ENTesticular cancer usually starts as a painless lump that a young man finds himself and then delays seeing a doctor, because nothing hurts. It mainly affects the young: in Germany it is the most common malignant tumour in men between 25 and 45. Yet it responds well to treatment, even after it has spread.
Testicular cancer treatment in Germany follows a clear national standard, and two things matter most: not losing time and banking sperm before treatment. Below: diagnosis, tumour types, surgery, metastases and specialists. Other testicular and urinary conditions are covered under urology in Germany.
How the diagnosis is confirmed
The diagnosis rests on scrotal ultrasound, blood tests and CT, and is confirmed on the removed tumour. Blood is tested for the markers AFP, hCG and LDH, proteins released by the tumour that later show how it responds to treatment. CT of the abdomen, pelvis and chest checks the lymph nodes and lungs.
A needle biopsy through the skin is usually not done. The testicle is examined during surgery through a groin incision, and the pathologist makes the final diagnosis on the removed testicle, so surgery is both diagnosis and first treatment. This follows the German S3 guideline on testicular germ cell tumours; an update is being prepared.
Seminoma and non-seminoma: why the difference matters
The difference matters because the two types grow and respond to treatment differently. Both arise from germ cells, the cells that produce sperm. Seminoma usually grows more slowly and is very sensitive to radiotherapy and chemotherapy; non-seminomas grow faster and more often raise the markers.
Tumour type, stage and markers after surgery decide whether further treatment is needed and which. If the cancer has spread, the international IGCCCG classification sorts patients into good, intermediate and poor prognosis groups, which set the number of chemotherapy cycles. General principles are covered under cancer treatment in Germany.
Surgery and what comes next
The first step is removing the affected testicle through a groin incision (orchiectomy); if wanted, a silicone prosthesis can be inserted in the same operation. One healthy testicle usually produces enough male hormones, and any shortfall is treated with medication. Fathering children remains possible, though some men already have reduced fertility at diagnosis.
So sperm banking is offered before surgery, or at the latest before chemotherapy or radiotherapy, since treatment can reduce fertility temporarily or long-term; it must be arranged within days. If the ejaculate contains no sperm, they can be retrieved from testicular tissue during the same operation.
Without metastases, there are three options: surveillance on a schedule, one or two short chemotherapy cycles, or radiotherapy for some seminomas. For seminoma and low-risk non-seminoma, the German guideline favours surveillance. The doctor explains the pros and cons, and the decision is shared.
If the cancer has spread
The main treatment is cisplatin-based chemotherapy in cycles, usually with etoposide and bleomycin; the number of cycles depends on the prognosis group. Each cycle takes several days on a ward or in a day clinic, and the fall in markers after the first cycles shows whether the tumour is responding. Small lymph node metastases of seminoma can also be irradiated.
Masses over a centimetre left in the retroperitoneal lymph nodes after chemotherapy for non-seminoma are removed. This retroperitoneal lymph node dissection, a demanding operation on the nodes along the large vessels at the back of the abdomen, belongs in experienced centres. Seminoma residues are usually monitored. On relapse, high-dose chemotherapy with the patient’s own stem cells, other regimens and clinical trials are discussed.
Patients can ask their doctor to coordinate the treatment plan with a second-opinion centre for testicular tumours. Follow-up lasts for years, frequent at first and later less so, and specialists advise never stopping it, as late relapses and late effects are possible. Oncological rehabilitation helps patients recover after chemotherapy.
Where testicular cancer is treated in Germany
Testicular cancer is treated throughout Germany; what counts is experience with these tumours. Prof. Marcus Hentrich, for example, is Medical Director of the Red Cross Clinic Munich and head of its haematology and oncology department; testicular and other urogenital tumours are among his main fields. In 2024 and 2025, FOCUS-Gesundheit listed him as a top doctor for testicular tumours.
Prof. Michael Rink is Head of Urology at the Catholic Marienkrankenhaus in Hamburg; his fields include uro-oncological surgery (including the testicles) and drug therapy for urological cancers. The city’s reputation matters less than a urologist and an oncologist who treat these tumours regularly and work together.
Frequently asked questions
Can I still have children after testicular cancer?
It is possible but cannot be predicted, so the chance is preserved before treatment. Chemotherapy and radiotherapy can reduce sperm production temporarily or long-term, and some men already have reduced fertility at diagnosis. Sperm is therefore frozen before surgery, or at least before chemotherapy, for later use in assisted reproduction.
Does the testicle always have to be removed?
Almost always: if the other testicle is healthy, the affected one is removed entirely. Removing only the tumour is considered in special cases, such as tumours in both testicles, a tumour in a single testicle or some benign growths. The pathologist’s report on the removed tissue then defines the tumour type and further treatment.
Can treatment continue in Germany if the testicle was removed at home?
Yes. German specialists work from the records: the histology report, slides and paraffin blocks, dated tumour markers from before and after surgery, and CT images. From these they determine tumour type and stage and choose between surveillance and chemotherapy. Dates matter, because doctors look at how the markers fall after surgery.
How AlenMed arranges testicular cancer treatment
AlenMed arranges treatment from your records: we collect and translate them and send them to urologists and oncologists at partner hospitals across Germany. We need the ultrasound, dated tumour markers, the post-surgery histology report, slides and CT images. If surgery is still ahead, sperm banking comes first. A slide review in Germany sometimes refines the tumour type, and with it the plan.
Costs depend on whether surgery alone is needed or also chemotherapy and lymph node surgery. After reviewing the records, the hospital states the amount in a cost estimate (Kostenvoranschlag); see cancer treatment costs in Germany. We help with the visa invitation, an interpreter and accommodation, and you leave with a follow-up plan for home. AlenMed’s office is in Munich; partner hospitals are all over Germany.
This material is for information only and is not an offer. The treatment plan is decided by a doctor at an in-person consultation.
News on this topic
Charité treats first beta-thalassemia patient with CRISPR
At Berlin Charité, a 19-year-old beta-thalassemia patient became the first in Germany to receive the newly approved CRISPR gene therapy Exagamglogene Autotemcel.
Real-World Breast Cancer Study Confirms High Five-Year Survival Rates in Germany
A landmark study of over 43,000 German patients reveals a five-year invasive disease-free survival rate of 82.9 percent in early hormone receptor-positive breast cancer.
FDA Approves Jülich Diagnostic Radiotracer FET for Brain Tumor Imaging
The FDA approves the diagnostic radiotracer FET (Pixclara®) for evaluating brain gliomas, highlighting decades of neuro-oncology research at Forschungszentrum Jülich.
