Testicular Cancer Treatment: What to Expect, and How Long It Takes to Recover

Testicular cancer is a rare cancer caused by an abnormal growth of cells in the testicles. Although it’s most common in males between the ages of 20 and 45, it can happen at any age. 

A diagnosis of cancer is always scary. But the good news is that testicular cancer is almost always curable when caught early. And there are effective treatment options available, so that even later-stage cancers can be cured.

What is testicular cancer?

Testicular cancer happens when the number of cells in the testicles increases to become a tumor. More than 90% of testicular cancers come from the cells that produce sperm. These are called germ cell tumors (GCT). According to the American Urological Association, GCTs can be divided into two types:

• Seminoma: It grows slowly and responds well to radiation and chemotherapy.

• Nonseminoma: It grows faster and may be more resistant to treatment.

There are also rare testicular tumors that don’t come from the cells that make sperm. Sertoli cell tumors come from the cells that help sperm grow. Leydig cell tumors develop from the cells that make testosterone.

How is testicular cancer diagnosed?

If you notice a lump or swelling in either testicle, that’s a sign you should visit your healthcare provider. There are several tests they may use to figure out if your symptoms are due to testicular cancer. These tests include:  

• Ultrasound: This will give a picture of the inside of the scrotum. It can tell the difference between a fluid-filled cyst, a solid tumor or a combination of the two.

• Blood tests: Testicular changes along with high levels of alpha feto-protein (AFP), human chorionic gonadotropin (HCG), or lactate dehydrogenase (LDH) may be a sign of testicular cancer.

• Surgery: This is the definitive way to look at a sample of tissue from the testicles to see if cancer is present. Rather than removing a small piece of testicular tissue to look for cancer cells (biopsy), a surgery to remove the whole testicle is often done if there are suspicions of cancer.

After confirming the diagnosis, your healthcare team will determine the stage of the testicular cancer. They do this by looking at four critical factors, or the TNM system:

• Tumor size (T)

• Involvement of any lymph nodes (N)

• Metastases or spread to other organs (M)

• Serum blood tests (S)

The testicular cancer stage is used to design the treatment plan and to give an idea of your outlook. It will range from stage 0 (least advanced) to stage 3 (most advanced). Earlier stages will predict a better outcome. This is usually marked by: 

• Smaller tumor size

• Few or no lymph nodes affected

• No metastases or spread to other areas of the body

• Low serum marker levels

Is testicular cancer curable?

Yes. Testicular cancer is one of the most curable types of cancer. For cancers that are caught in the early stages, the survival rate is 99%. Even people who have more advanced stages with spread to other organs have a survival rate of at least 75%.

The Testicular Cancer Foundation (TCF) suggests doing regular self-examinations. This will help you recognize any abnormal changes in your testicles early. An earlier diagnosis could mean shorter or less intensive treatment than diagnosis at a later stage. 

What treatment options are available for testicular cancer?

There are many different treatment options for testicular cancer. Your recommended treatment plan will depend on the type of tumor and the cancer stage.

Surgery

Surgery is the mainstay of treatment for testicular cancer. This usually involves removing the affected testicle and spermatic cord. In early stages, this may be the only treatment necessary. In more advanced stages, additional treatment may be needed. After surgery, your healthcare provider will likely have you return for regular checkups to make sure you remain cancer free.

Before surgery, you’ll want to have an open conversation about your plans for having children. If you’d like to keep the option to have children in the future, you may want to consider using a sperm bank to store your sperm.

Chemotherapy

Your healthcare provider may recommend chemotherapy depending on the type and stage of your testicular cancer. In more advanced cases with spread to other body parts, chemotherapy medications can help to kill or slow the growth of cancer. 

Many chemotherapy drugs have serious side effects. Your oncologist (cancer specialist) will use the medication that best treats your tumor with the fewest side effects.

Radiation therapy

Radiation therapy is sometimes used along with surgery or chemotherapy. It can help to kill cancer cells in the testicle and nearby tissues. This is useful only in the seminoma type of testicular cancer. The nonseminoma cancers are often resistant to radiation treatment. 

This may also be a treatment option if the cancer has spread. Radiation can help to shrink tumors that have spread to other organs.

Immunotherapy

Several studies are evaluating immunotherapy as a treatment option for testicular cancer. In this treatment, monoclonal antibody proteins are used to attack the cancer cells. In general, immunotherapy is for tumors that don’t respond to chemotherapy. The effectiveness of this treatment is unknown and research is ongoing.

How long is the recovery time for testicular cancer?

Treatment for testicular cancer typically includes surgery. Your recovery time after surgery will depend on several factors, such as:

• The extent of surgery

• Your overall health

• The stage of cancer at diagnosis

After surgery, most people are back to regular activities within a couple of weeks. The recovery time is shorter for laparoscopic surgery, since it’s less invasive. If lymph nodes have to be removed, especially from the abdomen, recovery can take much longer. Your oncologist can give you a better idea of what to expect based on your specific treatment plan.

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Written by:

Frank Schwalbe, MD

Frank Schwalbe, MD, is an assistant professor of anesthesiology at the Yale School of Medicine. He has practiced anesthesiology for 30 years.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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