If testicular cancer returns

What to do if cancer comes back

First, let’s make it clear — a cancer “relapse” or “recurrence” (when cancer comes back) is pretty rare with testicular cancer. But testicular cancer recurrence can happen. The good news is that even if it comes back, it can still usually be cured and taken care of. The risk of the cancer coming back depends on its type and stage. Talk to your doctor about the risk of relapse when you’re first having treatment. It’s normal to wonder about this, and talking to an expert about it can really help put your mind at ease.

If the cancer does come back, it will most likely be within two years of finishing your treatment. Less than one in 20 relapses happen later than that. If you do relapse, it’s likely that you’ll need further treatment.

It's important to talk with your doctor about the possibility of the cancer returning. Understanding the risk of recurrence and the treatment options may help you feel more prepared if the cancer does return.

Regular follow-up exams to check for signs that the cancer may be returning are extremely important. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence). Generally, because the entire testicle is removed, it’s pretty rare that cancer will return locally.

Your blood test results are important too. Doctors can notice signs — like a rising beta-hCG or AFP in your blood — that may indicate that cancer has returned. If your cancer does return, make sure to work with a doctor who is an expert in recurrent testicular cancer.

How do you treat testicular cancer that has returned?

For recurrent testicular cancer, treatment usually includes chemotherapy and/or surgery.

If the cancer was Stage One and returns during active surveillance, then the most common treatment is chemo with three or four cycles of BEP or four cycles of EP depending on the stage of cancer. (If this reads like nonsense to you, check out our section on chemo.)

If the cancer is only in the retroperitoneal lymph nodes and is a pure seminoma, then radiation therapy is usually the way to go. But if it’s in the retroperitoneal lymph nodes but is NON-seminoma, then RPLND on its own may be enough. Find more information about RPLND here.

Can a new cancer develop after testicular cancer?

Yes, it's possible for a new, unrelated cancer to develop (like rectal cancer), after having had testicular cancer once. While this is not the same as testicular cancer recurrence — it can be just as tough to process.

Let's break it down further:

Testicular cancer that started in one testicle, was treated and came back — would be known as a recurrence or relapse.

Testicular cancer that starts in a second testicle, and is unrelated to the first cancer, would be considered a new, second cancer.

A cancer that starts in a new part of the body, like the kidney or bladder, would also be considered a second cancer.

To stay on top of your health, one of the best things you can do is keep in touch with your doctor and go to your check-ups.