Seminoma medical therapy treatment - stage II
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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 II seminoma. External beam radiation therapy is offered after surgery for stage IIA or IIB seminoma.[1] Chemotherapy is offered after surgery for stage IIC seminoma. It may also be offered after surgery for stage IIA or IIB seminoma, when there are enlarged lymph nodes spread over a large area of the abdomen.[1]
Medical Therapy
The treatment options for stage II seminoma include:[1]
Surgery
- Surgery is the mainstay of treatment for stage II 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.[1]
- Retroperitoneal lymph node dissection (RPLND) is surgery to remove the lymph nodes in the retroperitoneum. Lymph nodes are usually removed from the same side of the body where the tumor was removed. It may be done when any residual tumor is bigger than 3 cm in diameter. RPLND may also be done if a man can’t have radiation therapy or chemotherapy after surgery to remove the tumor.
- Surgery is followed by radiation therapy or chemotherapy.
Radiation Therapy
- External beam radiation therapy is offered after surgery for stage IIA or IIB seminoma.[1]
- Radiation is directed at the lymph nodes in the retroperitoneum and in the pelvis. Higher doses of radiation are given for stage II seminomas than for stage I seminomas.
- Radiation treatments are usually given once a day, 5 days a week, for 3–4 weeks.[1]
Chemotherapy
- Chemotherapy is offered after surgery for stage IIC seminoma. It may also be offered after surgery for stage IIA or IIB seminoma, when there are enlarged lymph nodes spread over a large area of the abdomen.[1]
- Chemotherapy may also be used if any residual cancer remains after radiation therapy.
- BEP is bleomycin (Blenoxane), etoposide (Vepesid, VP-16), and cisplatin (Platinol AQ). It is given intravenously for 5 days, every 3 weeks, for 2–3 months.[1]
- EP is etoposide and cisplatin. It is given when bleomycin can’t be used because of the risk of lung damage. EP is given intravenously for 5 days, every 3 weeks, for 3 months.[1]