Non-seminomatous germ cell tumours
40–45% of patients with testicular cancer are diagnosed with non-seminoma. Of these, 55–60% will only have disease in the testicle, while 40–45% will have metastatic disease to lymph nodes, the lungs or other organs. Even with metastatic disease, most patients are cured.
Patients with metastatic non-seminoma are treated with a minimum of three courses of chemotherapy. Some patients need more intense treatment with additional drugs, or high-dose chemotherapy.
If there are visible tumour lesions remaining after chemotherapy, most patients will need surgery. The most common sites for this kind of surgery are the abdomen and the lungs.
Seminomatous germ cell tumours
55–60% of patients with testicular cancer are diagnosed with seminoma. Of these, 85% will only have disease in the testicle (CS1), while 15% will have metastatic disease to lymph nodes, the lungs or other organs. Even with metastatic disease, most patients are cured.
Earlier, patients with seminoma often received adjuvant radiotherapy, or radiotherapy as treatment for metastatic disease. As radiotherapy may increase the risk of secondary cancer, it is today less frequently used. Patients without metastasis are often managed by surveillance, or receive adjuvant carboplatin.
Patients with low-volume metastatic disease may be treated with surgery, while other patients with metastatic disease are treated with chemotherapy. Surgery is rarely used after chemotherapy.