Since a few patients may get another testis tumor , observation combined with self-examination and/or a baseline testicular sonography should always be done.
A new testicular cancer is treated according to the stages listed earlier. A relapse indicated only by an increasing HCG or AFP marker requires a completely new work-up.
• When the tumor is documented by CT scan , particularly in late relapsing cases, surgical debulking may be
warranted to identify the type of tumor that recurred, followed by salvage chemotherapy.
• When markers are positive yet cancer cannot be found by any diagnostic test (including MRI), salvage
chemotherapy should be started, since it is generally very successful in such cases. Some doctors, however,
may recommend exploratory surgery first.
• For metastases to the spinal cord and bone, radiation therapy is the treatment of choice to control local
symptoms. Brain metastases may be removed surgically, if possible, and should be followed by therapeutic
