Inside the scrotum are two egg-shaped glands called the testicles. The testicles are held there by the spermatic cord that also contains vessels and nerves of the testicles, and the vas deferens. Testicular cancer involves the formation of cancer cells in the tissues of one or both testicles. Treatments for testicular cancer and tumors that are present depends on the type of tumor and the stage and extent of the cancer. Most men can be completely cured.
The first step after finding the cancer will be to determine the type of cancer, which will be done by a microscopic exam. Cells will be classified as seminoma or non-seminoma. If both types of cells are found within one tumor it will be treated as non-seminoma. The next step will be staging of the cancer to see how far it has spread in the body. Stage l means the cancer has not spread further than the testicle, Stage ll means it has spread to lymph nodes in the abdomen, and Stage lll indicates that it has spread further, and may be as far as the liver or lungs.
Three main types of treatment may be used, and will depend on the class and stage of the disease.
• Surgical treatment. An orchiectomy includes removal of the testicle, and a lymphadenectomy involves removing the associated lymph nodes.
• Radiation therapy. Involves high-dose x-rays or other high energy rays that may be used after some surgeries. This therapy is normally limited to treatment of seminomas.
• Chemotherapy. Cancer cells will be targeted and destroyed by powerful drugs like cisplatin, etoposide and bleomycin which have increased the chances for survival for both classes of testicular tumors.
Stage l testicular cancer treatment may include:
If the tumor is determined to be a seminoma, treatment will likely involve removal of the testis, followed by radiation to the lymph nodes in the abdomen.
If the tumor is classed as non-seminoma, one of the following options may be chosen; radical inguinal orchiectomy and lymph node dissection or a radical inguinal orchiectomy and careful monitoring to see if the cancer comes back.
Stage ll testicular cancer treatment may include:
Seminoma tumors are further broken into bulky and non-bulky disease. If it is found to be a seminoma that is non-bulky, treatment will likely be surgery to remove the testis followed by external-beam radiation to lymph nodes in the abdomen. If they are determined as bulky, treatment will be a radical inguinal orchiectomy followed by chemotherapy or radiation therapy.
Non-seminoma tumors will be treated one of the following ways; radical inguinal orchiectomy and lymph node removal in abdomen; radical inguinal orchiectomy and lymph node removal followed by chemotherapy or radical inguinal orchiectomy followed by chemotherapy.
Stage lll testicular cancer treatments include:
Seminomas will be surgery to remove the testis followed by chemotherapy.
If found to be non-seminoma, the tumor may be treated by systemic chemotherapy or systemic chemotherapy followed by surgery to take out any remaining masses.
If the cancer is recurrent, treatment will again be determined by the class of the tumors, and may involve more chemotherapy, sometimes followed by a bone marrow or peripheral stem-cell transplant.
Treatments for testicular cancer and tumors have come a long way and offer a great chance of survival. More men are being cured of the cancer, which is why early detection is so important.
National Cancer Insitute: Testicular Cancer Treatments
American Cancer Society: Testicular Cancer
MayoClinic: Testicular Cancer
Cancer Research UK: Types of Treatment for Testicular Cancer
American Family Physician: Diagnosis and Treatment of Testicular Cancer
Memorial Sloan Kettering Cancer Center: Testicular Cancer treatment