Retroperitoneal Lymph Node Dissection - surgical removal of lymph nodes behind the peritoneum where testicular cancer spreads first. Used for residual masses after chemotherapy or primary staging in Stage II disease.

URO-ONCOLOGY · YOUNG MEN'S CANCER

Testicular Cancer Treatment Highly Curable
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Q: Is testicular cancer curable?

Yes - testicular cancer has one of the highest cure rates of all cancers. Even metastatic disease is curable in 70–80% of patients with modern chemotherapy. Stage I has a >99% 5-year survival.

Q: What is radical orchidectomy?

Surgical removal of the affected testicle through an inguinal (groin) incision. It is both diagnostic (provides histology) and curative for localised disease. The procedure is done under general anaesthesia and takes about an hour.

Q: Will I still be fertile after one testicle is removed?

Most men retain normal fertility with one healthy testicle. Sperm banking is strongly recommended before any chemotherapy or radiotherapy as a precaution.

Q: Does losing a testicle affect testosterone?

Usually no - the remaining testicle compensates. Testosterone levels and sexual function are generally maintained. A prosthetic implant can be placed for cosmetic reasons.

Q: What are the warning signs of testicular cancer?

A painless lump or swelling in the testicle, feeling of heaviness in the scrotum, or a dull ache in the lower abdomen. Any new scrotal mass in a man aged 15–35 should be evaluated urgently by ultrasound.

Testicular cancer is one of the most treatable cancers - even when it has spread. Dr. Nitin Shrivastava provides complete care from diagnosis through orchidectomy, chemotherapy coordination, and RPLND.

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Types of Testicular Cancer

Seminoma (~50%)

Peaks at age 30–40
Grows slower, more radiosensitive
Treated with surgery ± radiation/carboplatin
AFP marker always normal
Excellent prognosis at all stages

Non-Seminoma (~50%)

Embryonal, yolk-sac, choriocarcinoma, teratoma subtypes
Peaks at age 20–30; grows faster
AFP and/or beta-hCG elevated
BEP chemotherapy when metastatic
RPLND for residual masses post-chemo

Stage-by-Stage Treatment Pathway

Stage	Definition	Seminoma	Non-Seminoma	5-Yr Survival
Stage I	Confined to testis	Orchidectomy + surveillance or single carboplatin	Orchidectomy + surveillance or 1× BEP	>99%
Stage IIA	Nodes <2 cm	Radiation or 3× BEP	3× BEP / primary RPLND	~96%
Stage IIB/IIC	Nodes 2–5 cm	4× EP or 3× BEP	3× BEP then RPLND if residual	~88%
Stage III	Distant mets / high markers	4× BEP ± RPLND	4× BEP ± RPLND ± salvage	70–80%

Watch Dr. Nitin on Testicular Cancer

Patient education videos to help you understand your diagnosis

Testicular Cancer – Dr. Nitin Shrivastava

Testicular Cancer: Symptoms & Treatment

Uro-Oncology Surgery Explained

Radical Orchidectomy: Step by Step

Pre-op assessment

Tumour markers (AFP, β-hCG, LDH), CT staging, sperm banking offered to all pre-chemotherapy patients

Inguinal approach

A groin incision - NOT scrotal - prevents disrupting lymphatic drainage and ensures accurate staging

Cord control first

The spermatic cord is clamped at the internal ring before the testis is delivered, to prevent tumour seeding

Specimen to pathology

Entire testis sent for frozen section / histopathology; subtype and LVI status guide adjuvant decisions

Prosthesis option

Saline testicular implant placed immediately or at a later date if desired - same inguinal incision

24-hr discharge

Most patients discharged the next morning; return to desk work in 5–7 days

🧬 Sperm Banking - Do It Before Treatment

Chemotherapy and radiotherapy can impair fertility. Dr. Nitin routinely refers patients for sperm cryopreservation before any systemic treatment - protecting your future family options.

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MCh AIIMS Delhi · FRCS Oxford · Apollo Hospital Gurugram · 5★ · 450+ reviews

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Frequently Asked Questions

Is testicular cancer curable?

What is radical orchidectomy?

Will I still be fertile after one testicle is removed?

What is RPLND?

Does losing a testicle affect testosterone?

What are the warning signs of testicular cancer?

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Testicular Cancer Treatment Highly Curablewith Expert Care