When is radiotherapy recommended for testicular cancer?

Testicular cancer is not one single disease. Seminoma and non-seminoma tumours respond differently to treatment, so radiotherapy is not a routine choice for every person. When it is appropriate, treatment may focus on lymph nodes in the back of the abdomen or another defined area shown on scans. Doctors weigh this against surveillance, surgery or drug treatment, taking account of tumour markers, imaging, prior treatment and future health concerns. Treatment planning also considers the kidneys, bowel, spinal cord and the remaining testicle. A discussion about fertility and sperm storage should happen before treatment that could affect reproductive function.

Ask which tumour type is present, what the pathology and tumour-marker results show, and whether scans identify lymph-node involvement. Ask why radiotherapy is preferred over monitoring, surgery or medicines in your situation. Before treatment, discuss sperm banking, fertility, hormone function and protection of nearby organs. Bring a list of medicines and previous treatments. Keep scheduled examinations and scans, because follow-up checks the remaining testicle, lymph nodes, tumour markers and possible treatment effects.

Seek prompt assessment for a new testicular lump, persistent enlargement, heaviness, or pain that does not settle. Seek urgent help for sudden severe testicular pain, rapid swelling, fainting, vomiting with severe pain, or inability to pass urine. These symptoms need examination; a testicular symptom does not by itself establish cancer or indicate that radiotherapy is needed.

Is my tumour seminoma or non-seminoma, and how does that affect radiotherapy? What do my markers and scans show about lymph nodes? What are the alternatives and their effects on fertility, hormones, bowel, kidneys and the remaining testicle? Should I arrange sperm storage before treatment?