Testicular Cancer

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Specialists in Duke’s nationally ranked urology and cancer programs use the latest medical and surgical techniques to treat testicular cancer and preserve as much normal function as possible. We are experts at nerve-sparing surgery, a procedure that can stop cancer from spreading while retaining your ability to have children.

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Comprehensive Care for Testicular Cancer

If you are concerned about testicular cancer, the first thing you should know is that it’s highly treatable and very curable. Since it often occurs in young men, preserving your ability to father children is an important concern. Our experienced medical team ensures you receive the best care that results in effectively treating your cancer and preserving your reproductive abilities.

We treat many men with testicular cancer, ranging from basic, early-stage tumors to complex and advanced cases. Our testicular cancer care combines the knowledge and expertise of our urology and cancer programs. We use advanced imaging to determine the type of testicular cancer you have and recommend the best course of treatment.

If your cancer has spread, chemotherapy is usually required. If residual tumors remain after chemotherapy, our skilled surgical oncologists precisely remove lymph nodes using a surgical procedure that spares the nerves that control ejaculation. We are also expertly equipped to perform a stem cell transplant if needed for advanced testicular cancer that does not respond to conventional chemotherapy. We do everything possible to ensure you achieve the best possible outcome and return you to normal, healthy living as soon as possible.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Treatments

Depending on the stage and type of your testicular cancer, your doctors may recommend one or more of the following treatment options.

Active Surveillance

If cancer is found in its earliest stages, or has not spread beyond your testicle or testicles, your doctor may recommend that treatment not start immediately. Instead, you will undergo regular exams, including blood work and imaging scans designed to look for signs that the cancer has changed or spread.

Chemotherapy

Prevents tumors from spreading or treats testicular cancer that has already spread outside the testicle or testicles. It may be combined with surgery or radiation.

Radical Inguinal Orchiectomy

Surgical removal of one or both testicles, depending on the presence of cancer, as well as the spermatic cord through an abdominal incision. This procedure is the initial treatment for all stages of testicular cancer. Many times, it is the only treatment required. You may choose to have a prosthetic testicle filled with saline inserted during the procedure or at a later date to attain the look of a normal testicle.

Nerve-Sparing Retroperitoneal Lymph Node Dissection (RPLND)

Removes the lymph nodes in your retroperitoneum (the space in the back of your abdomen that holds your kidneys and pancreas) through an abdominal incision. The nerve-sparing surgery is performed by urologic surgeons who are specially trained in vascular techniques. The surgery prevents the cancer from spreading to other areas of your body and protects nerves located near the lymph nodes that control ejaculation.

Post-Chemotherapy RPLND

Post-chemotherapy retroperitoneal lymph node dissection (RPLND) removes lymph nodes in the retroperitoneum after chemotherapy. Testicular cancer typically spreads here through your retroperitoneal lymph nodes. We use this technique to remove any tumors that have spread to the lymph nodes.

Radiation Therapy

Kills cancer cells with high-energy light. Often used to prevent your cancer from returning, or as a primary treatment for seminoma, a specific type of testicular cancer.

High-Dose Chemotherapy with Stem Cell Transplant

Combines chemotherapy with a stem cell transplant to treat testicular cancer that returns after an initial course of chemotherapy. The stem cell transplant allows doctors to use higher doses of chemotherapy to kill as much of the cancer as possible, which can also deplete your body of its own defense cells. The stem cell transplant prevents the infections and bleeding that can occur when bone marrow is damaged. After the high-dose chemotherapy, you receive an infusion of your own stem cells, which grow into healthy blood cells.

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Tests

Blood Tests

Blood tests are used to identify substances, also referred to as tumor markers, that are normally found in your blood that may indicate cancer if found in abnormally high levels. Key tumor markers in testicular cancer include lactate dehydrogenase (LDH), human chorionic gonadotropin (hCG), and α-fetoprotein (AFP).

CT Scan

Cross-sectional imaging produces detailed pictures that can indicate whether cancer has spread to other sites in your body.

PET Scan

A radioactive sugar molecule is injected into your body to highlight organs and tissues that might contain cancer.

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

Why Choose Duke

The Duke Cancer Institute
The Duke Cancer Institute brings together the extensive resources of Duke University, Duke Health, and the Duke Comprehensive Cancer Center. We are committed to making innovative discoveries, developing new ways to prevent, diagnose, and treat cancer, and delivering those therapies in a patient- and family-centric way.

Testicular Cancer Thought Leaders
Duke is a National Cancer Institute-designated Comprehensive Cancer Center. We are also part of the National Comprehensive Cancer Network (NCCN), an alliance of the nation’s leading cancer centers dedicated to improving cancer care. We have representation on an NCCN panel responsible for developing the best evidenced-based methods for managing testicular cancer.

Nerve-Sparing Surgery
We know testicular cancer can alarm young men who want to father children. If your cancer must be surgically removed and your type and stage of cancer permit, we offer nerve-sparing surgery, which helps maintain normal ejaculation.

An Expert Team Dedicated to Your Care
Your testicular cancer care team includes specialists in testicular and urologic cancer, including urologic oncologists, surgeons, medical oncologists, and radiation oncologists. Our experts meet routinely to discuss our patients' care. This ensures you receive the most effective treatments.

Highly Trained Specialists
Our urologic oncologists are fellowship-trained, meaning they studied for additional years to become experts in urologic oncology. Our medical oncologists are fellowship-trained in genitourinary cancer, which includes testicular cancer.

Comforting Environment
Duke Cancer Center features spacious waiting areas, a Quiet Room, large infusion rooms, and a rooftop garden area where patients -- depending on their treatment regimen -- can receive chemotherapy outdoors.

Support for You and Your Loved Ones
Our comprehensive support services range from helping patients minimize the side effects of treatment to coping with the emotional and psychological effects of diagnosis and treatment. View our cancer support groups in our event calendar.

Patient Resources

Duke Specialty Pharmacy

This page was medically reviewed on 07/06/2023 by

Michael R. Abern, MD | Urologic Oncologist