Active surveillance
How long is active surveillance necessary?
If you had an orchiectomy and the cancer was completely removed along with your testicle, you may not need further treatment. Instead, your doctor may monitor you with regular blood tests (checking tumor markers), chest X-rays and CT scans for at least five years. This is called a surveillance policy, and it’s not as bad as it sounds.
Basically, surveillance is just about keeping on top of any cancerous cells that are remaining, while being ready in case the cancer has come back.
The number of check-ups and scans will depend on the type of testicular cancer you have and it’s important to stick to the surveillance policy outlined by your doctor. And hey, we know what it’s like – it can be easy to forget appointments or feel tempted to skip them entirely. But regular check-ins will help you stay on top of any cancer that may come back.
What's involved?
Even if you’re done with treatment, your doctors will still want to watch you closely.
So, it’s critical that you go to all of your follow-up appointments. During these visits, your doctors will give you a quick exam and ask about any problems you’re having.
They may also order lab tests or imaging tests(such as chest X-rays and CT scans) to look for signs of cancer or treatment side effects. Almost all cancer treatments can have side effects. Some may last for a few weeks to months, but others can last the rest of your life. This is the time for you to talk to your cancer care team about any changes or problems you notice and ask any questions you have.
Follow-up care is extremely important after treatment of testicular cancer because even if it comes back, it’s often still curable. This is why finding it early is so important.
Your health care team will explain what tests you need and how often they should be done. Generally, it comes down to the type of testicular cancer you had.
For non-seminoma cancer, usually follow-up testing involves blood tests. Doctors will be on the lookout for tumor markers – things with big names like alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH).
If you had seminoma cancer, these tumor markers are not as helpful. Instead, imaging tests (such as CT scans and X-rays) are used to spot a relapse as soon as possible.
Depending on the type of treatment, you may also need specific follow-up tests to keep track of any possible complications.
But don’t worry, as time goes by you won’t have to do these tests as frequently.
Make a special effort to keep all appointments with your cancer care team and follow their instructions carefully. Your main job at these check-ups is to report any new or recurring symptoms as soon as you notice them. Most of the time, if the cancer comes back, it does so in the first two years. Still, there is always an outside chance the cancer can come back later. There’s also a small chance that you will develop a new cancer in the other testicle. If you do notice any changes, you know what to do – tell your doctor straight away.
Seeing a new doctor
At some point after your cancer diagnosis and treatment, you may find yourself needing to see a new doctor. There’s a good chance this doctor won’t know your medical history, so you need to be able to give them all the details of your journey.
We recommend keeping track of all your details as you go along, so you don’t have to scramble for them later. Make sure you always have the following information handy:
A copy of your pathology report(s) from any biopsies or surgeries and your blood marker results
If you had surgery, a copy of your operative report(s)
If you stayed in the hospital, a copy of the discharge summary that doctors prepare when patients are sent home
If you had radiation therapy, a copy of the treatment summary
If you had chemotherapy or other medicines, 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 stored digitally on a DVD, etc.
