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Testicular Cancer Treatment (PDQ®)

Patient Version
Last Modified: 10/02/2011

Treatment Options by Stage

Stage I Testicular Cancer
Stage II Testicular Cancer
Stage III Testicular Cancer

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Stage I Testicular Cancer

Treatment of stage I testicular cancer depends on whether the cancer is a seminoma or a nonseminoma.

Treatment of seminoma may include the following:

Treatment of nonseminoma may include the following:

  • Surgery to remove the testicle, with long-term follow-up.
  • Surgery to remove the testicle and lymph nodes in the abdomen, with long-term follow-up.
  • Surgery followed by chemotherapy for patients at high risk of recurrence, with long-term follow-up.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage I malignant testicular germ cell tumor 1. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 2.

Stage II Testicular Cancer

Treatment of stage II testicular cancer depends on whether the cancer is a seminoma or a nonseminoma.

Treatment of seminoma may include the following:

Treatment of nonseminoma may include the following:

  • Surgery to remove the testicle and lymph nodes, with long-term follow-up.
  • Surgery to remove the testicle and lymph nodes, followed by combination chemotherapy and long-term follow-up.
  • Surgery to remove the testicle, followed by combination chemotherapy and a second surgery if cancer remains, with long-term follow-up.
  • Combination chemotherapy before surgery to remove the testicle, for cancer that has spread and is thought to be life-threatening.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage II malignant testicular germ cell tumor 3. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 2.

Stage III Testicular Cancer

Treatment of stage III testicular cancer depends on whether the cancer is a seminoma or a nonseminoma.

Treatment of seminoma may include the following:

Treatment of nonseminoma may include the following:

  • Surgery to remove the testicle, followed by combination chemotherapy.
  • Combination chemotherapy followed by surgery to remove the testicle and all remaining tumors. Additional chemotherapy may be given if the tumor tissue removed contains cancer cells that are growing or if follow-up tests show that cancer is progressing.
  • Combination chemotherapy before surgery to remove the testicle, for cancer that has spread and is thought to be life-threatening.
  • A clinical trial of chemotherapy.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage III malignant testicular germ cell tumor 4. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 2.



