Seminoma medical therapy treatment - stage I

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

Surgery is the mainstay of treatment for stage I seminoma. Active surveillance is the preferred treatment option after surgery for stage I seminoma. External beam radiation therapy may be offered after surgery for stage I seminoma, if a man can’t complete the regular and frequent follow-up of active surveillance. Chemotherapy may be offered after surgery for stage I seminoma if a man can’t complete the regular and frequent follow-up of active surveillance.

Medical Therapy

The treatment options for stage I seminoma include:

• Surgery
• Active surveillance
• Radiotherapy
• Chemotherapy

Surgery

• Surgery is the mainstay of treatment for stage I seminoma.
• Radical inguinal orchiectomy is the preferred surgery. This surgery removes the testicle and spermatic cord through a small opening in the groin. It’s usually done as part of diagnosis.
• Surgery is followed by active surveillance, radiation therapy, or chemotherapy.

Active Surveillance

• Active surveillance is the preferred treatment option after surgery for stage I seminoma, because there is a low risk that the cancer will recur.
• It involves regular and frequent follow-up to look for signs and symptoms of recurrence. Tests done during a visit include a physical exam, blood tests to check serum tumor marker levels, and imaging tests.
• If the cancer recurs, it usually happens between 12 and 18 months after surgery. Treatment is given only if cancer recurs.

Radiation therapy

• External beam radiation therapy may be offered after surgery for stage I seminoma, if a man can’t complete the regular and frequent follow-up of active surveillance.
• Radiation is directed at the retroperitoneal lymph nodes. It is sometimes given to the lymph nodes in the pelvis as well.
• The radiation is usually given once a day, 5 days a week, for 2–4 weeks.
• Radiation therapy to the pelvis can cause long-term side effects, such as fertility problems and heart damage.

Chemotherapy

• Chemotherapy may be offered after surgery for stage I seminoma if a man can’t complete the regular and frequent follow-up of active surveillance.
• Most patients are given carboplatin. This drug often works as well as radiation therapy in men with stage I seminoma.
• Carboplatin is usually given intravenously. It is given one time for about 30 minutes. There is not enough research to show that repeating treatment with carboplatin is better than receiving it one time, but 2 cycles are sometimes used to reduce the risk of recurrence.

Advantages and Disadvantages

_{Advantages and disadvantages of different management options in the treatment of stage I seminoma.}