The first treatment is surgery to remove the testicle. After 6 to 8 weeks, tests will be done to find out if your cancer is low-risk or high-risk. Some men who choose surveillance will need more treatment. But any of the three choices will cure the cancer in about 99 out of 100 men with nonseminoma cancer.1
For men with low-risk (stage IA) nonseminoma, cancer comes back in about 20 to 30 out of 100 men.2 Most experts agree that surveillance is the preferred option for low-risk nonseminoma.
For men with high-risk (stage IB) nonseminoma, cancer comes back in about 50 out of 100 men.2 Experts disagree on the best treatment for high-risk nonseminoma. Many recommend chemotherapy, some recommend surveillance, and a few recommend lymph node surgery.
Surveillance means that you are
being watched closely by your doctor but are not having further
You have exams, chest X-rays, and blood tests regularly
during the first few years, as well as
CT scans. It can be hard to go to the doctor's office
that often. Unless your cancer comes back, the number of checkups and tests
will gradually decrease over the next 10 years.
With surveillance, you may be able to avoid the risks and
side effects of lymph node surgery or chemotherapy.
Even when cancer is
found after a period of surveillance, it is almost always possible to cure if it's
found early. Because of this, most experts consider surveillance the preferred option for men
with low-risk cancer.
often called "chemo," is the use of very strong drugs to kill cancer cells.
A short course of chemo has been designed for stage I nonseminoma cancer, especially for men who have high-risk cancer. Several medicines are used.
Lymph node surgery
The full name for this surgery is
retroperitoneal lymph node dissection (or RPLND). It is surgery to
remove lymph nodes in the lower back and pelvis. These lymph nodes may contain
During the early phases of the
cancer, it can be very hard to tell if these lymph nodes have cancer without
taking them out. In the past, doing this often caused infertility. Modern
nerve-sparing methods have greatly lowered the chances
Having this surgery isn't routine treatment for stage I nonseminoma. But if you and your doctor decide that this treatment is the best option for you, think about having it done at a hospital where many of these surgeries are done.