How to treat recurrence of testicular cancer

Testicular cancer is a malignant tumor disease that occurs in the testicular tissue. It has multiple and complex causes, so there are many ways to treat testicular cancer. Each patient should choose the appropriate treatment method based on his or her condition. Of course, the possibility of recurrence after treatment cannot be ruled out. Today I will tell you how to treat recurrent testicular cancer.

First, the treatment of clinical stage I testicular cancer

Any testicular tumor should be treated with high-position orchiectomy first, and then the treatment plan should be selected according to the pathological type and clinical stage. Spermatogonia are highly radiosensitive, and a lower dose can eliminate metastatic lesions without causing obvious radiation damage. For clinical stage I testicular seminoma, after high-position orchiectomy, the ipsilateral iliac lymph nodes and retroperitoneal lymph nodes should be preventively irradiated. Linear accelerator high-energy rays, 60Co and kilovoltage X-rays can all be used as external radiation sources. However, high-dose preventive irradiation is not necessary.

Second, the treatment of clinical stage II testicular cancer

In clinical stage IIa, the retroperitoneal metastatic lymph nodes are small, and the irradiation field is the same as that in clinical stage I. In clinical stage IIb, the metastatic lymph nodes are large, and the irradiation field should be designed according to the size of the metastatic lesions to fully include the lymph nodes. For patients with extensive abdominal metastasis, whole abdomen irradiation should be performed. The dose fractionation of radiotherapy for clinical stage II is the same as that for clinical stage I. After irradiating the mid-plane dose of 25Gy, the metastatic lymph nodes in stage IIa are enhanced by 10Gy in a reduced field, and the total mid-plane dose should reach 35Gy/4~5 weeks or more; the enhanced irradiation in stage IIb is 15Gy, and the total dose reaches 40Gy. Whether clinical stage II testicular seminoma requires preventive radiation in the mediastinum and left supraclavicular region is still controversial.

Third, the treatment of clinical stage III and IV testicular cancer

Clinical stage II, III and IV testicular seminoma all require a combination of radiation and chemotherapy. The treatment of stage III cases is the same as that of stage II, but the radiation dose to the metastatic lymph nodes in the mediastinum and left supraclavicular region should reach 35~40Gy/5~6 weeks. For clinical stage IV cases with distant metastasis before treatment, chemotherapy should be the main treatment, supplemented by radiotherapy to control local lesions, and no preventive radiation should be performed. The treatment is reasonable to use chemotherapy-radiotherapy-chemotherapy, that is, the "sandwich" technique, that is, 3 courses of chemotherapy first, followed by irradiation of 35~40Gy/5~6 weeks, and then 3~4 courses of chemotherapy.

Testicular cancer is sensitive to a variety of anti-tumor drugs. Recently, the main treatment used is combined chemotherapy with PVB or VAB-6, PVP16. The cure rate for stage III cases is as high as 90%.

There are many methods for the treatment of testicular cancer, but not all methods are suitable for every patient. We just want to say that we are not afraid of being ill. What is scary is not taking it seriously or giving up and not going to the hospital for treatment. Patients must seek medical treatment in time, which will increase the patient's chance of survival and make it possible to recover health.