Glossary Terms

abdomen (AB-doh-men)
The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
cell (sel)
The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
centimeter (SEN-tih-MEE-ter)
A measure of length in the metric system. There are 100 centimeters in a meter and 2½ centimeters in an inch.
chemotherapy (KEE-moh-THAYR-uh-pee)
Treatment with drugs that kill cancer cells.
clinical trial (KLIH-nih-kul TRY-ul)
A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.
combination chemotherapy (KOM-bih-NAY-shun KEE-moh-THAYR-uh-pee)
Treatment using more than one anticancer drug.
follow-up (FAH-loh-up)
Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.
lymph node (limf node)
A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.
nonseminoma (NON-seh-mih-NOH-muh)
A type of cancer that begins in cells that form sperm or eggs. There are several types of nonseminoma tumors, including embryonal carcinoma, malignant teratoma, choriocarcinoma, and yolk sac tumor. These tumors are usually made up of more than one type of cancer cell. Although nonseminomas occur most often in the testicles or ovaries, they can occur in other tissues, such as the brain, chest, or abdomen. This happens when cells that have the ability to form sperm or eggs are found in other parts of the body.
pelvis (PEL-vus)
The lower part of the abdomen, located between the hip bones.
PET scan (… skan)
A procedure in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. Because cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body. Also called positron emission tomography scan.
progression (pruh-GREH-shun)
In medicine, the course of a disease, such as cancer, as it becomes worse or spreads in the body.
radiation therapy (RAY-dee-AY-shun THAYR-uh-pee)
The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.
recurrence (ree-KER-ents)
Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrent cancer.
scan (skan)
A picture of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body.
seminoma (SEH-mih-NOH-muh)
A type of cancer that begins in cells that make sperm or eggs. Seminomas occur most often in the testicles or the ovaries. They may also occur in other organs, such as the brain, chest, or abdomen. This happens when cells that have the ability to form sperm or eggs are found in other parts of the body. Seminomas grow and spread slowly.
stage (stayj)
The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.
stage I testicular cancer (...tes-TIH-kyuh-ler KAN-ser)
Stage I is divided into stage IA, stage IB, and stage IS, and is determined after a radical inguinal orchiectomy (surgery to remove the testicle) is done. In stage IA, cancer is in the testicle and epididymis and may have spread to the inner layer of the membrane surrounding the testicle; all tumor marker levels are normal. In stage IB, cancer is in the testicle and the epididymis and has spread to the blood or lymph vessels in the testicle; or has spread to the outer layer of the membrane surrounding the testicle; or is in the spermatic cord or the scrotum and may be in the blood or lymph vessels of the testicle; all tumor marker levels are normal. In stage IS, cancer is found anywhere within the testicle, spermatic cord, or the scrotum, and either all tumor marker levels are slightly above normal or one or more tumor marker levels are moderately above normal or high.
stage II testicular cancer (...tes-TIH-kyuh-ler KAN-ser)
Stage II is divided into stage IIA, stage IIB, and stage IIC, and is determined after a radical inguinal orchiectomy (surgery to remove the testicle) is done. In stage IIA, cancer is anywhere within the testicle, spermatic cord, or scrotum; and has spread to up to 5 lymph nodes in the abdomen (none larger than 2 centimeters); all tumor marker levels are normal or slightly above normal. In stage IIB, cancer is anywhere within the testicle, spermatic cord, or scrotum; and has spread to up to 5 lymph nodes in the abdomen (at least one of the lymph nodes is larger than 2 centimeters, but none is larger than 5 centimeters), or has spread to more than 5 lymph nodes (the lymph nodes are not larger than 5 centimeters); all tumor marker levels are normal or slightly above normal. In stage IIC, cancer is anywhere within the testicle, spermatic cord, or scrotum; and has spread to a lymph node in the abdomen that is larger than 5 centimeters; all tumor marker levels are normal or slightly above normal.
stage III testicular cancer (...tes-TIH-kyuh-ler KAN-ser)
Stage III is divided into stage IIIA, stage IIIB, and stage IIIC, and is determined after a radical inguinal orchiectomy (surgery to remove the testicle) is done. In stage IIIA, cancer is anywhere within the testicle, spermatic cord, or scrotum; may have spread to one or more lymph nodes in the abdomen; and has spread to distant lymph nodes or to the lungs; tumor marker levels may range from normal to slightly above normal. In stage IIIB, cancer is anywhere within the testicle, spermatic cord, or scrotum; and may have spread to one or more lymph nodes in the abdomen, to distant lymph nodes or to the lungs; the level of one or more tumor markers is moderately above normal. In stage IIIC, cancer is anywhere within the testicle, spermatic cord, or scrotum; and may have spread to one or more lymph nodes in the abdomen, to distant lymph nodes, or to the lungs; the level of one or more tumor markers is high; OR, cancer is anywhere within the testicle, spermatic cord, or scrotum; and may have spread to one or more lymph nodes in the abdomen; and has not spread to distant lymph nodes or the lung but has spread to other parts of the body; tumor marker levels may range from normal to high.
surgery (SER-juh-ree)
A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.
testicle (TES-tih-kul)
One of two egg-shaped glands inside the scrotum that produce sperm and male hormones. Also called testis.
tissue (TIH-shoo)
A group or layer of cells that work together to perform a specific function.
tumor (TOO-mer)
An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.
watchful waiting (WACH-ful WAY-ting)
Closely watching a patient’s condition but not giving treatment unless symptoms appear or change. Watchful waiting is sometimes used in conditions that progress slowly. It is also used when the risks of treatment are greater than the possible benefits. During watchful waiting, patients may be given certain tests and exams. Watchful waiting is sometimes used in prostate cancer. It is a type of expectant management.

Table of Links

1http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=38778&tt=1&a
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2http://www.cancer.gov/clinicaltrials
3http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=38779&tt=1&a
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4http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=38780&tt=1&a
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