After testicular cancer treatment
Surveillance with markers and scans, hormone and fertility questions, the long-term effects of cisplatin, and looking after the remaining testicle.
3 min read · Part of Cancer Types
Written by The LifeAfterward editorial team from the sources listed at the end of this page.
Not individually reviewed by a clinician. This page is written from published clinical guidance, listed in full at the end, and is general information rather than medical advice — your own team knows your case. See our editorial standards.
Last checked against its sources · Last updated · Next check due
In short
- Outcomes are excellent, and surveillance is intensive in the early years precisely because relapse is treatable when caught.
- Surveillance typically combines tumour markers, examination and CT scans on a defined schedule.
- Cisplatin has long-term effects worth monitoring: hearing, neuropathy, kidney function and cardiovascular risk.
- Testosterone levels and fertility should be checked rather than assumed, and self-examination of the remaining testicle continues.
What this means
Testicular cancer survivorship is largely about two things: a demanding surveillance schedule in the first years, and long-term general health afterwards. Because most people are young at diagnosis, the cardiovascular and metabolic effects of treatment matter over decades, and they are the part most often left unmonitored once the scans stop.
Surveillance
- Tumour markers — AFP, beta-hCG and LDH — at regular intervals. Interpreted as a trend, and occasionally raised for benign reasons.
- CT scans on a defined schedule, most frequent in the first two years, then reducing. Chest imaging as required.
- Clinical examination, including the remaining testicle.
- Schedules differ substantially by stage, tumour type and whether you had chemotherapy, radiotherapy or surveillance alone.
Testosterone and fertility
- Ask for testosterone to be checked, particularly if you have fatigue, low mood, low libido, erectile difficulty or reduced bone density. Low testosterone is treatable and is frequently missed.
- Fertility can be affected by the cancer itself as well as by treatment. Semen analysis after treatment gives a clear answer, and sperm can recover over one to three years.
- If sperm was stored, keep track of the storage arrangements and consent renewals — these have deadlines.
- See fertility after treatment.
Long-term effects of chemotherapy
- Hearing loss and tinnitus after cisplatin — ask for an audiology assessment if you notice difficulty in noisy rooms or ringing.
- Peripheral neuropathy — see neuropathy.
- Kidney function — worth checking periodically.
- Cardiovascular and metabolic risk — increased after platinum chemotherapy. Blood pressure, cholesterol, glucose and weight deserve active attention from your thirties onwards, not your sixties.
- Raynaud-type symptoms — cold, painful fingers and toes, reported after platinum chemotherapy.
- Fatigue — common and usually improves over the first year.
The remaining testicle
- There is a small increased risk of a cancer in the other testicle, so monthly self-examination continues indefinitely.
- Check after a warm shower: roll each testicle between thumb and fingers, feeling for a hard lump, swelling, or a change in size or weight.
- The epididymis — a soft tube behind the testicle — is normal anatomy and often mistaken for a lump.
- Report any new firm lump, swelling, ache or heaviness promptly.
What to ask your healthcare team
- What is my surveillance schedule, and for how long does it continue?
- What do my tumour markers look like, and what change would concern you?
- Can I have my testosterone level checked?
- Should I have a semen analysis, and what are my fertility options?
- Do I need hearing or kidney assessment after cisplatin?
- Who monitors my cardiovascular risk long term?
Save questions to My Journey so you have them in the room, or use a ready-made list.
When to seek medical advice
Contact your healthcare team if you have:
- A lump, swelling, ache or change in the remaining testicle.
- Back pain, abdominal pain or a lump in the abdomen.
- Persistent cough, breathlessness or coughing blood.
- Fatigue, low mood or low libido that could indicate low testosterone.
- New hearing difficulty or tinnitus.
Get emergency help the same day if you have:
- Sudden severe testicular pain — seek urgent assessment.
- Severe breathlessness, chest pain or coughing blood.
If you are worried and unsure, contact your team anyway — they would far rather hear from you unnecessarily than late. What to do in an emergency.
Common questions
How long is follow-up after testicular cancer?
Usually around five years, with the most intensive surveillance in the first two, though this depends on stage, tumour type and treatment. Long-term health monitoring — testosterone, cardiovascular risk, hearing and kidney function — matters well beyond that.
Will I be able to have children after testicular cancer?
Many men do. Fertility can be affected by the cancer itself as well as by treatment, and sperm production may recover over one to three years. A semen analysis gives a direct answer, and stored sperm remains an option where preservation took place.
Sources
This page was written from the guidance below and checked against it on . Links are re-checked at each review — see our editorial standards.
- ASCO (Cancer.Net). Survivorship
- National Comprehensive Cancer Network. NCCN Guidelines for Patients
- National Cancer Institute (US). Follow-up medical care after cancer treatment
- Journal of Clinical Oncology (2020). Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers: ASCO Guideline Update (Loprinzi et al.)
- National Cancer Institute (US). Late effects of cancer treatment