Treatment for testicular cancer is usually very successful and most men can now be completely cured, even if the cancer has spread beyond the testicles. The treatment will depend on the type of cancer (whether it is a teratoma or a seminoma) and whether it has spread beyond the testes.

There are three main types of treatment surgery, chemotherapy and radiotherapy.

If your tests show that you have testicular cancer, you will be looked after by a multidisciplinary team. This is a team of staff who specialise in treating testicular cancer and in giving information and support. It will normally include:

• surgeons who are experienced in testicular surgery
• specialist nurses who give information and support
• oncologists – doctors who have experience in testicular cancer treatment using chemotherapy and radiotherapy
• radiologists who help to analyse scans and x-rays
• pathologists who advise on the type and extent of the cancer.

Other staff will also be available to help you if necessary, such as:

• physiotherapists
• counsellors and psychologists
• social workers.

If you have any questions about your treatment don't be afraid to ask your doctor or a nurse. It often helps to make a list of questions before you go for appointments. You may also like to take a close friend or relative with you when you see the doctor.

If you work, it may be helpful to ask the doctor or specialist nurse, whether the treatment may affect your ability to work. We have a separate section on employment issues.

Many people are frightened at the idea of having cancer treatments, because of the side effects that can occur.

Some people ask what would happen if they did not have any treatment. If no treatment is given, the cancer is likely to continue to grow and develop slowly and spread to other parts of the body. It can then stop these parts of the body working properly.

Although many of the treatments can cause side effects, these can usually be controlled with medicines.

Early-stage testicular cancer

In people with early-stage testicular cancer, surgery alone may cure the cancer. But often, treatment with chemotherapy or radiotherapy is also given to reduce the risk of the cancer coming back. These treatments are successful in curing the cancer in over 95% of men (more than nine out of ten).

If the cancer comes back

If testicular cancer comes back, the treatment can again get rid of the cancer in most men.

Advanced stage

If the cancer comes back again, or has spread widely in the body, further treatment may still be able to get rid of the cancer. In the rare situation where a cure is not possible, treatment may be able to control the cancer, leading to an improvement in symptoms and a better quality of life. However, for some men in this situation the treatment will have little effect upon the cancer and they will get the side effects without any of the benefit.

Making decisions about treatment in this situation can be difficult, and you may need to discuss in detail with your doctor whether you wish to have treatment. If you choose not to, you can still be given supportive (palliative) care – with medicines to control any symptoms.

Before you have any treatment, your doctor will explain its aims to you. They will usually ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should have been given full information about:

• the type and extent of the treatment you are advised to have
• the advantages and disadvantages of the treatment
• any other treatments that may be available
• any significant risks or side effects of the treatment.

If you do not understand what you have been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it is not unusual for people to need repeated explanations.

People often feel that the hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you. The staff should be willing to make time for you to ask questions.

You can always ask for more time to decide about the treatment if you feel that you can't make a decision when it is first explained.

You are also free to choose not to have the treatment. The staff can explain what may happen if you do not have it. It is important to tell a doctor or the nurse in charge, so that they can record your decision in your medical notes.

You do not have to give a reason for not wanting to have treatment, but it can be helpful to let the staff know your concerns so that they can give you the best advice.

Usually a number of cancer specialists work together as a team and they use national treatment guidelines to decide on the most suitable treatment for a patient. Even so, you may want to have another medical opinion. Most doctors will be willing to refer you to another specialist for a second opinion, if you feel it will be helpful. The second opinion may cause a delay in the start of your treatment, so you and your doctor need to be confident that it will give you useful information.

If you go for a second opinion, it may be a good idea to take a friend or relative with you, and have a list of questions ready, so that you can make sure your concerns are covered.