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Testicular cancer

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Generally, doctors use four kinds of treatments for testicular cancer. They are:

  • Radical inguinal orchiectomy. This surgical procedure involves removing one or both testicles through a cut in the groin. Lymph nodes in the abdomen also may be removed (lymph node dissection). If just one cancerous testicle is removed, there's a small chance that the other will become cancerous at some point. As a result, your doctor will likely recommend regular follow-up exams with a urologist.

  • External beam radiation therapy. This treatment uses high-dose X-rays or other high-energy radiation to kill cancer cells. Seminomas are highly sensitive to radiation therapy, but nonseminomas are not.

  • Chemotherapy. Chemotherapy is used to kill cancer cells outside the testicle. This drug therapy is usually given by infusions into your veins (intravenous), typically in the hospital several days each month. In some cases, chemotherapy may be given by intramuscular injection or in pill form.

  • Bone marrow transplant. In this procedure, bone marrow is taken from you, treated with drugs to kill any cancer cells and then frozen. You then undergo chemotherapy, with or without radiation, to destroy the remaining cancer cells in your body. The chemotherapy also destroys your remaining bone marrow. The frozen marrow is then thawed and injected back into you through a needle in a vein. This relatively new treatment for testicular cancer has shown some promising initial results. Yet doctors don't routinely recommend it because traditional chemotherapy treatments are typically very successful.

Surgery may be in combination with radiation therapy or chemotherapy or both. It depends on the type and the stage of your cancer. Your age and overall health also are factors in choosing treatment options.

You may wonder how treatment for testicular cancer will affect your appearance and sex life. Keep the following in mind:

  • Artificial implants. After the surgical removal of a testicle, you can have an artificial testicle (prosthesis) placed inside your scrotum. The artificial implant has the weight and feel of a normal testicle.

  • Surgery and your sex life. The surgical removal of lymph nodes won't affect your ability to achieve an erection or an orgasm. However, this surgery may cause sterility by interfering with ejaculation. Some men recover the ability to ejaculate without treatment; medication may help others. If you undergo surgery, ask about special techniques that may protect your ability to ejaculate.

  • Radiation therapy and your sex life. Radiation therapy probably won't change your ability to have sex. However, radiation does interfere with sperm production. The effect is usually temporary, and most men regain their fertility within a few months. As a precaution, many men store sperm at a special facility (sperm bank) before treatment, where it can be preserved for later use.

  • Chemotherapy and your sex life. Chemotherapy doesn't have to interfere with a normal sex life. The fatigue caused by chemotherapy, however, may decrease your interest in sexual activity during the months of treatment. Some anti-cancer drugs affect sperm production. Although the effect can be permanent, many men regain their fertility later. Men concerned about their fertility can have their sperm frozen and preserved (cryopreserved) before chemotherapy.


A simple procedure called testicular self-examination (TSE) can improve your chances of finding a tumor. Beginning in your mid-teenage years, and throughout your life, examine your testicles regularly.

A good time to examine your testicles is after a warm bath or shower. The heat from the water relaxes your scrotum, making it easier for you to find anything unusual. Do this once a month.

To do this examination, follow these steps:

  • Stand in front of a mirror. Look for any swelling on the skin of the scrotum.

  • Examine each testicle with both hands. Place the index and middle fingers under the testicle while placing your thumbs on the top.

  • Gently roll the testicle between the thumbs and the fingers. Remember that the testicles are usually smooth, oval shaped and somewhat firm. It's normal for one testicle to be slightly larger than the other. Also, the cord leading upward from the top of the testicle (epididymis) is a normal part of the scrotum. By regularly performing this exam, you will become more familiar with your testicles and aware of any changes that might be of concern.

  • If you find a lump, call your doctor as soon as possible. Testicular cancer is highly treatable, especially when identified early.

Regular self-examination is an important health habit. But it can't substitute for a doctor's examination. Your doctor should check your testicles whenever you have a physical exam. If you have an undescended testicle — less than two testicles in your scrotum — be sure to tell your doctor, who may refer you to a urologist for treatment or a more specialized exam.


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