# Seminoma

Source: https://onco.cc/cancers/seminoma/  
OnCo record `seminoma` (Cancer). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Seminoma is the slower, more radiosensitive half of testicular cancer. After removal of the testicle most men need no further treatment and are simply monitored; those who relapse or present with spread are cured with a short course of chemotherapy.

## Summary

Seminoma arises from germ cell neoplasia in situ and presents as a painless testicular mass, with modest rises in hCG and LDH but never AFP, which would mark a non-seminomatous element. After radical inguinal orchidectomy, stage I disease is managed by surveillance in most men, since only about one in six relapse and all are salvageable; a single dose of carboplatin (MRC TE19) or, rarely now, para-aortic radiotherapy are alternatives. Stage II disease with small nodes is treated with radiotherapy or chemotherapy, and bulkier or metastatic disease with three cycles of BEP or four of EP, curing more than 90 percent; residual masses after chemotherapy are assessed with PET rather than removed. Long-term follow-up watches for second cancers and cardiovascular effects of treatment.

## Fields

- Kind: Cancer
- Last checked: 2026-09-17
- Also known as: Classic seminoma; Pure seminoma; Germinoma (when in the brain)
- Tags: subtype-page
- Group: genitourinary
- Burden: Just over half of testicular germ cell tumours, peaking in men in their thirties; almost every patient is cured, and the effort now goes into giving the least treatment that keeps it that way.
- Subtypes: Stage I seminoma (surveillance); Stage II seminoma (nodal); Advanced seminoma (IGCCCG good or intermediate risk); Spermatocytic tumour (older men, almost never metastasises)
- Biomarkers: hCG (mildly raised in a minority) and LDH; AFP normal by definition; Tumour size and rete testis invasion (relapse risk in stage I); PET after chemotherapy for residual masses over 3 cm

## Standard of care

- Stage I: Orchidectomy then surveillance; single-dose carboplatin as an alternative; radiotherapy now rarely used because of second cancers. ([Carboplatin](https://onco.cc/drugs/carboplatin/), [Active surveillance](https://onco.cc/technologies/active-surveillance/))
- Stage II: Radiotherapy for small-volume nodes or chemotherapy (BEP or EP) for larger nodes; de-escalation trials of carboplatin with radiotherapy ongoing. ([Cisplatin](https://onco.cc/drugs/cisplatin/), [Etoposide](https://onco.cc/drugs/etoposide/), [Bleomycin](https://onco.cc/drugs/bleomycin/), [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/))
- Advanced: Three cycles of BEP or four of EP for good risk, four cycles of BEP for intermediate risk; PET-directed management of residual masses. ([Bleomycin](https://onco.cc/drugs/bleomycin/), [Etoposide](https://onco.cc/drugs/etoposide/), [Cisplatin](https://onco.cc/drugs/cisplatin/), [PET (positron emission tomography)](https://onco.cc/technologies/pet/))

## State of the art

- Surveillance has replaced adjuvant radiotherapy as the standard for stage I, sparing most men any treatment beyond surgery.
- Cure rates above 95 percent make late toxicity, second cancers and heart disease the main concern.
- De-escalation trials aim to cut chemotherapy and radiotherapy doses further in stage II.

## Open problems

- Predicting which stage I patients will relapse.
- Late effects of platinum and radiotherapy decades on.
- Rare relapses more than five years out.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Seminoma
- Wikipedia: https://en.wikipedia.org/wiki/Seminoma

## Connected records

- drugs: [Bleomycin](https://onco.cc/drugs/bleomycin/), [Carboplatin](https://onco.cc/drugs/carboplatin/), [Cisplatin](https://onco.cc/drugs/cisplatin/), [Etoposide](https://onco.cc/drugs/etoposide/)
- technologies: [Active surveillance](https://onco.cc/technologies/active-surveillance/), [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/), [PET (positron emission tomography)](https://onco.cc/technologies/pet/)
- cancers: [Testicular germ cell tumours](https://onco.cc/cancers/testicular/)

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JSON: https://onco.cc/api/v1/entities/seminoma.json