Note: The following list of radiation questions is aimed at someone that is going to have a radiation treatments or is trying to decide between radiation and surveillance. He has already been diagnosed with a pure seminoma tumor, and has had enough tests done to determine that he is not a candidate for primary chemotherapy (advanced Stage II or Stage III). Keep in mind that radiation is used for testicular cancer far less often than in the past. There is a greater concern about long term side effects and second cancers, particularly if the disease is not contained and you eventually need chemotherapy as well. It may make more sense to do chemotherapy now and be done with treatment. This should definitely be a part of your discussion with the doctor.

Important: You should be having this discussion with a radiation oncologist, not a urologist. That said, keep in mind that the radiation oncologist is going to be biased towards radiotherapy. I encourage you to also speak with a medical oncologist for a second opinion.

If you have any comments, questions, or suggestions about this list, please feel free to send me an email!

WHY RADIATION?

• What Stage is my cancer?
• What is the significance of cancer found in the lymph nodes?
• Why is radiation recommended for me?
• Why is it necessary to radiate the lymph nodes?
• What is a port?
• Can you show me where these lymph nodes are and what part of my body would be radiated?
• Do I have any other choice of treatment? (Surveillance? Chemo?)
• If surveillance is an option (If you are Stage 1, it is an option), can I see a medical oncologist before making a decision about the radiation treatments?
• What are the benefits of having radiation?
• What are the risks and side-effects of the treatments?
• What do I have to gain or lose by not having the radiation now?
• Will I be cured?
• If I choose surveillance and the cancer comes back, will I be treated by radiation or by chemotherapy?
• What type of costs am I looking at?
• Have you treated someone for stage and type cancer before? If so, how many?
• What percentage of patients usually respond to this treatment?
• How quickly must I decide about my treatment?
• Will a reduction or delay in treatment reduce my chances of being cured?

RADIATION TREATMENT

• How soon should radiotherapy be started?
• In what form and how often will the treatment be given?
• What kind of radiation are you going to use?
• How does the doctor work out the radiotherapy dose?
• How long will each treatment take?
• How long will the entire course of therapy last?
• Where will I have to go for treatment?
• Who will administer my treatments?
• How often, during treatment, will I see a physician? a nurse?
• Can I drive to and from my appointments?
• Will I need someone to accompany me to the treatments?
• Can I stay alone after my treatments, or do I need to have someone stay with me?
• Can I continue to work, exercise, etc. during these treatments? Are there special precautions I should take while on radiotherapy or afterwards?
• What will it feel like to get treated?
• What type of results should I expect to see with the treatment?
• Will there be tests during my treatment to determine if it is working?
• Are there any medications I should not take while I'm going through treatment?
• What are the precautions or restrictions during treatment? After treatment? (For example, skin creams, lotion, underarm shaving, etc.)
• Are there any activities I should or should not do while I m going through treatment?

AFTER THE RADIATION TREATMENTS

• What happens when the treatment finishes?
• What does it take to say we're done? What is the criteria to stop treatment and go to the monitor phase?
• How can I tell if the treatment is working?
• How long will it be before I feel better and can get back to my normal routine?
• How often are checkups and tests required after treatment is completed and which specialist will manage my care?
• Would you be willing to consult with an expert if a problem arises?

RADIATION RELATED SIDE EFFECTS

• What are the side effects of this treatment?

• Nausea?
• Vomiting?
• Hair loss (will my hair grow back in the radiation port?)
• Low blood cell counts? (anemia: low red-blood-cell count, neutropenia: low count of one type of white-blood cell, low platelets, etc.)
• Diarrhea/constipation?
• Skin changes?
• Incontinence?
• Infertility?
• Pain?
• Sores along the digestive tract?
• Ulcers?
• Fatigue?
• When might these side effects occur?
• How long will the side effects last?
• What can I do to reduce the side effects?
• Will side effects get better/worse/same over the course of treatment?
• What kind of "schedule" can I expect during the radiation treatments (when will I begin having nausea, when will I stop having nausea.)?
• How can I get practical advice in dealing with side effects?
• Could these side effects be life-threatening?
• Which side effects should I report to the health care provider immediately?
• Will my treatment affect driving?
• Will the treatment affect my work/education?
• Will I still be able to look after my family, or will I need help?
• Does radiotherapy make you radioactive?
• Will radiotherapy make my hair fall out?
• How will it affect my sex life?
• If I can have sex during or after my treatment, will my partner be at risk in any way?
• What type of precautions do I need to take?
• Will radiotherapy make me infertile?
• Will I be able to father children after the treatment?
• How can I find out more about the sperm banking service?
• What are the long term side effects of radiotherapy?
• Will I be able to live a normal life when I get older?

RADIATION SUPPORT

• Who can I talk to about problems with sex and fertility?
• Where can we go to get emotional/mental/marital/medical support during treatment? Does the hospital/clinic offer such services?
• I'm worried about what my friends will say. How can I handle that?

RADIATION MISCELLANEOUS

• Can changing what I eat help me recover from my cancer and/or the radiotherapy?
• Is there anything I should avoid?
• Who can I talk to about what I should be eating?
• What are the telephone numbers I should have in order to reach you? the nurse? the hospital?
• When do I next see you?