Radiotherapy for testicular cancer

What is radiotherapy?

Radiotherapy uses high-energy rays to destroy cancer cells, while doing as little harm as possible to normal cells nearby. It is sometimes used to treat testicular cancer. You may have radiotherapy to treat a seminoma and, more rarely, a non-seminoma.

If you have a stage 2 seminoma, you may have radiotherapy either:

instead of chemotherapy
or with chemotherapy.

Radiotherapy for stage 2 seminomas is given to reduce the small risk of the cancer returning in the lymph nodes at the back of the abdomen.

Having radiotherapy for testicular cancer

You normally have radiotherapy treatment in the hospital radiotherapy outpatient department as a series of short daily sessions. The treatments are usually given from Monday to Friday, with a rest at the weekend.

Each treatment takes 10 to 15 minutes. Your doctor will discuss the treatment and possible side effects with you. A course of radiotherapy for seminoma may last 2 to 3 weeks.

At the beginning of each session of radiotherapy, the radiographer will position you carefully on the couch and make sure you are comfortable.

During your treatment you will be alone in the room, but you can talk to the radiographer who will watch you from the next room. Radiotherapy is not painful, but you will have to lie still for a few minutes during the treatment.

Radiotherapy does not make you radioactive. It is safe for you to be with other people, including children, throughout your treatment.

Support from Macmillan

Macmillan is here to support you. If you would like to talk, you can:

Call the Macmillan Support Line on 0808 808 00 00.
Chat to our specialists online.
Visit our testicular cancer forum to talk with people who have been affected by testicular cancer, share your experience, and ask an expert your questions.

Planning your radiotherapy

Radiotherapy has to be carefully planned to make sure it’s as effective as possible. It’s planned by a cancer specialist (clinical oncologist) and it may take a few visits.

On your first visit to the radiotherapy department, you’ll be asked to have a CT scan or lie under a machine called a simulator, which takes x-rays of the area to be treated.

You may need some small marks made on your skin to help the radiographer (who gives you your treatment) position you accurately and to show where the rays will be aimed at. These marks need to be able to be seen throughout your treatment, so permanent marks (like tiny tattoos) are usually used. These are extremely small, and will only be done with your permission. It may be a little uncomfortable while they are done.

Side effects

Radiotherapy to your tummy (abdomen) can cause side effects. But these can usually be controlled with medicines. Your doctor or specialist nurse will tell you more about what to expect. These side effects usually disappear gradually once your course of treatment has finished.

It is important to let your doctor know if you are having any problems with side effects. Most side effects are mild, and you can have medicines to treat them successfully.

Skin changes

The skin in the treated area may become red (if you have white skin) or darker (if you have black or brown skin). But this will improve after your treatment finishes. You will get advice on looking after your skin. Your specialist can prescribe cream if your skin is sore or uncomfortable.

Feeling sick nausea

Radiotherapy to the tummy area may make you feel sick. Your doctor will prescribe anti-sickness medicine to prevent or stop this. They will probably advise you to take these medicines regularly during treatment. Let your doctor know if the tablets are not working for you. There are other medicines they can prescribe.

Tiredness

Radiotherapy often makes people feel tired, especially towards the end of treatment. Try to pace yourself, and avoid doing anything that you do not really need to do. Gentle exercise, such as short walks, can help to improve tiredness. It is good to balance this with plenty of rest.

Sometimes, tiredness can last up to 8 weeks or longer after treatment finishes. Your energy levels will then slowly improve.

Diarrhoea

You might get some diarrhoea, but you can usually control this with medicines your doctor can prescribe. Let your doctor know if this is a problem. Make sure you drink plenty of fluids. Try to eat fewer high-fibre foods, such as fruit, vegetables, beans, pulses and wholewheat cereals.

Effects on fertility

Radiotherapy to the lymph nodes in the tummy will not affect your ability to have sex. It does not usually cause infertility. But your specialist may advise you to think about storing sperm before treatment starts.

Preventing pregnancy

During radiotherapy, a small dose of radiation reaches the remaining testicle. This may temporarily affect your sperm. So you will be advised to use effective contraception during treatment.

There is no evidence that radiotherapy has any effect on children you have after treatment. But you are usually advised to use contraception for 6 to 12 months after treatment. This allows time for your sperm to recover from any damage that treatment may have caused.

About our information

References

Below is a sample of the sources used in our testicular cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

European Association of Urology. Guidelines on Cancer. 2016. Available from: www.baus.org.uk/_userfiles/pages/files/professionals/sections/oncology/EAU2015-Testicular-Cancer.pdf (accessed August 2018)

European Society for Medical Oncology, eUpdate. Testicular Seminoma and Non-Seminoma Treatment Recommendations. June 2017. Available from: www.esmo.org/Guidelines/Genitourinary-Cancers/Testicular-Seminoma-and-Non-Seminoma/eUpdate-Treatment-Recommendation (accessed August 2018).

Scottish Intercollegiate Guidelines Network, Management of adult testicular germ cell tumours. Available from: www.sign.ac.uk/sign-124-management-of-adult-testicular-germ-cell-tumours.html (accessed August 2018).

UpToDate. Clinical manifestations, diagnosis, and staging of testicular germ cell tumors. January 2018. Available from: www.uptodate.com/contents/clinical-manifestations-diagnosis-and-staging-of-testicular-germ-cell-tumors (accessed August 2018).

Reviewers

This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Jim Barber, Consultant Clinical Oncologist.

Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

Content under review

Due to the pandemic, there have been delays in us updating this information as quickly as we would have wanted. Our team is working hard to put this right.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We try to make sure our information is as clear as possible. We use plain English, avoid jargon, explain any medical words, use illustrations to explain text, and make sure important points are highlighted clearly.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected. Our aims are for our information to be as clear and relevant as possible for everyone.

You can read more about how we produce our information here.