Treating testicular cancer is based mainly on the stage and type of cancer. Among the different stages of tumors, pure seminomas and non-seminomas are treated differently. This is because pure seminomas are germ cell tumors and non-seminomas are mixed germ cell tumors. Before testicular cancer forms into a specific tumor, it goes through stage 0 or carcinoma in situ.
Stage 0
As mentioned above, Carcinoma In Situ (CIS) is a stage 0 cancer that has not spread outside the testicle. If a biopsy to test for testicular cancer shows CIS, the best form of treatment is surgery. However, doctors might not recommend treating it immediately. They might examine the stage with physical exams, ultrasound, and blood tests to obtain the tumor marker levels. The tumor marker levels show whether the cancer is invasive and spreading to the nearby areas.
If left untreated, the cancer might turn into any of the two types of tumors mentioned above. Let’s look at both the types of testicular cancer stages and the possible ways to treat them.
Seminomas
- Stage I
This form of cancer can be cured in almost every patient. Stage I states that cancer has formed into a tumor but is still localized and has not spread to the nearby areas. The first form of treatment, in this case, is surgery, which involves removing the testicle and spermatic cord. After surgery, the doctors might recommend radiotherapy, which is aimed at the paraaortic lymph nodes. Low doses of 10 to 15 treatments over a couple of weeks might be recommended. - Stage II
This stage denotes that the seminomas cells from the tumor have spread from the testicle to the lymph nodes. After removing the testicles surgically, doctors usually recommend radiation treatment to the retroperitoneal lymph nodes. They might also use chemotherapy as a failsafe treatment and observe the patient closely for three to six months to confirm if they need further treatment.
Non-seminomas
- Stage I
This type of tumor is different from seminomas as it is caused by malignant germ cells. The first form of treatment for this is radical inguinal orchiectomy, that is, removing the testicle and tumor. Based on the body’s response and the doctor’s observation, retroperitoneal lymph node dissection (RPLND) might be advised for the aggressive growth of cancer. Although this form of treatment has a high cure rate, the patient might lose their ability to ejaculate normally. Instead of surgery, some oncologists might also advise a single cycle of chemotherapy and keep the patient under observation. - Stage II
This stage states that the malignant cells from the tumor have spread to other lymph nodes apart from the retroperitoneal lymph node. After surgery, the doctors might suggest three to four cycles of chemotherapy based on the type of medication, if the tumor marker levels are normal. In rare cases, RPLND might also be needed to remove the malignant cells from the local spot. - Stage III
Considered as the advanced stage of testicular cancer, the malignant cells have spread to distant parts of the body from the lymph nodes in this stage. Stage III cancer is usually treated with radical inguinal orchiectomy and three to four cycles of chemotherapy. If cancer has spread to distant parts of the body such as the liver, bones, or brain, the doctors might recommend surgery (for seminomas form of cancer) and chemotherapy sessions based on the extent of the spread.
