About cancerTypes of cancerTesticular cancer

Treatment for testicular cancer

Page last updated: December 2025

The information on this webpage was adapted from Understanding Testicular Cancer - A guide for people with cancer, their families and friends (2025 edition). This webpage was last updated in December 2025.

Expert content reviewers:

This information was developed with help from a range of health professionals and people affected by thyroid cancer:

A/Prof Peter Grimison, Medical Oncologist, Chris O’Brien Lifehouse and Royal Prince Alfred Hospital, NSW
Marc Diocera, Genitourinary Nurse Consultant, Peter MacCallum Cancer Centre, VIC
A/Prof Peter Heathcote, Urologist, Brisbane Urology Clinic, QLD
Dr Michael Huo, Radiation Oncologist, Princess Alexandra Hospital, QLD
A/Prof Joseph McKendrick, Medical Oncologist, Epworth Eastern Hospital, VIC
Dr Tonia Mezzini, Sexual Health Physician, East Obstetrics and Gynaecology, SA
Dominic Oen, Clinical Psychologist, Bankstown Cancer Centre, NSW
Dr Benjamin Thomas, Urological Surgeon, The Royal Melbourne Hospital and The University of Melbourne, VIC
Paul Zawa, Consumer

Most people have an orchidectomy to remove the affected testicle, and this is usually done to confirm a diagnosis. If the cancer has not spread, this may be the only treatment needed.

After surgery, you will need regular check-ups and tests to monitor for any signs that the cancer has come back. This is called active surveillance.

If the cancer has spread, after an orchidectomy you may have chemotherapy or more surgery to remove lymph nodes in the abdomen (retroperitoneal lymph node dissection or RPLND), or radiation therapy.

Radiation therapy is not used very often to treat testicular cancer. It may be used instead of chemotherapy or surgery to treat cancer that has spread to lymph nodes in the abdomen.

Chemotherapy

Chemotherapy uses drugs to kill or slow the growth of cancer cells. Chemotherapy may be used at different stages of testicular cancer:

To reduce the risk of cancer coming back – If you have early testicular cancer that has not spread (stage 1), you may be offered chemotherapy after surgery. This is called adjuvant chemotherapy. Adjuvant chemotherapy usually consists of 1–2 cycles of chemotherapy, and is followed by 5–10 years of active surveillance.
To treat cancer that has spread – Chemotherapy may be recommended after surgery to destroy any cancer cells that have spread. This usually involves 3–4 cycles of chemotherapy. Your doctor will discuss the treatment plan with you. Depending on how you respond to the treatment, you may need more surgery or chemotherapy. You will then have active surveillance for 5–10 years.
Before surgery (neoadjuvant) – Rarely, when the cancer has spread to other parts of the body, chemotherapy may be given before surgery to help control the spread and reduce symptoms.

How chemotherapy is given

Chemotherapy is generally given through a drip inserted into a vein (intravenously) but some drugs may be given by injection into a muscle (intramuscularly).

Usually, you have chemotherapy during day visits to a hospital or treatment centre. For some types of chemotherapy, you may need to go to hospital several days in a row.

Side effects of chemotherapy

Everyone reacts differently to chemotherapy. Some people do not experience any side effects, while others have a few. Most side effects are temporary, and there are medicines that can help reduce your discomfort.

Talk to your doctor or nurse about any side effects you have and ways to manage them. Common side effects include fatigue, nausea, hair loss and tingling in the hands and feet. You may experience erection problems and bowel issues.

It is important to tell your treatment team if you have a cough that won’t go away, or are experiencing shortness of breath, as chemotherapy can affect the lungs. Chemotherapy can also affect your fertility.

About a week after a treatment session, your white blood cell levels may drop, making you more likely to get infections. If you feel unwell or have a temperature of 38°C or higher, call your treatment team or go to a nearby hospital emergency department.

