At Penn, our medical oncologists are part of large multidisciplinary teams whose approach to cancer is to treat the entire individual — not just the disease.
Medical oncologists are physicians who specialize in the diagnosis and treatment of cancer. Our oncologists work closely with radiation and surgical oncologists to treat testicular cancer patients with medical therapies such as chemotherapy, and bone marrow and stem cell transplants.
Chemotherapy uses drugs to attack cancer cells, slowing or stopping their ability to grow and multiply. Chemotherapy may also be given:
- Orally: taking pills or capsules by mouth
- Intravenously (IV): injecting medication into a vein
- Intramuscularly (IM): injecting medication into a muscle
- Subcutaneously: injecting medication under the skin
Chemotherapy is not a "one-size-fits-all" cancer treatment. The wide range of cancer-fighting drugs attack different types of cancer cells at varying stages of cell development. Our oncologists are known for their expertise in determining which drug or combination of drugs will be the most effective in treating the various types of cancer.
High-Dose Chemotherapy with Stem-Cell Transplant
High-dose chemotherapy with stem cell transplant is a treatment that gives high doses of chemotherapy while replacing stem cells destroyed by the cancer treatment. Stem cell transplant is very similar to a bone marrow transplant except that the stem cells are harvested from the patient's bloodstream rather than the bone marrow. The purpose of stem cell transplant in cancer treatment is similar to transplanting bone marrow, namely to make it possible for patients to receive very high doses of chemotherapy and/or radiation therapy.
Today, more and more people are surviving cancer. Clinical trials, like the clinical trial for proton therapy to treat testicular cancer, benefit patients with access to breakthrough therapies and treatments. These new advances in cancer treatment are occurring every day at Penn Medicine, giving patients hope that even greater discoveries lie ahead.
Through clinical trials:
- Diagnosing cancer has become more precise.
- Radiation and surgical techniques have advanced.
- Medications are more successful.
- Development of new, targeted therapy for testicular cancer.
- Combinations of medical, surgical and radiation therapy are improving treatment effectiveness and enhancing outcomes.
- Strategies to address the late effects of cancer and its treatment are improving quality of life.
Radiation therapy uses high-energy X-rays to kill cancer cells. At Penn Radiation Oncology, we use the latest equipment and technology available to treat testicular cancer. Our radiation oncologists are recognized leaders in techniques that target radiation precisely to the treatment area while sparing normal tissue.
At Penn, men with testicular cancer have access to new and advanced treatment options and ongoing clinical trials in radiation therapy including proton therapy. As part of our commitment to advancing cancer care in patients, radiation oncologists are also researching how radiation treatment affects the quality of life for cancer patients.
Penn Medicine's Roberts Proton Therapy Center is the largest and most advanced facility in the world for this precise form of cancer radiation. Our patients have access to one of the most sophisticated weapons against cancer, seamlessly integrated with the full range of oncology services available at the Abramson Cancer Center.
Proton therapy is external beam radiotherapy in which protons are directed at a tumor. The radiation dose that is given through the protons is very precise, and limits the exposure of normal tissues. The result for testicular cancer is the chance of fewer harmful side effects.
Proton therapy, like all forms of radiation therapy, works by aiming the energized particles, in this case protons, onto the target tumor. These particles damage the DNA of cells, ultimately causing their death. Unlike X-rays, protons can be manipulated to release most of their energy only when they reach their target, eliminating exit radiation. With proton therapy, the goal is to reduce the possibility of second cancers that may come as a result of radiotherapy.
Penn Radiation Oncology is partnering with other leading cancer centers to evaluate proton beam therapy for the treatment of testicular cancers.
Image-Guided Radiation Therapy
Image-guided radiation therapy (IGRT) uses frequent imaging during a course of radiation therapy to improve the precision and accuracy of the delivery of radiation treatment.
In IGRT, proton gantries and linear accelerators (machines that deliver radiation) are equipped with imaging technology that take pictures of the tumor immediately before and during the time radiation is delivered. Specialized computer software compares these images of the tumor to the images taken during the simulation to establish the treatment plan. Necessary adjustments can then be made to the patient's position and/or the radiation beams to more precisely target radiation at the cancer and avoid exposure to the healthy surrounding tissue.
Intensity-Modulated Radiation Therapy (IMRT) or Conformal Radiation Therapy
Our radiation oncologists also use conformal radiation therapy and, in some cases, intensity-modulated radiation therapy (IMRT), to treat testicular cancer. IMRT is an advanced mode of high-precision radiotherapy that utilizes computer-controlled linear accelerators to deliver precise radiation doses to tumors or specific areas within the tumors. Radiation therapy, including IMRT, stops cancer cells from dividing and growing, thus slowing or stopping tumor growth. In many cases, radiation therapy is capable of killing all of the cancer cells.
Using 3-D computed tomography (CT) images in conjunction with computerized dose calculations, IMRT and conformal radiation therapy allows for the radiation dose to conform more precisely to the three-dimensional shape of the tumor by controlling, or modulating the intensity of the radiation beam in multiple small volumes. The therapy allows higher radiation doses to be focused on regions within the tumor while minimizing the dose to surrounding normal critical structures.
Surgery is an essential treatment for patients with testicular cancer. Surgery to remove a testicle is called radical inguinal orchiectomy. During this surgery, the testicle with cancer is removed, as well as some of the affected lymph nodes.
Even if surgery removes all the cancer that can be seen at the time of the surgery, some patients may receive chemotherapy after surgery to kill any remaining cancer cells.
In addition to standard treatments and clinical trials, you may wish to add additional therapies and treatments such as massage therapy, acupuncture and art therapy. These therapies do not have curative intent, and are designed to complement standard treatments, not take their place.
Integrative Oncology Services
At Penn, our integrative oncology services can supplement traditional cancer treatments such as chemotherapy, surgery and radiation therapy. While conventional medicine plays a critical role in eradicating cancer, integrative oncology services offer you ways to enhance the quality of your life, minimize or reduce the side effects of cancer and cancer treatment, and promote healing and recovery.
Our cancer specialists are knowledgeable and supportive of complementary cancer treatments. Our cancer team works with you and your family to integrate these supportive programs into the overall care plan, while ensuring your health and safety.
The Abramson Cancer Center's range of integrative oncology services is designed to help you cope with the cancer experience and improve your overall sense of well-being.
Joan Karnell Supportive Services at Pennsylvania Hospital offers an extensive variety of supportive care programs for patients and families, from diagnosis through survivorship. These programs are available at no cost to the patients treated at Pennsylvania Hospital, and some are open to patients treated elsewhere. These services include social work counseling, nutrition counseling, psychological counseling and spiritual counseling.
The Cancer Appetite and Rehabilitation Clinic focuses on patients with loss of appetite and weight.
The Supportive Oncology Clinic helps to manage cancer related symptoms. Integrative support programs include:
Palliative care provides medical and non-medical interventions to ease the symptoms of cancer and its treatment. Palliative care includes physical, emotional and spiritual care that can enhance the quality of life for cancer patients. Palliative care can be used to complement traditional cancer therapies, or can be used when curative therapies are no longer an option to treat symptoms and improve quality of life.
Palliative care is an approach to patient care that can be integrated with curative therapies at any point from diagnosis to survivorship or end of life care. Palliative care services include palliative chemotherapy, radiation therapy and surgery as well as psychological counseling, art therapy and support groups for patients and families.
Penn Home Care and Hospice Services
Penn Home Care and Hospice Services offer a full range of home health care needs by partnering three top-level home health care services under one roof:
Penn Home Care and Hospice Services offer an array of specialized therapies and medications for patients with cancer and cancer-related conditions.