Northern Centre for Cancer Care

Radiotherapy of the testes leukaemia for children

This page has been written to give you general information and answer some of the questions you may have about the side effects of radiotherapy.

We hope you will find this helpful.

Introduction

When the testes contain some leukaemia cells, radiation treatment (radiotherapy) to the testes is recommended. The total radiation dose has to be spread out over quite a long time to make the individual treatments safe. We usually give 12 treatments, one every day (usually excluding weekends and bank holidays). At each session, the patient spends about ten minutes in the treatment room but most of this time is spent getting him/her into exactly the right position.

Radiotherapy does not hurt; it is rather like having an ordinary X-ray. So that we can treat both testes the patient must lie very still on their back. Lying still can be very difficult for some children, especially very young ones. Occasionally we have to use a general anaesthetic.


Side effects

 The dose of radiotherapy to control leukaemia is relatively small which means that side effects are usually mild. Some of the side effects happen immediately, some of them happen soon after completing the course of treatment and some take a longer time to show.

The dose of radiotherapy to control leukaemia is relatively small which means that side effects are usually mild. Some of the side effects happen immediately, some of them happen soon after completing the course of treatment and some take a longer time to show.

Immediate side-effects

  • Tiredness can occur but it is usually mild and only lasts about four weeks.
  • Sickness is unusual during this treatment.

Side effects after completing treatment

  • The skin of the scrotum and groins may change colour, eg become pink or darkened.
  • The skin may become itchy and sore after treatment. It is best to avoid soap and bubble bath and to bathe in warm water only and to gently dab the area dry. Any skin reaction should settle down within four weeks.
  • In older children the pubic hair has usually been lost as a result of chemotherapy but if not it will start to fall out about two weeks after the start of treatment. It starts to grow back about three months after any chemotherapy causing hair loss is finished. 
  • It is possible to get some mild discomfort on passing urine, this is uncommon. If this does happen, it is important to drink plenty fluids.

Long-term side effects

  • These are the hardest to predict and, unfortunately, when they do happen they are permanent.
  • Radiation will affect the production of sperm from the testicle and will lead to infertility.
  • The part of the testes which makes the male hormone (testosterone) is also affected in most cases. This means that nine out of ten males treated will need testosterone replacement at some stage. An endocrinologist (a doctor specialising in hormones) may be asked to be involved in the follow up to advise when testosterone is needed.
  • We are finding that, very rarely, children who have had treatment for one tumour can develop another type of tumour some years later. Your oncologist will explain this during the consent process.

During follow up we will be looking out for all these problems.

More information

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