Oncologists are doctors who have spent years training in the diagnosis and treatment of cancer. They’re going to be an important part of your team and will probably lead your care plan from here on out. Consider them your main testicular cancer doctor. They’ll work with a wide range of other health professionals to figure out what’s best for you. There are three types of oncologists:Medical oncologistA medical oncologist treats cancer using chemotherapy or other medications, such as hormone therapy and immunotherapy. You’ll likely meet with a medical oncologist your first testicular cancer appointment.Surgical oncologistAs the name suggests, these oncologists are expert surgeons who will remove the tumor or cancerous tissue in an operation. If you need a tissue sample taken (i.e. a biopsy) these are the people who’ll do that for you.Radiation oncologistThese are the people behind the X-ray machine. They use radiation (or radiotherapy) to injure or destroy cancer cells so they can’t multiply.
Before seeing the oncologist you may need to have a few tests done, so they have information to work from. These include: Blood testThis will be to check for what are called tumor markers. They’re proteins with complicated names like alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG) and lactate dehydrogenase (LDH). Basically, they’ll help the doctors learn more about what’s going on inside your body.CT (computerized tomography) scanCT scans use X-rays to take big 3D snapshots of your body. Chest X-raySometimes you might need a chest X-ray. It might seem like it’s too far away from your nuts to be useful, but it’s used to determine the stage of cancer and is helpful for follow-up screenings. MRI (Magnetic resonance imaging)This scan uses strong magnetic fields and radio waves to produce detailed images of the inside of the body.MRIs are all bark and no bite — it’ll sound noisy but is totally painless. You will be placed on a bed that travels into a tunnel shaped magnet and usually you’ll just lie there for around half an hour as the scan is completed. Phew! That may sound like a lot of poking and prodding, but these tests are so important for your oncologists to get all the information they need.Sometimes a PET scan may also be used, you can learn about that here. And if you’re looking for more information on the other tests you might experience, we have that covered too.
Your oncologist will have the results from your biopsy and any other tests you've had. There might be a lot of medical terms thrown at you but stay calm and ask as many questions as you’d like. They'll talk to you about the type and stage of your cancer. This will impact the treatment you’ll need and they’ll discuss that too. Tumors come in different shapes and sizes, depending on the types of cells and the genetic structure that make up the cancer. Meanwhile, the stage is determined by the spread of cancer outside the testicle (if at all). Hear from Medical Oncologist Dr. Ben Tran:
Stage 1Cancer is found only in the testicle.Stage 2Cancer has spread to the lymph nodes in the abdomen or pelvis.Stage 3Cancer has spread beyond the lymph nodes to other areas of the body, such as the lungs, liver or brain.What are lymph nodes? Lymph nodes are small, bean-shaped glands found throughout the body. They are part of the lymphatic system, which is basically a big network of tubes that links your bloodstream and the rest of your body. The lymphatic system carries fluid, nutrients, and waste between the two. Cancer cells can sneak into the lymphatic system from an organ and then take up home in lymph nodes.
There are two main types of testicular cancer:
Both develop from germ cells in your nuts. The treatments are quite similar for both, so the exact type won’t make much difference to you.
Meeting the oncologist can sometimes leave your head spinning. But don’t worry, simply ask as many questions as you’d like. Don’t worry about sound stupid or being embarrassed, they’ve heard it all a thousand times before.
Can the treatment cure my cancer?
What kind of testicular cancer do I have?
Has my cancer spread beyond the testicle?
What is the stage of my cancer? What does this mean for me?
Will I need other tests before we can decide on treatment?
Will I need to see other doctors?
How much experience do you have treating this type of cancer?
What are my treatment choices? What do you recommend? Why?
Do I need a retroperitoneal lymph node dissection? If so, how many have you done?
What should I do to be ready for treatment?
How long will treatment last? What will it be like? Where will it be done?
What risks or possible side effects can I expect from my treatment?
How long will it take me to recover from treatment?
How soon after treatment can I have sex? Or masturbate?
What are the chances I will become infertile? Should I bank sperm?
What are the chances that my cancer will come back? What will we do if that happens?
Does one type of treatment reduce the risk of recurrence (cancer coming back) more than another?
Should I get a second opinion before I start treatment, and when would a second opinion be helpful to me?
What type of follow-up will I need after treatment?
Based on the stage of the cancer and the type of tumor, your oncologist will put together a game plan. Options may include:
Depending on what treatment you've already had, such as surgery (an orchiectomy) your doctor may also talk to you about active surveillance. Whatever the best course of action for you is, remember that you’re in good hands. Follow any of the links above to learn more about the next step in your journey.