Moving on after treatment for testicular cancer

For most men with testicular cancer, treatment removes or destroys the cancer. While it can feel good to be done with treatment, it can also be stressful. You may find that you now worry about the cancer coming back. This is a very common concern among those who have had cancer. (When cancer comes back, it is called a recurrence.)

It may take a while before your recovery begins to feel real and your fears are somewhat relieved. You can learn more about what to look for and how to learn to live with the chance of cancer coming back in Living With Uncertainty: The Fear of Cancer Recurrence.

For a few people, the cancer may never go away completely. These people may get regular treatments with chemo, radiation, or other treatments to try to help keep the cancer in check. Learning to live with cancer that does not go away can be hard and very stressful. Our document, When Cancer Doesn't Go Away, talks more about this.

Follow-up care

When treatment ends, your doctors will still want to watch you closely. There is still a good chance for cure even if the tumor comes back, so finding it early is important.

Your doctor will explain what tests you need and how often they should be done. You will need blood tests to measure levels of certain protein markers to see if the cancer has come back. You will also need x-rays, CT scans, and other tests to see whether the cancer has come back, has spread, or whether there is a new tumor. After a few years these visits and tests will not have to be done as often.

Most of the time, if the cancer comes back, it does so in the first 5 years. Still, there is always an outside chance the cancer can come back later. Also, there is about a 3% chance that men who have had cancer in one testicle will develop a cancer in the other. Usually this is a new cancer and is not spread (metastasis) from the first tumor. Should your cancer come back, the American Cancer Society document called When Your Cancer Comes Back: Cancer Recurrence can help you learn how to cope with this phase of your treatment. You can get a copy by calling 1-800-227-2345.

Most men get cancer in only one testicle. The other testicle usually can make enough testosterone (the male hormone) to keep the man healthy. If the other testicle needs to be removed because a new cancer develops, that man will need to take some form of testosterone the rest of his life. Most often this is in the form of a gel or patch that is applied to the skin or a monthly shot (given in a doctor’s office). If you need to take testosterone, talk to your doctor about what form is best for you.

Testicular cancer or its treatment can make a man infertile. Before treatment starts, men who wish to father children may want to think about storing sperm in a sperm bank for later use. But the disease can cause low sperm counts, which may make it hard to get a good sample. In some cases, if one testicle is left, fertility returns (for a short time or for good) after the cancer has been treated.

Even when sperm counts in semen are very low, men have options for fathering children. One of these options is in vitro fertilization. An egg cell that has been removed from your partner's ovary is fertilized by your sperm cells in a lab and then returned to her uterus. Be sure to discuss any fertility concerns with your doctor before your treatment begins.

Almost any cancer treatment has side effects. Some may last for a few weeks to several months, but others can be permanent. Be sure to tell your cancer care team about any symptoms or side effects that bother you so they can help you manage them. It is also important to keep health insurance. While you hope your cancer won't come back, it could happen. If it does, you don't want to have to worry about paying for treatment.

Should your cancer come back, our document called When Your Cancer Comes Back: Cancer Recurrence can give you information on how to manage and cope with this phase of your treatment.

Seeing a new doctor

At some point after your cancer is found and treated, you may find yourself in the office of a new doctor. It is important that you be able to give your new doctor the exact details of your diagnosis and treatment. Make sure you have this information handy and always keep copies for yourself:

• A copy of your pathology report from any biopsy or surgery
• If you had surgery, a copy of your operative report
• If you were in the hospital, a copy of the discharge summary that the doctor wrote when you were sent home from the hospital
• If you had radiation treatment, a copy of the treatment summary
• If you had chemo or targeted therapies, a list of your drugs, drug doses, and when you took them
• Copies of your CT scans (or other imaging tests) – these can often be placed on a DVD

The doctor may want copies of this information for his records, but always keep copies for yourself.