Treatment

  • Before you have treatment, the doctors need to find out whether the cancer has spread to any other parts of your body (the stage of the cancer) and at what speed it is growing at.
  • One of the hardest things is waiting to hear about the stage and grade of the cancer, this can be pretty worrying, but this information is important, as it helps your doctors plan the right treatment.
  • Treatment for testicular cancer is usually really successful and most men are completely cured. This is true even if the cancer has spread beyond the testicles.
  • There are two main types of treatment, surgery and chemotherapy. Most men need a combination of both treatments, but the exact treatment plan will depend on the stage of the cancer.
  • Surgery – Involves removing the affected testicle during an operation.
  • Chemotherapy – Uses anti-cancer drugs.
  • Once you have finished treatment you will be followed up closely and this will involve blood tests to check on the tumour markers. If the markers become raised, it may be that the cancer has come back. If there has been a recurrence of the cancer, more treatment can be given to try to get rid of it. There is more information about these tumour markers in the information about diagnosis.
  • If you have any questions about your treatment, don’t be afraid to ask your doctor or nurse. They’ll be happy to help you understand what’s involved.
  • Surgery to remove the testicle is the main treatment for testicular cancer. You might hear your doctors talk about an ‘orchidectomy’, which is the medical name for the operation. You may feel shocked and scared by the thought of such an operation, but it does give a really good chance of completely curing the cancer – often without the need for further treatment.
  • Further Surgery
  • Close to the testicles, in the abdominal area, are lymph nodes. These are part of the body’s immune system and help fight infection. Cancer cells can lodge in these lymph nodes making them slightly enlarged. Chemotherapy is often used to get rid of any cells in the lymph nodes but if this doesn’t work they may have to be removed surgically. The medical name for this operation is ‘lymph node dissection’.
  • What are the effects of surgery?
  • The effects very much depend on what surgery you have. Most men only need surgery to remove one testicle and make a full recovery. A false testicle can be placed in the scrotum so that you won’t notice a difference and the other testicle will produce enough hormones for you. If you needed both removed then you can be given hormone injections.
  • Chemotherapy is the use of anti-cancer drugs to destroy cancer cells. Sometimes it is used to shrink a large testicular tumour before surgery, so that it can be removed more easily. It is also used after surgery to help reduce the risk of the cancer coming back and to treat any cancer that has spread to the lymph nodes in the abdomen.
  • How is it given?
  • Chemo is given by injection into a vein (intravenously) – this may be through a cannula, central line or a PICC line. Most people need between 2 and 4 sessions. Each session involves staying in hospital for a few days to have the treatment. This is then followed by a 3-week rest period before the next session, to allow your body to recover from any side effects of treatment. If the cancer has spread to other parts of your body, then you may need to have 4-6 sessions of chemo. In this situation the chemo may be given every week.
  • Which drugs?
  • The drugs most often used to treat testicular cancer are cisplatin, etoposide and bleomycin. Giving these drugs together is sometimes called a BEP.
  • Another is carboplatin.
  • are there any side effects?
  • Different chemo drugs cause different side effects. Some people just have a few side effects and others have more. It’s hard to predict how it’s going to be for you as everyone is different and reactions can vary from treatment to treatment.
  • Almost all side effects are short term and will gradually disappear once treatment stops. Most men will experience side effects, and the most common are hair loss, tiredness, sickness (which can be controlled) and a lowered imune system, which means you pick up infections more easily. You may also feel low in mood. If you want to know more about the regimen and side effects of chemotherapy, there is lots more information in the chemotherapy and the deal with it section.
  • Carboplatyn How it works: Platinum-based chemotherapy weakens or destroys cancer cells by damaging the genetic material in the cells and making it hard for cells to repair any genetic damage.
  • Uses: Carboplatin is used to treat testicular cancer and usually is given in combination with other chemotherapy medicines.
  • BEP chemotherapy regimen is used to treat testicular cancer and also a type of ovarian cancer known as a germ cell tumour.
  • Which drugs?
  • Bleomycin, Etoposide, CisPlatin
  • How is it given?
  • Into a vein, intravenously. This maybe through a canula, central line or a PICC line. They are all given as a drip or infusion. You will also be given anti-sickness drugs and lots of fluids intravenously.
  • Are there any side effects?
  • Chemotherapy can cause unpleasant side effects. The main ones are mentioned here and you can find out ways of coping with them by visiting the deal with it section.
  • Lowered resistance to infections: Your immune system doesn’t work as well as it should when you’re having chemo, so you might pick up more colds or infections