Longer-term side effects of chemotherapy

Chemotherapy for testicular cancer can sometimes lead to other long-term side effects, including:

Heart and blood vessels problems – Chemotherapy can increase the risk of heart disease, stroke or blood circulation problems. Ask your doctor if you need regular heart checks after treatment.
Risks of other cancers – People who have chemotherapy for testicular cancer are at a slightly higher risk of developing leukaemia, which is a blood cancer. Having chemotherapy may also increase the risk of developing a new unrelated cancer.
Low testosterone levels – Having chemotherapy after surgery can increase the risk of developing low testosterone levels (hypogonadism). Low testosterone levels may cause symptoms such as tiredness, muscle loss and reduced sex drive. Testosterone levels will be checked as part of follow-up care, and some people may need testosterone replacement therapy.

Using contraception during treatment

You’ll probably be advised you to use barrier contraception (condom, female condom or dental dam) during chemotherapy and for a time after.

This protects your partner from any chemotherapy drugs that may still be in your body fluids.

You will also be advised to use contraception to prevent pregnancy, as chemotherapy drugs can damage sperm.

Surgery to remove lymph nodes

If testicular cancer spreads, it most commonly spreads to the lymph nodes at the back of the abdomen (retroperitoneum).

In some cases, an operation called retroperitoneal lymph node dissection (RPLND or lymphadenectomy) is done to remove these lymph nodes.

An RPLND is a long and complex operation, which should be performed by an experienced surgeon in a specialist centre. Sometimes, an RPLND is done instead of chemotherapy.

There are two ways to perform an RPLND:

open surgery – a surgeon makes a large cut from the breastbone to below the bellybutton. The surgeon then removes the lymph nodes and any remaining cancer from the back of the abdomen.
robotic surgery – this is a keyhole surgery where a surgeon inserts surgical instruments through several small cuts in the abdomen with help from a robotic system.

Side effects from RPLND

It can take many weeks to recover from an RPLND. At first, you will probably be very tired and may not be able to do as much as you’re used to. Other side effects include:

Pain – It is common to have pain and tenderness in the abdomen. Your doctor can prescribe pain medicines to make you more comfortable.
Ejaculation changes – RPLND can sometimes damage the nerves that help with ejaculation. This means semen might not come out of the penis during orgasm (called anejaculation or “dry orgasm”). It’s not harmful, but it can affect fertility. Some surgeons can use a special method called nerve-sparing surgery to try to protect these nerves, but it’s not always possible. If you may want to have children in the future, talk to your surgeon about storing sperm before the surgery.
Fluid build-up in abdomen (belly) – Called chylous ascites, lymphatic fluid can build up in the abdomen after an RPLND. You may feel bloated or your belly could feel swollen. Sometimes, the fluid will need to be drained. Your doctor will advise you.

Testicular cancer clinical trials

Cancer clinical trials are research studies that test whether a new approach to prevention, screening, diagnosis, or treatment works better than current methods and is safe.

There are clinical trials for testicular cancer open to recruitment in Victoria. This list shows the most recently updated testicular cancer studies on the Victorian Cancer Trials Link (VCTL).

Visit the VCTL to find more testicular cancer clinical trials.

Follow-up appointments

After your treatment ends, you will have regular appointments to monitor your health, manage any long-term side effects and check that the cancer hasn’t come back.

Active surveillance for testicular cancer usually continues for 5–10 years. During the check-ups, you will usually have a physical examination and you may have blood tests to monitor tumour markers, x-rays or scans.

It is important to go to your follow-up appointments, as tests can find any return of the cancer early, when it is easier to treat.

Regularly looking at and feeling your remaining testicle to know what’s normal can also help find cancer in that testicle early.

If you develop any symptoms or health problems between follow-up appointments, let your doctor know immediately.

Will testicular cancer come back?

Treatment for testicular cancer usually has a good outcome and most people will be cured, even if the cancer has spread. Only about 2–5% of people who have had cancer in one testicle get cancer in the other testicle.

Sometimes testicular cancer does come back after treatment. This is why active surveillance is important.

Treatment will depend on where it has spread to and what type of testicular cancer it is. People with cancer that comes back may have surgery, chemotherapy, radiation therapy or a combination of treatments.