Testicular Cancer FAQs
The multidisciplinary Testicular Cancer Program in Seattle, Washington, is a group of highly specialized providers within the Cancer Institute at Virginia Mason dedicated to treating patients with testicular cancer. Read some of our frequently asked questions (FAQs). If you have questions of your own, feel free to call (206) 341-1420.
- Could my testicle have to be removed?
- Can't the surgeon just cut out the cancer and leave the testicle?
- What are all the treatment options for testicular cancer?
- How is Virginia Mason’s approach to testicular cancer treatment different from other medical centers?
- Where does testicular cancer spread?
- Will I need chemo?
- Will I still be able to have sex?
- Will I still be able to father children?
- Will my testosterone level be affected?
- Will the cancer come back?
- If I have to have my testicle removed, is it possible to get an implant/prosthetic?
1. Could my testicle have to be removed?
In most cases, the testicle with the cancer is removed, which is necessary for accurate diagnosis and to remove the primary tumor. Before removal of the testicle, blood and ultrasound tests are performed to understand the exact nature of the mass. Note that removing one testicle does not usually affect sexual function and, in most cases, also does not cause infertility.
2. Can't the surgeon just cut out the cancer and leave the testicle?
This may seem logical, but even if the surgeon got all of the cancer, leaving part of the testicle intact is risky because precancerous cells could too easily be lurking and could turn cancerous again.
3. What are all the treatment options for testicular cancer?
Fortunately, cure rates of testicular cancer are among the highest for all cancers — more than 95 percent of all testicular cancer patients are ultimately cured of their illness. Options for treatment depend on whether and where the disease has spread at the time of treatment. Stage 1 patients are almost always treated by removing the testicle through a surgical procedure (called an inguinal orchiectomy) in which an incision is made near the groin. The surgery is not done through the scrotum. Early-stage patients with cancer only in the testicle have options, including:
- Close observation over time
- Brief treatments with chemotherapy
- Abdominal surgery if lymph nodes are found to be cancerous
Radiation is rarely used these days. Almost all patients with far advanced disease require chemotherapy treatment for two to three months; this is true with or without the surgery to remove lymph nodes in the abdomen. Learn more about diagnosis and treatment for testicular cancer.
4. How is Virginia Mason's approach to testicular cancer treatment different from other medical centers?
Testicular cancer is an uncommon disease, and few institutions see more than one or two patients a year. World-wide guidelines are now recommending that the management of testicular cancer be performed at or in collaboration with high-volume medical centers like Virginia Mason. In the U.S., there are only a handful of centers that see a high number of patients, have teams of surgeons, pathologists and medical oncologists with extensive focus on testicular cancer, and have the experience to customize treatment to the needs of each patient.
Led by Christopher Porter, MD and Semra Olgac, MD, our multi-disciplinary team sees more patients than all but one center west of the Mississippi. Dr. Porter is a world leader in the clinical care and research of testicular cancer, and publishes on their experience and research on a regular basis. Many of the current national and international guidelines for testicular cancer originate from the work at Virginia Mason.
5. Where does testicular cancer spread?
The spread of testicular cancer is usually predictable. About 75 percent of the time, there is no evidence of spread beyond the testicle at the time of diagnosis. After the initial development of cancer in the testicle, the next most likely area of spread is to the lymph nodes in the back of the abdomen. After the testicular cancer spreads to this area, further spread is most often to the lungs. Fortunately, very rarely do we see patients whose testicular cancer has spread to the brain, liver or bones, but even these patients with far advanced disease have a reasonable chance of cure with aggressive treatments.
6. Will I need chemo?
The need for chemotherapy depends very much of the extent of the disease at the time of treatment. Patients with advanced disease almost always require chemotherapy to be cured. Early-stage disease — with the cancer in the testicle only — rarely requires chemotherapy.
8. Will I still be able to father children?
Given the high cure rate for those with testicular cancer, yes, you will most likely be able to have biological children. Even with one testicle removed, most men produce plenty of healthy sperm from the other testicle. Some men who develop testicular cancer are genetically likely to have fertility issues, however. The fertility medicine clinic at Virginia Mason assists our patients who seek fertility testing.
9. Will my testosterone level be affected?
Cancer in both testicles is very rare, and the remaining testicle typically still produces enough of the main male hormone, testosterone. However, some testicular cancer patients have low testosterone levels to begin with. If testosterone is found to be low, it can be easily replaced through shots, pills or patches that will be needed for life. Testosterone replacement therapy has been around for many years and has proven safe and effective.
11. If I have to have my testicle removed, is it possible to get an implant/prosthetic?
There are medical supply companies that manufacture nearly natural implants that can help preserve your symmetry. With a high-quality prosthetic, only you will know that you have the implant. Our testicular cancer surgeon is experienced in placing these prosthetics and it can be done sometimes during the same surgery to remove the cancerous tumor. We offer resources to help our patients make the decision about implants, as they're not for everyone.