After you have surgery for testicular cancer, you may have questions about what comes next. You naturally might wonder how it will affect your sex life. You could have other concerns:
- Can I still father a child?
- How will I feel after the surgery?
- Will I need more treatments? How will they make me feel?
This is one of the most treatable cancers. About 95% of men will survive more than 5 years after it’s diagnosed. That gives you plenty of room to think about your life after surgery.
Sex
This might be the first question on your mind: What will this do to my sex life?
If you had just one testicle taken out, you should be able to get an erection and have sex after you recover.
If both of them have to be removed, you can no longer make sperm or father children. And since the testicles also make the male hormone testosterone, you might have a lower sex drive. You also could lose muscle mass and have hot flashes. You may tire out more easily.
Your doctor can suggest ways to work through these problems.
If you still hope to father children, you might want to talk to your doctor about saving, or “banking,” some of your sperm before surgery.
Testosterone supplements, most often given through injections, skin patches or a gel, can boost levels of that hormone.
When to Avoid Fathering a Child
If you need chemotherapy or radiation after surgery, you should not try to get a woman pregnant. There’s a greater chance of birth defects or health problems while you’re undergoing treatments. You may want to wear a condom.
Once your treatment is done, the chance of birth defects or health problems decreases. Ask your doctor about how long to wait before trying to father a baby.
After Lymph Nodes Are Removed
If your doctor found that your cancer spread beyond the testicle, they may have taken out some of the lymph nodes in your abdomen as well.
This procedure has a longer recovery and a higher chance of complications than removing a testicle. But you can still get erections and have sex after this kind of surgery.
One possible problem is your nerves that control ejaculation during sex might be damaged.
If that happens, it can cause something called retrograde ejaculation: Your semen spurts backward into the bladder instead of forward through the penis. Doctors have found ways of avoiding those nerves. Talk with your doctor about this before surgery.
Appearance
After surgery, you may have concerns about how you look to a sexual partner, or in a locker room.
Some men who have a testicle removed get a prosthetic, or artificial, testicle. A doctor can place one in the scrotum so you’ll look and feel more like you did before. Most of these are made of silicone rubber on the outside. Inside they are filled with either saline, which is salt water, or a silicone gel.
You might not want one. It’s a personal decision. Talk it over with your doctor and see how you both feel about another surgery.
Support
Life with cancer can bring up strong emotions, even if your treatment goes well. You might have scars, lose your hair, lose weight or strength, or watch your body change in other ways that affect your mood.
There are many groups that can connect you with people who have gone through the same thing. They can give advice, help you learn more about your illness or just provide moral support.
Sound Mind and Body
Good eating habits, sleep, and exercise can also help you through treatment. If you smoke, you’ll probably want to ask your doctor for help quitting.
You might find you have less interest in sex in the weeks after your surgery. This can be normal. A cancer diagnosis can be upsetting, and you may have to go through therapy that leaves you feeling tired.
You could find your interest in sex returning after you’ve had some time to get over your treatment. Bring up any concerns you have about this with your doctor.
Follow-up Treatments and Tests
Even if doctors have removed all signs of cancer during surgery, you’re going to be asked to come back for regular checkups and tests.
Your follow-ups usually will be scheduled every few months in the first few years, then less often over time. You can expect to get blood tests, scans, and other procedures to make sure your cancer hasn’t come back.
But if your cancer has spread and surgery isn’t a good option, you’re going to need more treatment. That usually means radiation or chemotherapy.
Radiation Therapy
This treatment uses X-rays or other high-energy beams to destroy cancer cells.
Radiation may make you feel very tired. You may throw up -- or feel like you’re going to -- or have diarrhea. These are side effects.
If you have a testicle left, doctors will try to protect it during radiation. But the treatment can affect your sperm count. There’s a bigger chance you will be infertile afterward. As with surgery, you might want to ask your doctor about banking your sperm before you start radiation.
Chemotherapy
Chemotherapy, or “chemo,” means fighting cancer cells with medicine. The drugs either kill them or stop them from splitting into more cells. You may take pills or get liquid drugs through an IV, which is a tube placed in a vein. Which kind you get depends on your case.
The side effects of chemo can differ from one person to another, but you might:
- Feel sick in your stomach
- Lose hair
- Have less energy
- Have more chance of infection
- Have problems with your kidneys, lungs, or nerves
Your doctor has ways to ease these. Talk with them about that before you start treatment.
Chemotherapy is likely to cause infertility, and it could be permanent. Whatever treatment you get, talk to your doctor about preserving your sperm if you still want children.
High dose chemo followed by a stem cell transplant is an option for some men but is typically only used if their cancer has come back after treatment.
