Choosing treatment for stage I seminoma: who should get what?

We agree that physicians should choose active surveillance for their patients if they have the means to afford health insurance and are relatively stable within their careers. Prophylactic radiotherapy should be offered to patients who need a relaxed follow-up schedule for financial, emotional, or compliance reasons. For adjuvant carboplatin, longer follow-up data are needed to better define survival, long-term toxicities, frequency of second primary testicular cancers, quality of life, and cost to the healthcare system.