  • Feeling sick: The drugs can cause nausea (feeling sick), but medicines are given to help prevent and control this
  • Hair loss: This usually starts about 3 to 4 weeks after the first dose of etoposide chemo. Hair may be lost completely or it may thin. You could also have thinning and loss of your eyelashes, eyebrows and other body hair
  • Loss of appetite: You may go off your food while you’re having this treatment
  • Tiredness and a general feeling of weakness: You will have less energy than normal and you might feel tired more easily
  • Sore mouth and taste changes: Your mouth might become sore and dry and you may notice small ulcers
  • Your kidneys may be affected: This usually doesn’t cause any problems, but to make sure that no damage is done you’ll have a blood test before each treatment (to check your kidneys are working).You’ll also be given a ‘drip’ of fluids into your vein before and after the chemo to keep your kidneys working well
  • Changes in nails: Your nails may become darker or ridged. This usually returns to normal within a few months of finishing treatment.
  • Is there anything else I should know?
  • This chemotherapy can also affect fertility. It can really help to talk this through with your doctors they may advise you to store sperm before you start treatment. For more information see the fertility section.
  • It is generally advised that you should not father a child whilst you having treatment for cancer. It is important to use contraception during and for a few months after you have finished treatment. There is more information in the fertility and sexuality sections.
  • How will I feel?
  • Chemo affects everyone differently, but it’s likely that you’ll feel rough sometimes (and better at others). You might also feel depressed, irritable, sad or angry. All of these feelings are normal. It can really help to talk things over with someone close or a counsellor to help you cope with it all. If you want more to find out more about coping with it, there is lots more information in the deal with it section.
  • Carboplatin
  • How it works: Platinum-based chemotherapy weakens or destroys cancer cells by damaging the genetic material in the cells and making it hard for cells to repair any genetic damage.
  • Uses: Carboplatin is used to treat testicular cancer and usually is given in combination with other chemotherapy medicines.
  • Carboplatin is a drug used in chemotherapy cancer treatments for a variety of cancers. It is generally used in treating ovarian and lung cancer. Carboplatin has also been used in treating testicular cancer in individuals with stage 1 seminoma, recent research indicating that this approach is more effective than the adjuvant radiotherapy.
  • Carboplatin comes in the form of a transparent and colorless fluid which can be administered as a drip infusion in one of the following ways: it is either inserted via a fine tube placed into a vein in the back of the hand, through a similar tube but this time inserted under the skin into a vein close to the collarbone or it is inserted through a fine tube into a vein in the crook of the arm.
  • A carboplatin infusion lasts for about an hour to complete and in the course of the therapy it is usually administered in several sessions over a period of months. The duration of the treatment and the number of treatment sessions will depend on the type of cancer that one is being treated for. During these treatment sessions carboplatin will usually be paired with other chemotherapy drugs as part of a combination regimen.
  • Nausea and loss of appetite come as side effects of all chemotherapy treatment drugs; nausea can begin at any time during the treatment, usually after the treatment is given and can last for up to an entire day, and this leads to a general loss of appetite. Both these problems can be taken care of or managed through anti-sickness drugs and advice on how to boost your appetite and maintain your weight. Also these are much less severe than in the case of cisplatin.
  • Radiotherapy is the use of high energy x-rays and similar rays, such as photons, to treat illnesses. X-rays were discovered about 100 years ago and since then radiation has been used to help diagnose and treat cancer.
  • Radiotherapy is used:
  • To cure the cancer
  • Radiotherapy can be given to destroy the tumour and, hopefully, cure the cancer. It can be given before or after surgery or chemo. Sometimes radiotherapy and chemotherapy are given at the same time which is known as chemoradiotherapy.
  • to relieve symptoms
  • This is called ‘palliative treatment’. Sometimes, if it’s not possible to cure a cancer, radiotherapy may be given to relieve symptoms, for example, to lessen pain. Lower doses of radiotherapy are given than in curative treatment, maybe just one or two treatments over a shorter period of time.
  • In stem cell & bone marrow transplants.
  • This is called total body irradiation and is less common than the other types of radiotherapy. It’s mainly used for people who are having a bone marrow or stem cell transplant, for example, as a treatment for leukaemia. A large, single dose (or 6 to 8 smaller doses) of radiation, is given to the whole body to destroy the cells of the bone marrow. Very high doses of chemo are given, followed by new bone marrow or stem cells to replace the destroyed bone marrow. There will be more about this in our stem cell transplants section.

 

Leave Comment