Urology Associates of Central Missouri unites with Missouri Cancer Associates team of specialists providing comprehensive surgical and medical management of urologic cancers including; kidney, adrenal, bladder, prostate, testicular cancer and genital cancers.
Regular team meetings in a Tumor Board setting determine the most appropriate treatment and care options in each individual case. Together Urology Associates of Central Missouri and Missouri Cancer Associates make collaborative decisions and treatment plans.
Diagnosis & Treatment
Depending on the type of cancer and stage, as well as other factors like age and health, we could use a combination of therapies.
- Radiation Therapy
Surgery is usually the first treatment for all testicular cancers, sometimes augmented by chemotherapy and/or radiation therapy.
Radical Inguinal Orchiectomy
This type of surgery removes the testicle or testes containing the cancer through a small incision made just above the pubic area. Early in the operation, the surgeon ties off the blood and lymph vessels in the spermatic cord to avoid spreading cancer cells into the surgical wound or releasing them into the bloodstream. All stages of testicular cancer can be treated with this surgery.
Retroperitoneal Lymph Node Dissection (RPLND)
In some cases, either during or in a separate surgery from the orchiectomy, it may be necessary to remove some lymph nodes at the back of the abdomen. This isn’t always the case, so it’s important to fully discuss this and possible alternatives with your doctor.
A laparoscope is a narrow, lighted tube with a camera at the end. The surgeon can use this to see inside the abdomen. Using this, very small incisions and long, thin tools, the surgeon can remove lymph nodes without putting hands inside the patient’s body. This seems to be much easier on the patient because of minimal invasion, and patients recover more quickly. However, doctors aren’t sure if this procedure is as effective as standard “open” surgery. If cancer is found in the lymph nodes, chemotherapy may be deemed necessary as well.
Chemotherapy is drug-based cancer treatment commonly taken by pill or intravenous therapy. Testicular cancer patients are usually treated by intravenous drug therapy. Chemotherapy is considered a systemic therapy, because it travels through your body to reach and destroy cancer cells. This is especially effective when cancer cells have broken from the main tumor to reach lymph nodes or distant organs. Chemotherapy is given in cycles, with a treatment period followed by a rest period. Cycles usually last three to four weeks.
If cancer cells have spread to lymph nodes, radiation therapy is a treatment option. It uses a high-energy beam to destroy or slow the growth of cancer cells. This beam could either be gamma or X-rays, or subatomic particles (electrons, protons or neutrons). If the beam is delivered from a machine outside the body, it is called “external beam radiation.” It’s like getting an intense X-ray. The treatment itself only lasts a few minutes but it takes longer to get set up. Radiation can affect healthy tissue as well, but we do our best to minimize these effects using the Calypso System. Common side effects include fatigue, nausea or diarrhea. Sometimes, the skin reacts as if sunburnt, but that fades in time. Possible long-term effects include damage to blood vessels or other organs near the treatment site and an increased chance of getting a second non-testicular cancer later in life.