Last updated: 07-Oct-2026
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For most men whose cancer is confined to the testis, surveillance is the treatment, so each visit is kept on time, like a dose.
On surveillance, visits come every three months for two years, with AFP, hCG and LDH each time, then six-monthly to five years.
Blood markers and scans are both needed, because some returns show only on a scan and some only in the blood.
After the testis is removed, most men whose cancer has not spread are offered surveillance instead of more treatment. Surveillance means no chemotherapy now, and close checks so that any return is found early and treated.
That only works if the checks happen. So surveillance is run with the seriousness of treatment, and the visits are closest together in the first two years.
Before surveillance is chosen, one practical question is asked: can you attend? If regular visits will be hard, because of distance, work that moves you around, or no phone, a single dose of carboplatin is discussed openly instead of a schedule that will fail.
About two weeks after the operation you come back to the OPD. This visit sets up everything that follows:
Your follow-up path is chosen at this visit, and you leave with the schedule for that path.
On surveillance, the first two years carry the closest checks. Every three months you have:
A CT scan of the abdomen and pelvis is done at set points in these two years, following the EAU 2026 protocol. Whether the chest is imaged, and how, depends on your risk. The exact months are written into your schedule at the two-week visit.
From the third year, the clinical review and the markers move to every six months, and scans become less frequent.
Fewer visits do not mean the risk has gone. They mean the checks are now spaced to match it.
There is no single follow-up schedule for everyone. The plan follows the treatment:
Markers are not a substitute for scans, and scans are not a substitute for markers. Some returns of this cancer raise no marker and show only on a scan. Others show in the blood before anything is seen on a scan.
So both are done, at the stated intervals, for the stated time. Skipping one because the other was normal leaves a gap.
If a marker rises, it is not simply watched. You are restaged with scans, and the tumour board discusses your case the same week.
| When | What is checked | What it looks for |
|---|---|---|
| Two weeks after the operation | Wound, pathology, staging CT, markers, sperm banking | Markers back to normal; the right follow-up path |
| Every 3 months, years 1 and 2 | AFP, beta-hCG, LDH; clinical review; CT abdomen and pelvis at set points | An early return, in the blood or on the scan |
| Every 6 months, years 3 to 5 | Clinical review and markers; fewer scans | A later return |
| One year after treatment, then periodically | Morning testosterone | Low hormone levels after treatment |
| Every month, at home | Self-examination of the other testis | A new lump |
| Beyond five years | Survivorship plan; heart and metabolic checks | Late return; long-term effects of treatment |
Each month, examine the remaining testis yourself. A new tumour can appear in the other testis, and the team shows you how to check at the first visit.
Do not wait for the next visit if you notice any of these:
Late return is real in this disease. A late relapse, or a slowly growing teratoma, can show up years later as back pain or a mass. A growing teratoma is treated with surgery, not chemotherapy.
So no one is discharged without a survivorship plan. It covers:
Results from tests done elsewhere can be sent ahead, so each visit starts with them already read. Decisions are made at the visit, after examination.
No. Some returns of this cancer show only on a scan and raise no marker. The scans in your schedule are done even when the blood tests are normal.
It is not watched for months. You are restaged with scans, and the tumour board discusses your case the same week. The next step is decided from those results.
It depends on whether you can keep the visits. If regular visits will be hard, say so at the start. A single dose of carboplatin may then be discussed as the alternative.
Closest in the first two years, six-monthly to five years, and after that through a survivorship plan. A late return can happen in this cancer, so you are not simply discharged at five years.
Treatment can lower testosterone over time. It is checked about a year after treatment and from time to time after that, and treated if low levels cause symptoms.
Testicular cancer as a whole is covered on the testicular cancer surgery page. For the operation and fertility decisions, see surgery, sperm banking and nerve-sparing RPLND.
Dr Swati Shah — MS, DrNB (Surgical Oncology) · Testicular Cancer Surgeon
Consultation at the Gota OPD, Ahmedabad. Surgery at Apollo Hospital, Bhat, Gandhinagar.
Gota OPD, Ahmedabad — Gota, Ahmedabad, Gujarat
Apollo Hospital, Bhat, Gandhinagar — Apollo Hospital International Limited, Plot No. 1 A, GIDC Bhat Industrial Estate, Bhat, Gandhinagar, Gujarat
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