Testicular Cancer

Surveillance after seminoma

After an operation to remove a testicle for cancer it is important that men are seen regularly for blood tests (every couple of months for a seminoma), x-rays and other checks (see 'Follow-up'), at least for the first few years.

If a man has a seminoma, and if there is no spread of the disease, a single dose of chemotherapy (carboplatin) is used after surgery to treat the cancer (Macmillan Cancer Support for more information).

Until fairly recently surveillance after surgery (regular monitoring with frequent blood tests and x-rays), without chemotherapy, radiotherapy or other adjuvant therapy, has not been considered a suitable option for men with stage 1 (early stage) seminoma, because with a seminoma the blood tests are not very reliable in detecting recurrence. However, because there are some concerns about the long-term effects of some treatments, such as chemotherapy and radiotherapy, some doctors now offer men, with a stage 1 seminoma, surveillance as another option after surgery, as long as they understand the pros and cons, and as long as they agree to attend outpatient clinics regularly for checks and CT scans. 

Many doctors consider that surveillance alone for men with seminoma is still 'experimental' or 'unproven'. This is partly because there is uncertainty about the number of CT scans that are needed for men with early stage 1 seminoma, who have chosen surveillance. 

Not all patients are happy with the idea of surveillance. One man, who had a seminoma, was told that there were three possible treatment options, radiotherapy, chemotherapy or surveillance, but he was told he would have radiotherapy. He trusted his doctors to make the right decision, and was glad to be given radiotherapy. He found the idea of surveillance rather worrying, and in stark contrast to the earlier pattern of his diagnosis and treatment, which focused on prompt treatment.

Two men with seminoma were discouraged from choosing surveillance as an option, even though they wanted to follow that route. One man was upset because he wanted surveillance, but his doctor told him that the health authority wouldn't allow it because the frequent CT scans that he would need would cost more than a short course of radiotherapy.

Another man chose surveillance, but his oncologist wasn't keen on the idea because he was worried about the level of radiation that would be delivered with frequent CT scans. In the end the man 'reluctantly' agreed to have a single dose of Carboplatin (chemotherapy).

Last reviewed March 2015.

Last updated March 2015.

 

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