Active surveillance for testicular cancer
You may be offered active surveillance if you have normal tumour markers and CT scan results after surgery to remove the testicle (called an orchiectomy). Active surveillance means that your healthcare team watches the cancer closely rather than giving treatment right away. They will use tests and exams to check if testicular cancer is progressing or your condition is getting worse. Treatment is given when the cancer comes back (recurs).
You may be offered active surveillance for stage 1 testicular cancer after a radical inguinal orchiectomy (an orchiectomy). It is the preferred treatment for stage 1 testicular cancer after surgery because it helps avoid problems or side effects that can happen with chemotherapy or radiation therapy. There is no evidence so far that people won’t live as long when they get active surveillance compared to other treatments. And there is no evidence that active surveillance has other negative effects if or when you start treatment or on your cancer outcome in general.
There are no standard active surveillance schedules for testicular cancer. Active surveillance may last for 5 to 10 years. You may have follow-up visits every 2 to 6 months for the first 3 years and then less often for the remaining years.
Tests that are often done during a follow-up visit include:
- physical exam
- blood tests to check tumour marker levels
- chest x-ray
- CT scan of the abdomen
Alberta Health Services. Testicular Germ Cell Tumours Clinical Practice Guideline GU-001. Version 7 ed. Alberta Health Services; 2016: https://www.albertahealthservices.ca/assets/info/hp/cancer/if-hp-cancer-guide-gu001-testicular.pdf.
American Cancer Society. Treatment Options for Testicular Cancer, by Type and Stage. 2018: https://www.cancer.org/cancer/testicular-cancer/treating/by-stage.html.
American Society of Clinical Oncology. Testicular Cancer: Treatment Options. 2017: https://www.cancer.net/cancer-types/testicular-cancer/treatment-options.
BC Cancer Agency (BCCA). Cancer Management Guidelines: Testis Nonseminomatous Germ Cell Tumours (With or Without Seminoma). 2013: http://www.bccancer.bc.ca/books/testis/management/nonseminomatous-germ-cell-tumours-(with-or-without-seminoma).
BC Cancer Agency (BCCA). Cancer Management Guidelines: Testis Pure Seminomas. 2013: http://www.bccancer.bc.ca/books/testis/management/pure-seminomas.
National Cancer Institute. Testicular Cancer Treatment (PDQ®) Health Professional Version. Bethesda, MD: National Cancer Institute; 2018: https://www.cancer.gov/types/testicular/hp/testicular-treatment-pdq.
Wood L, Kollmannsberger C, Jewett M, et al . Canadian consensus guidelines for the management of testicular germ cell cancer. Canadian Urological Association Journal. Montreal: Canadian Urological Association; 2010.