# 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

## Sections of this record

The page is a hub with ten sections in reading order; large sections have their own page. The same plan as JSON: https://onco.cc/api/v1/cancers/seminoma/sections.json

- Overview (on the hub): The TL;DR, the family this cancer belongs to, the organ, who gets it and what the state of the art is. https://onco.cc/cancers/seminoma/#overview [3 state-of-the-art points]
- Types and stages (on the hub): Anatomy, the subtypes and how they differ, how it is staged, and where advanced disease spreads. https://onco.cc/cancers/seminoma/#what-it-is [4 subtypes]
- Symptoms and diagnosis (on the hub): How this cancer shows itself, how the diagnosis is confirmed, and the biomarkers clinicians test for. https://onco.cc/cancers/seminoma/#finding-it [4 biomarkers]
- Treatment (on the hub): The standard of care by setting, the medicines, surgery and radiotherapy named in it, and the regimens behind them. https://onco.cc/cancers/seminoma/#treating-it [3 settings, 3 decisions with options]
- Trials and papers (on the hub): Trials recruiting now, the landmark trials, the trials held by this cancer's subtypes, the key papers and what they mean, the latest literature, and the milestones year by year. https://onco.cc/cancers/seminoma/#evidence [3 key papers, 3 milestones]
- Biology and targets (on the hub): The molecular landscape: the targets and how often each appears, the pathways, the mechanics stages and the preclinical models. https://onco.cc/cancers/seminoma/#science [1 target]
- Countries and centres (own page): Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes. https://onco.cc/cancers/seminoma/where-you-are/
- Decisions and support (on the hub): The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask. https://onco.cc/cancers/seminoma/#living-with-it [15 questions, 6 red cards]
- Pipeline and open problems (own page): Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record. https://onco.cc/cancers/seminoma/coming/ [4 medicines, 3 open problems]
- Data (own page): Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked. https://onco.cc/cancers/seminoma/data/ [22 connected records]

## 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

- cancers: [Embryonal carcinoma of the testis](https://onco.cc/cancers/embryonal-carcinoma-testis/), [Germ cell neoplasia in situ (GCNIS)](https://onco.cc/cancers/germ-cell-neoplasia-in-situ/), [Leydig cell tumour of the testis](https://onco.cc/cancers/leydig-cell-tumour/), [Mediastinal germ cell tumour](https://onco.cc/cancers/mediastinal-germ-cell-tumour/), [Non-seminomatous germ cell tumour](https://onco.cc/cancers/non-seminoma/), [Retroperitoneal germ cell tumour](https://onco.cc/cancers/retroperitoneal-germ-cell-tumour/), [Spermatocytic tumour of the testis](https://onco.cc/cancers/spermatocytic-tumour/), [Testicular germ cell tumours](https://onco.cc/cancers/testicular/)
- key papers: [International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers](https://onco.cc/key-papers/paper-igcccg-classification-jco-1997/), [MRC TE19/EORTC 30982: radiotherapy versus single-dose carboplatin as adjuvant treatment for stage I seminoma](https://onco.cc/key-papers/paper-mrc-te19-carboplatin-seminoma-oliver-lancet-2005/), [SEMPET: FDG-PET as a predictor of viable tumour in post-chemotherapy seminoma residuals](https://onco.cc/key-papers/paper-sempet-de-santis-jco-2004/)
- 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/), [AFP, hCG and LDH in germ cell tumours (IGCCCG risk groups)](https://onco.cc/technologies/germ-cell-tumour-markers/), [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/), [PET (positron emission tomography)](https://onco.cc/technologies/pet/)
- people: [Maria De Santis](https://onco.cc/people/maria-de-santis/)
- terms: [Bowel cancer after abdominal and pelvic radiotherapy](https://onco.cc/terms/second-primary-bowel-after-abdominal-radiotherapy/), [Choices made at the time of treatment that change the second cancer risk](https://onco.cc/terms/rejuv-second-choices-made-at-treatment/), [What is not a second cancer: recurrence, metastasis and field cancerisation](https://onco.cc/terms/rejuv-second-what-is-not-a-second-cancer/)

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