Orchidectomy & Testicular Cancer

Testicular cancer forms in one of the two testicles, which are contained within a sac of skin known as the scrotum which hangs behind the penis. Testicles secrete sex hormones and contain germ cells which give rise to sperm; most testicular tumors arise in the germ cells. Testicular cancer is rare, but is the most common cancer affecting males between the ages of 15 and 34. It is treated with a high success rate, and several treatment options exist. The primary treatment is orchidectomy; sometimes called orchiectomy, which is the surgical removal of the affected testis.

Symptoms and Diagnosis

• The Mayo Clinic lists the symptoms of testicular cancer as including enlargement of the testicle, a testicular lump, pain of the testicle or scrotum, enlargement of the breasts, fluid retention in the scrotum and achiness of the abdomen and groin. It is recommended to seek medical care if any of these symptoms persist for two weeks or more. Physicians may order blood tests and an ultrasound of the testicle to confirm a diagnosis.

Orchidectomy

• First line treatment of testicular cancer is orchidectomy or the surgical removal of the entire testicle. Saline-filled prosthetic testicles are available and may be surgically inserted following testis removal. Lymph nodes of the groin may also be removed either at the same time as orchidectomy or at a later date; this is done in cases where there is suspicion that the cancer has spread. According to the Mayo Clinic, surgery may be the only treatment necessary if the cancer is detected at an early stage.

Other Treatments

• The patient may undergo both radiation and chemotherapy in conjunction with orchidectomy. Chemotherapy drugs may be in the form of pills or injections. As these drugs are systemic, meaning that they travel throughout the body, they aim to kill cancer cells that may have spread from the original tumor site. The Canadian Cancer Society describes radiation therapy as an external treatment in which a large beam of radiation is focused directly on the tumor to kill cancer cells. For some patients, watchful waiting may be the only recommendation after surgery. This will involve frequent visits to your doctor, blood tests, X-rays and CT scans of the abdomen for the first year following orchidectomy.

Side Effects

• Orchidectomy alone may cause short term pain and nausea but no lasting side effects. Lymph node removal surgery does run the risk of severing surrounding nerves which could cause difficulty with ejaculation. Side effects of radiation therapy consist of fatigue, site irritation and potential infertility. Chemotherapy side effects may include fatigue, nausea, hair loss, increased risk of infection and infertility. The National Cancer Institute states that other medications are often used to combat the side effects of chemotherapy.

Considerations

• Orchidectomy of one testicle should not result in either impotency or sterility so long as the other testicle is functioning normally. However, both radiation and chemotherapy treatments may affect sperm production of the remaining testicle; so patients are counseled to consider sperm banking should they wish to father children in the future.