Testicular Cancer

This section provides information on how testicular cancer is treated in the Belfast Health and Social Care Trust.

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Types of Testicular Cancer

There are two main types of testicular cancer:

  • Seminoma: These usually occur in men between 25 and 55 years of age.
  • Non-seminomatous germ cell tumours (NSGCTs): These tumours used to be called teratomas. This group of tumours usually affects younger men – from about 15 to 35 years old. It includes different types of tumours such as teratoma and embryonal tumours. Many are a mixture of these types and other tumours, including seminoma.

Rare types of testicular cancer include:

  • Non-Hodgkin lymphoma
  • Leydig Cell
  • Sertoli cell tumours

Sometimes cancer cells from the testicle can spread to nearby lymph nodes (also known as glands). Doctors will discuss this with patients diagnosed with testicular cancer, so it can be helpful to understand a bit more about it. Cancer cells can be picked up by the lymph fluid and carried to lymph nodes in other parts of the body. Lymph vessels in the testicles carry fluid to a collection of lymph nodes at the back of the stomach (abdomen).


Investigations and Diagnosis

 
As part of the pathway for diagnosis and management of testicular cancer, patients may be sent for a number of investigations in Belfast City Hospital.

Blood tests: Some testicular cancers produce chemicals, which are released into the bloodstream. The two main chemicals, called tumour markers, are alpha-fetoprotein (AFP) and beta human chorionic gonadotrophin (BHCG). If they are present in the blood, they can be used to measure the effect of treatment on the cancer or detect recurrence of the cancer.


Types of Treatment

Surgery:

For most patients with testicular cancer, surgery may be the most appropriate treatment.

  • Orchidectomy: The standard treatment for localised disease is an orchidectomy (surgical removal of the testicle), which usually takes place within a few weeks of diagnosis. The procedure is via an incision (cut) in the groin and not through the scrotal sac. An artificial testicle (prosthesis) can be inserted into the scrotum to restore a normal appearance. The removed testicle is sent to the laboratory and examined further to find out which type of testicular cancer it is. Patients can usually go home the same or next day. 
  • Lymph Node Dissection: If the cancer has spread to the lymph nodes then patients may have a lymph node dissection at a later date.

Urology cancer surgery for Northern Ireland is provided at Belfast City Hospital by specialist uro-oncology surgeons.

Patients are informed of the approximate date of surgery or waiting time by their surgeon. When they come to the hospital for surgery they will be admitted to Level 3 of the Belfast City Hospital Tower; this is a urology specialist ward. Staff on the ward will be on hand to answer any questions and they can refer patients to a urology clinical nurse specialist if required.

Chemotherapy

There are two main types of chemotherapy used to treat testicular cancer:

  • BEP Chemotherapy- patients receive this treatment as an inpatient in the Cancer Centre
  • Carboplatin Chemotherapy- patients receive this as an outpatient in the Bridgewater Suite of the Belfast City Hospital.

For general information on chemotherapy in the Belfast Health and Social Care Trust, please follow this link.

Radiotherapy

Patients diagnosed with testicular cancer may sometimes receive radiotherapy. For general information on radiotherapy in the Belfast Health and Social Care Trust, please follow this link.


Follow Up

After treatment is completed, patients will have regular check-ups with blood tests, scans and x-rays. The frequency of these review appointments will differ for each patient. These appointments allow the team to assess patient progress following treatment. The check-ups are also a good opportunity to discuss any problems or worries patients may have with their doctor.

Follow up appointments will take place in the Teratoma Clinic in Bridgewater Suite, Belfast City Hospital Tower.
If patients notice any new symptoms, or have any worries, they should contact the Teratoma Clinic, to discuss the symptoms as they may need additional treatment or rehabilitation services such as a dietician or physiotherapy services.

It is vital that patients who have been diagnosed with testicular cancer attend regular follow up appointments.

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