Testicular cancer medical therapy

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

Testicular cancer Microchapters
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Overview

The predominant therapy for testicular cancer is surgical resection. Adjunctive chemotherapy and radiation therapy may be required.

Medical Therapy

Radiation therapy

• Radiation therapy works best for seminomas. Non-seminomas do not respond well to radiation therapy.
• External beam radiation may be used for stage I and II seminomas after orchiectomy.
• Radiation treatments are usually given once a day, 5 days a week, for 2–4 weeks.

Chemotherapy

Standard-dose chemotherapy

• The most common chemotherapy combinations used to treat testicular cancer are:

• Bleomycin, etoposide, and cisplatin

• It is usually given IV every 3 weeks for 2–3 months, or 3 or 4 cycles. In some cases, 1 or 2 cycles may be given for stage I non-seminomas.

• Etoposide and cisplatin

• It is used when bleomycin affects the lungs or there is a high risk that it will cause lung damage. It is given IV every 3 weeks for 3 months, or 4 cycles.

• Etoposide, ifosfamide, and cisplatin

• It may be used when bleomycin affects the lungs or there is a high risk that it will cause lung damage. It is given IV every 3 weeks for 3 months, or 4 cycles.

• If testicular cancer does not respond to the above drugs or if it recurs, the following chemotherapy combinations may be used. These are sometimes called salvage, or second-line, chemotherapy.

• Paclitaxel, ifosfamide and cisplatin

• It is given IV every 3 weeks for 3 months, or 4 cycles.

• Etoposide, ifosfamide and cisplatin.

• It is given IV every 3 weeks for 3 months, or 4 cycles.

• Etoposide or vinblastine, ifosfamide and cisplatin

• It is given IV every 3 weeks for 3 months, or 4 cycles.

High-dose chemotherapy

• High-dose chemotherapy with carboplatin and etoposide may be used if testicular cancer recurs after it is treated with standard-dose chemotherapy.

Palliative chemotherapy

• Palliative therapy is given to relieve symptoms, rather than to treat the cancer itself. Gemcitabine may be given with oxaliplatin, paclitaxel or both as palliative treatment for seminomas or non-seminomas.

References

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