Testicular Cancer
Testicular cancers are cancers that develop and grow from cells in the testicles.
These are separated into two groups based on where they started growing:
- Germ Cell Tumours (GCT): which account for approximately 95% of all testicular cancers and develop from the cells that produce sperm.
- Non Germ Cell Tumours (NGCT): which account for the remaining 5% and develop from the structural cells that comprise the testicle.
Depending on what the cancer looks like under a microscope, The GCT group is then further separated into subtypes, known as Seminomas (60%), Non-Seminomas (30%), and Mixed (10%).
These subtypes are important as they change the recommended treatment options. Radiation therapy is currently only recommended in the Seminoma subgroup.
Radiation Therapy and Testicular Cancer
The best person to talk to about radiation therapy for testicular cancer is a radiation oncologist. You can ask your doctor for a referral to a radiation oncologist to learn if radiation therapy is an option for you.
The Treatment Team
Doctors make a treatment plan for each person based on:
- the type of cancer
- where the cancer is
- what other treatments have been tried
- the person’s health.
Treatment for testicular cancer usually starts with surgical removal of the involved testicle, as this is required make the diagnosis of the cancer and subtype.
There are multiple further treatment options, ranging for close surveillance, to radiotherapy or chemotherapy.
The type of treatment a person gets is worked out by a team of doctors and health professionals often called a Multidisciplinary Team.
A highly trained radiation oncology team takes care of people having radiation therapy. This includes radiation oncologists, radiation therapists, medical physicists and radiation oncology nurses.
Role of Radiation Therapy for Testicular Cancer
If the cancer is confined to the testicle, surgical removal alone followed by close surveillance is often sufficient to cure the disease in the majority of cases.
If the cancer has spread beyond the testicle, either radiation therapy or chemotherapy can be considered to treat these areas. The decision between these two options is complex and depends on multiple factors. It is best discussed with either your radiation oncologist or medical oncologist.
Types of Radiation Therapy used In Testicular Cancer
External Beam Radiation Therapy (EBRT) is the most common type of radiation therapy used in testicular cancer.
Advanced techniques allow the doctor to target the radiation on the cancer while limiting radiation to healthy parts of the body.
Doctors usually do radiation treatment once a day, 5 days a week from Monday to Friday.
Near the end of treatment some people receive 2 treatments a day, or have extra days added to their treatment to make up for any missed days.
The length of treatment is usually 2-3 weeks (10-15 total sessions) but may vary slightly depending on certain cancer related factors.
Patient Positioning
During the delivery of radiation therapy, the patient is lying down on a treatment table with their arms by their side. It is important that this position is comfortable, as you have to stay still during the treatment.
A device known as a scrotal shield is used, which is placed around the healthy testicle to prevent unnecessary radiation exposure
General Side Effects of Radiation Therapy
Radiation therapy is more effective with fewer side effects than ever before.
Recent advances mean radiation oncologists can effectively treat the cancer while getting less radiation on healthy body parts. This means much fewer side effects.
Side effects from radiation therapy vary between people, even for those having the same treatment.
Palliative treatment courses usually have very few side effects as the doses are lower when compared to curative treatments, which involve higher doses and therefore more side effects.
While some people feel no side effects, some feel mild side effects, such as tiredness or skin redness during and/or just after treatment. These usually get better within 1-2 weeks.
Before starting treatment, your radiation oncologist will talk to you about side effects and answer your questions.
The potential side effects of radiation therapy for testicular cancer are divided into:
- Early side effects: can occur during and shortly after treatment
- Late side effects: can occur months to years after treatment and depend upon the areas treated.
For more information, go to the Potential Side Effects page.
Early Side Effects of of Radiation Therapy for Testicular Cancer
Early side effects occur during and shortly after radiation treatment.
Common early side effects of radiation therapy for testicular cancer include:
Fatigue: This is very common in the second half of treatment and varies between people. Fatigue may continue for several weeks after treatment.
Other side effects of radiation treatment may come from body parts close to where the radiation is targeted.
Nausea: Some people will experience feelings of nausea, and even episodes of vomiting while on radiation therapy. This is one of the more common side effects, and there are multiple medication options that can be trialled to prevent or reduce these symptoms.
Diarrhoea: It is possible to experience diarrhoea during the treatment period, with people experiencing both loose stools and increased frequency of stools. If it is particularly troubling, there are some medication options that can be considered to manage this.
Burning/frequent urination: It is possible to experience symptoms similar to a urinary tract infection. This can include burning pain when urinating and needing to frequently urinate small amounts. This is expected to resolve shortly after treatment and can be managed with medications.
Skin changes: Some people get red, itchy skin. This usually gets better 1-2 weeks after treatment. Doctors can offer advice and medications that help.
Hair loss: Some people lose their hair in the area treated. How much hair grows back depends on the radiation dose to the skin. If the skin is in or near a high dose area, the hair loss will last. Hair loss due to low dose radiation generally grows back.
Fertility Problems: This can occur due to radiation dose received by the other testicle. While this is expected to recover somewhat after the treatment, we recommend discussing with your oncologist regarding fertility options including sperm banking prior to any treatment.
Late Side Effects of Radiation Therapy for Testicular Cancer
Late side effects vary between people and can happen a few months to a few years after treatment.
These side effects may never occur, occur once, continue over time, or come and go.
Bowel changes: In some cases, changes to regular bowel habits can continue or emerge after the radiation has finished. This can present as either constipation or diarrhoea. In general, chronic bowel changes after radiotherapy for testicular cancer are rare.
Stomach Ulcers: While this is rare, exposure of the stomach to radiation can increase the risk of developing stomach ulcers in the future.
Kidney damage: Exposure of the kidneys to radiation can cause impaired kidney function in the future.
Hair loss: Permanent hair loss can occur in the area that has been treated.
Skin changes: Thinning and dryness of skin and changes in skin tone can happen after treatment. Blood vessels may be more noticeable.
Nerve/spinal cord injury: Irritation of the spinal cord or nerves within the pelvis causing an electric-like feeling can occur several months after treatment. This usually doesn’t need treatment and gets better in time. Long-term effects are rare.
Increased fracture risk: Exposure of radiation to the bones can increase the risk of fractures occurring in the future.
Fertility problems: While rare, sometimes fertility problems can persist long term after radiotherapy for testicular cancer.
Development of a second cancer: Cancers caused by radiation therapy are a very rare side effect. However, as testicular cancer usually effects young men and has an excellent survival rate, any increased risk of developing further cancers in the future should be considered carefully. This risk was much higher in the past, when higher doses of radiation were used over a larger area.
Other Useful Resources for Testicular Cancer
Find additional information about cancer types, research groups, and support groups.
Radiation Oncologist
The best person to talk to is a radiation oncologist. You can ask your doctor for a referral to find out if radiation treatment is right for you.
GPs and Health Professionals
Information for any health professional involved in a patient's cancer care with a particular focus on primary care providers.
Talking to Your Doctor
Your GP or other doctors in the cancer team can organise a referral to a radiation oncologist.
Treatment Centres
Search and find your closest Radiation Oncology Treatment Centre.
