A man’s lifetime risk of dying from testicular cancer is low — about 1 in 5,000, according the American Cancer Society. One reason the risk is so low is that testicular cancer, which can affect one or both of the testicles, is relatively rare compared with other types of cancer, according to the National Cancer Institute. What’s more, the disease can usually be effectively treated with surgery, radiation, or chemotherapy (or a combination of treatments).
Orchiectomy (Surgery)
Surgery is the standard treatment for testicular cancer. The surgical procedure to remove a testicle affected by cancer is called a radical inguinal orchiectomy. To perform the orchiectomy, your surgeon will make an incision in your lower abdomen (groin) just above the pubic area, and push your testicle up from your scrotum and out through the incision. Your surgeon will then cut through and remove the spermatic cord, which connects the testicle to your abdomen, and tie off the severed ends of the cord (which contains blood and lymph vessels). Your sexual performance will not be affected if you only have one testicle removed. However, losing both testicles results in infertility (since your body no longer produces sperm) and can cause various symptoms related to decreased hormone production, including:
Lower sex driveErectile dysfunctionFatigueHot flashesLoss of muscle mass
Taking hormone supplements can help resolve these testosterone-related issues. In addition to removing your testicles, your surgeon may also remove lymph nodes at the back of your abdomen, which may be affected by the cancer. In this procedure, called a retroperitoneal lymph node dissection, your surgeon will create a large incision down the middle of your abdomen. Alternatively, your surgeon may be able to remove the lymph nodes laparoscopically, which requires a small incision and a narrow, fiber-optic instrument called a laparoscope. These procedures may result in temporary bowel obstruction, wound infections, and long-term retrograde ejaculation, in which semen is ejected backward into the bladder instead of out of the body through the urethra.
Radiation Therapy
Radiation is often used after surgery to kill cancer cells still in the testicular region, or those that have spread to nearby lymph nodes. During radiation therapy, a beam of high-energy X-rays, gamma rays, or particles (electrons, protons, or neutrons) is directed at small areas affected by the cancer. This treatment may be done externally using a machine outside of your body, or internally with radioactive substances delivered using needles, seeds, wires, or catheters. Common side effects of radiation therapy include fatigue, nausea, and diarrhea. Though uncommon, some men experience issues with their skin in the treated area, such as redness, blistering, and peeling. There is always some danger associated with subjecting the body to radiation. For instance, radiation may damage blood vessels and other nearby tissues or organs, increase your risk of getting other cancers, and may affect fertility (in men who have one remaining testicle).
Chemotherapy
Chemotherapy, or “chemo,” is most often used to treat testicular cancer that has spread to the lymph nodes and other organs in the body. It may also be used to reduce the risk of the cancer returning. Chemotherapy for treatment of testicular cancer consists of one or more drugs that are swallowed or injected into the body, such as cisplatin or carboplatin (Platinol), etoposide (Etopophos), or bleomycin. Chemo is a systemic treatment that affects the whole body, and can cause a wide range of side effects, including:
Hair lossMouth soresReduced appetiteDiarrheaNausea and vomitingHigher susceptibility to infectionsFatigueEasy bruising and bleeding
Some chemo drugs may also cause severe side effects, affecting your ability to hear and potentially damaging your kidneys, nerves, lungs, or bladder.
