When we talk about treatments for testicular cancer, we talk about various modalities including surgery, radiation therapy and chemotherapy. We know that testicular cancer is highly responsive to all of these treatment modalities. In fact, the survival rate for testicular cancer is very high, exceeding 90% to 95% if patients follow the appropriate recommendations by their physicians and undergo their required therapies.
Now, radiation for testicular cancer is done in certain conditions. Not all types of testicular cancer are treatable with radiation, but when we speak about testicular cancer we talk about two broad categories. There are seminomas and there are what we call nonseminomatous germ cell tumors. The nonseminomas encompass a range of various types of cancers, but when we talk about radiation, radiation is most commonly used for the treatment of the seminoma type of testicular cancer.
Depending on the stage of your cancer, then we may or may not recommend radiation therapy following the removal of the testicle. In some cases, if you have cancer confined to the testicle with no evidence of cancer anywhere else, then we will offer patients several options if you have a seminoma. We will say, "You could choose to do surveillance," which means monitoring of the cancer to see if it recurs and only treat in the future if it recurs. The second option, even if you don't have evidence on a CT scan of disease in the abdominal area would be to undergo radiation to the abdominal area because there is a possibility there could be cancerous tissue in the lymph nodes that is microscopic and not detectable by CT imaging.
In those cases, then, undergoing radiation therapy reduces the risk of development of cancer down the road and reduces the risk of spread of cancer. Although in some cases it may be overkill because not everybody in that situation would have cancer in those lymph nodes. But in general we will counsel patients who have what we call stage one seminoma, which means cancer confined to the testicle with no evidence of the disease anywhere else. We will council them on the options of surveillance versus radiation therapy. It would then be the patient's decision to determine what they would want to do.