Testicular cancer medical therapy
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2], Shanshan Cen, M.D. [3]
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Testicular cancer Microchapters |
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Treatment |
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Overview
The predominant therapy for testicular cancer is surgical resection. Adjunctive chemotherapy and radiation therapy may be required.
Medical Therapy
Seminoma Stage IA and IB
- Surveillance for pT1-T3 tumors or
- Single agent carboplatin for 1 or 2 cycles followed with chest X-ray and CT scan of the abdomen and pelvis or
- Radiation therapy
Stage IS
- Recheck the serum marker and the chest X-ray and Ct scan of abdominen and pelvis
Stage IIA
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.<ref>Testicular cancer.2015 Canadian Cancer Society.
- 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:
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- 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.
- 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-seminoma.
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