Radiation therapy for testicular cancer

Radiation therapy uses a beam of high-energy rays (such as gamma rays or x-rays) or particles (such as electrons, protons, or neutrons) to destroy cancer cells or slow their rate of growth. In treating testicular cancer, radiation is used mainly to kill cancer cells that have spread to lymph nodes.

Radiation therapy delivered from a machine outside the body is known as external beam radiation. The treatment is much like getting an x-ray, but the radiation is more intense. The procedure itself is painless. Before your treatments start, the medical team will take careful measurements to determine the correct angles for aiming the radiation beams and the proper dose of radiation. Each treatment lasts only a few minutes, but the setup time – getting you into place for treatment – usually takes longer.

In general, radiation therapy is mainly used for patients with seminoma, which is very sensitive to radiation. It does not seem to work well for non-seminomas. Sometimes it’s used after orchiectomy (the operation to remove the testicle) and is directed at the lymph nodes at the back of the abdomen (the retroperitoneal lymph nodes). This is to kill any tiny bits of cancer in those lymph nodes that can’t be seen. It can also be used to treat small amounts of seminoma that have spread to the nodes (based on changes seen on CT and PET scans).

Possible side effects

Radiation therapy can affect nearby healthy tissue along with the cancer cells. To reduce the risk of side effects, doctors carefully figure out the exact dose you need and aim the beam as accurately as they can to hit the target. Generally, treatment of testicular cancer uses lower radiation doses than those needed for other types of cancer.

Common side effects can include fatigue, nausea, or diarrhea. Some men have a skin reaction that is like a sunburn, but it’s uncommon. This slowly fades away. If radiation reaches the healthy testicle it can affect fertility (sperm counts), so a special protective device is placed over the remaining testicle to help protect it.

Radiation can also have some long-term effects, such as damage to blood vessels or other organs near the treated lymph nodes and an increased risk of getting a second cancer (outside of the testicle) later in life. These risks were higher in the past when higher doses were used and more tissue was exposed to radiation.