Can I Get Another Cancer After Having Testicular Cancer?

Cancer survivors can be affected by a number of health problems, but often their greatest concern is facing cancer again. If a cancer comes back after treatment it is called a “recurrence.” But some cancer survivors may develop a new, unrelated cancer later. This is called a “second cancer.” No matter what type of cancer you have had, it is still possible to get another (new) cancer, even after surviving the first.

Unfortunately, being treated for cancer doesn’t mean you can’t get another cancer. People who have had cancer can still get the same types of cancers that other people get. In fact, certain types of cancer and cancer treatments can be linked to a higher risk of certain second cancers.

Survivors of testicular cancer can get any second cancer, but they have an increased risk of:

The most common cancer seen in testicular cancer survivors is a second testicular cancer. Overall, 2% to 5% of men who have had cancer in 1 testicle will eventually have it in the other testicle. The second cancer is not from treating the first cancer with radiation or chemotherapy. In fact, those treated with surgery alone still have an increased risk of a second testicular cancer. The chance of getting a second testicular cancer is actually lower in men who were treated with chemotherapy.

Compared with most men in the general population, testicular cancer survivors are up to twice as likely to develop a new cancer outside the testicle. The chance of a second cancer changes over time and depends on which treatments were used and how old the patient was when he was treated.

Treatment with radiation is linked to some cancers after testicular cancer. The risk is highest for cancers in the area that received radiation (the radiation field). Patients treated with radiation to the abdomen and pelvis have increased risks of:

If the radiation field includes the chest, the patient has an increased risk of:

Radiation treatments also increase the risk of melanoma skin cancer and connective tissue cancer (sarcoma).

The risks of these cancers starts going up within 5 years and doubles after 10 years in those men who were treated with radiation alone. This risk remains high and doesn’t seem to go down with time. The risks are generally greater with higher radiation doses or if the patient got both chemotherapy and radiation.

In recent years, radiation therapy for testicular cancer has changed. Lower doses of radiation are used, and preventive radiation treatment to the chest has been stopped. Long-term follow-up studies are needed to see if these changes have lowered the cancer risks.

Chemotherapy is also linked to an increased risk of cancers, which is slightly less than what is seen after radiation.

The increased risk of leukemia and myelodysplastic syndrome (MDS) after treatment for testicular cancer is linked to treatment with chemotherapy. Use of the chemotherapy drug cisplatin is linked most often to leukemia and MDS, although high doses of etoposide (VP-16, Etopophos®, or Vepesid®) are sometimes also a factor (doses higher than what are normally used today). Radiation given with chemotherapy seems to increase risk even more. Leukemia and MDS are both uncommon cancers normally, so even though the risk of these cancers is higher than average, very few patients develop them from their treatment.

Follow-up after treatment

After completing treatment for testicular cancer, you should still see your doctor regularly. You may have tests for a number of years to look for signs the cancer has come back or spread. Experts don’t recommend any other testing to look for second cancers in people without symptoms. Let your doctor know about any new symptoms or problems, because they could be caused by the cancer coming back or by a new disease or second cancer.

Survivors can perform regular testicular self-exams to look for cancer in the remaining testicle.

All patients should follow the American Cancer Society guidelines for the early detection of cancer, such as those for colorectal cancer.

The Children’s Oncology Group has guidelines for the follow-up of patients treated for cancer as a child, teen, or young adult, including screening for second cancers. These can be found at www.survivorshipguidelines.org.

All survivors of testicular cancer should avoid tobacco smoke, as smoking increases the risk of many cancers.

To help maintain good health, survivors should also:

These steps may also lower the risk of some cancers.

See Second Cancers in Adults for more information about causes of second cancers.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: January 20, 2015 Last Revised: February 12, 2016

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