Adjuvant radiation therapy for stage I seminoma is no longer recommended as standard treatment. Today, chemotherapy for testicular cancer is given as a single course of carboplatin. The treatment is simpler to carry-out, causes less acute side effects and is not associated with the same delayed side effects such as secondary cancer and benign abdominal illnesses, as radiation therapy.
If radiation therapy is chosen it is administered for seminoma stage I and stage II A,
Patients with nonseminoma should usually not have radiation therapy.
In cases where there is a new primary tumor in the other testicle in a patient previously treated with an orchiectomy, a tumor resection should be considered instead of a new orchiectomy. This is possible for small tumors, however, the surgical treatment must then be followed by radiation treatment to the remaining testis with 2 Gy x 10, for a total 20 Gy. By sparing testicular tissue, testosterone production is preserved, and hormone substitution is not necessary.