Testicular cancer

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Supportive care for testicular cancer

Supportive care helps people meet the physical, practical, emotional and spiritual challenges of testicular cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.

Recovering from testicular cancer and adjusting to life after treatment is different for each man, depending on the stage of the cancer, the type of treatment and many other factors. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects. A man who has been treated for testicular cancer may have the following concerns.

Self-esteem and body image

How a person feels about themselves is called self-esteem. Body image is how a person sees their own body. Testicular cancer and its treatments can affect a man’s self-esteem and body image.

After surgery to remove one or both testicles, the scrotum looks and feels empty. This may cause concern, anxiety and feelings of embarrassment. It may also cause feelings of being less masculine and attractive. Men with testicular cancer may feel uncomfortable around others because of changes to their body.

Talking about feelings may help some men cope with their changed body image. Support from other testicular cancer survivors and professional counsellors can help. Reconstruction with a testicular prosthesis (artificial testicle) may also help you cope with changes to body image and self-esteem.

For many people, body image and how they think other people see them is closely linked to self-esteem. It may be a real concern for them and can cause considerable distress. They may feel angry or upset, afraid to go out or afraid others will reject them, even if the effects of treatment may not show on the outside of the body.

Find out more about how to cope with problems of self-esteem and body image.

Sexuality

Many men continue to have strong, supportive relationships and a satisfying sex life after testicular cancer. Cancer cannot be spread through sexual contact with a partner.

Having surgery to remove one testicle (called a radical inguinal orchiectomy, or an orchiectomy) should not affect a man’s ability to have an erection and ejaculate because the remaining testicle can make enough testosterone and sperm. Men who have both testicles removed or have lower than normal testosterone levels after the removal of one testicle are usually given testosterone replacement therapy by an injection or a skin patch.

Some treatments for testicular cancer can cause certain sexual problems. Retrograde ejaculation and dry orgasm can be caused by a retroperitoneal lymph node dissection (RPLND). Erectile dysfunction can happen during chemotherapy because drugs can lower testosterone levels. It may also be caused by an RPLND and radiation therapy when damage to nerves and blood vessels affect a man’s ability to have erections.

Talk to your doctor about sexual problems that happen because of testicular cancer treatment and how to manage them. Some men and their partners may need counselling to help them cope with the effects of testicular cancer and its treatments on their sexual relationships.

Find out more about sexual problems for men and how they can be managed.

Fertility

Some treatments for testicular cancer can cause fertility problems, which can affect a man’s ability to produce children (get someone pregnant). Infertility happens when the testicles don’t make enough sperm or the sperm is damaged. Depending on the treatments given, the man’s age and other factors, infertility may be temporary or permanent.

Some surgeries for testicular cancer can cause a permanent loss of fertility. If both testicles are removed (called a bilateral orchiectomy), the man no longer makes sperm so he can’t have children. An RPLND can also cause nerve damage that may result in retrograde ejaculation, which makes a man infertile.

Chemotherapy and radiation therapy can lower the number of healthy sperm made by the testicles. This is usually temporary. Sperm production returns to normal after treatment is finished. Sometimes it can take up to 2 years after treatment for sperm counts and health to return to normal.

If a man wants to have children in the future, he may be offered sperm storing or banking before treatments like RPLND, chemotherapy or radiation therapy. This is because it is hard to know how these treatments will affect fertility. Sperm is collected before treatment starts in case the sperm count does not return to normal after treatment. The sperm is frozen and stored for future use in fertilization procedures known as artificial insemination.

Find out more about fertility problems and how they can be managed.

Questions to ask about supportive care

To make decisions that are right for you, ask your healthcare team questions about supportive care.

testosterone

A male sex hormone that causes male sex characteristics to develop (such as deep voice and facial hair) and stimulates the development of the male reproductive system and sexual activity.

Testosterone is made mainly by the testicles. Small amounts of testosterone are also made in the adrenal glands. It may also be produced in the lab to treat certain conditions.

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