the diagnostic procedure, we may perform additional surgery (retroperitoneal lymph node dissection) or a course of chemotherapy.
• Stage II Seminoma. After the diagnostic procedure, youwill have the options of radiation therapy or an extended of chemotherapy.
• Stage III. Yourprimary treatment will likely be chemotherapy whether the cancer is classified as seminoma or nonseminoma.

Meet Our Team

Our multidisciplinary team includes the following core faculty members.

Medical Oncology
Matthew Galsky, MD
William Oh, MD

Urology
Simon Hall, MD
Michael Palese, MD

Radiation Oncology
Richard Stock, MD