Testicular cancer

Content written by John P. Mulhall, MD

Testicular cancer is generally a cancer of young men. It is routinely a curable cancer, especially when diagnosed in its early stages. The treatment of testis cancer includes removal of the cancerous testicle, usually followed by either radiation to the abdomen or chemotherapy (depending on which type of testis cancer exists). In some men who have large lymph glands in their retroperitoneum (the space behind the abdominal cavity) a surgical procedure is required to remove these lymph glands. This procedure is known as a retroperitoneal lymph node dissection (RPLND). Men with testis cancer can run into sexual problems in one of three ways. As mentioned elsewhere the diagnosis of cancer particularly when combined with the potentially emasculating testicle removal surgery is associated with high levels of distress, which may lead to loss of libido and erectile dysfunction. The chemotherapy used to treat testis cancer can impair testicle function in the remaining testicle and often leads to problems with test off from production, which may lead to a variety of symptoms including loss of libido. Finally RPLND surgery particularly when performed following chemotherapy may be associated with temporary and sometimes permanent loss of the ability to ejaculate. This is not to say that the man will not experience orgasm, but the orgasm will be dry with the absence of ejaculation.