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  • Looking after yourself after treatment for testicular cancer

    Contents

    Cancer can cause physical and emotional strain. It’s important to try to look after your well-being as much as possible.

    Nutrition

    Eating healthy food can help you cope with treatment and side effects. A dietitian can help you manage special dietary needs or eating problems, and choose the best foods for your situation.

    For more information call Cancer Council 13 11 20 if you would like a free copy of Nutrition and Cancer.

    Staying active

    Physical activity may help to reduce tiredness, improve circulation and elevate mood. The amount and type of exercise you do depends on what you are used to, how you feel and your doctor’s advice. If your only treatment was an orchidectomy you may be able to resume vigorous exercise (such as playing sport) 6–8 weeks after the operation. Men who’ve had chemotherapy, radiotherapy or other types of surgery may need longer to recover from treatment. Your doctor can give you advice about this.

    Cancer Council’s Exercise for People Living with Cancer booklet provides more information about the benefits of exercise and outlines simple exercises that you may want to try. 

    Complementary therapies

    These therapies are used with conventional medical treatments. You may have therapies such as massage, relaxation and acupuncture to increase your sense of control, decrease stress and anxiety, and improve your mood. Let your doctor know about any therapies you are using or thinking about trying as some may not be safe or evidence-based.

    Alternative therapies are used instead of conventional medical treatments. These therapies, such as coffee enemas and magnet therapy, can be harmful. 

    For more information call Cancer Council 13 11 20 if you would like a free copy of our Understanding Complementary Therapies book.

    Relationships with others

    Having cancer can affect your relationships with family, friends and colleagues. This may be because cancer is stressful, tiring and upsetting, or as a result of more positive changes to your values, priorities, or outlook on life.

    Give yourself time to adjust to what’s happening, and do the same for others. People may deal with the cancer in different ways – for example by being overly positive, playing down fears, or keeping a distance. It may be helpful to discuss your feelings with each other.

    For more information call Cancer Council 13 11 20 if you would like a free copy of our Emotions and Cancer book.

    Fertility

    Most men treated for testicular cancer, especially men with one testicle remaining, can go on to have children naturally.
     
    Your doctor may advise you to use certain types of contraception, such as condoms, during and after treatment. This is to protect your partner and avoid pregnancy as chemotherapy and radiotherapy can be toxic to your partner or harm a developing baby.
     
    Ask your doctors how long you should use contraception as the amount of time will depend on the treatment you receive. It may be for up to 6–12 months.
     
    Chemotherapy and radiotherapy can temporarily decrease sperm production – particularly radiotherapy to the pelvis. Sperm counts usually increase when treatment is over but sometimes it can take one or more years before there’s enough healthy sperm to conceive. In some cases infertility can be permanent. For this reason, some men choose to store (bank) sperm before treatment starts for use at a later date. 
     
    Sperm banking is one of the easiest and most effective methods of preserving fertility, and samples can be stored for many years. Although there is a cost involved, most sperm-banking facilities have various payment options to make it more affordable.

    Men who have both testicles removed, which is rarely required, will no longer produce sperm and will be infertile. Men who experience retrograde ejaculation will also be infertile.

    Infertility can be very upsetting for you and your family, and you may have many mixed emotions about the future. It may help to talk to a counsellor or family member about how you are feeling.

    For more information call Cancer Council 13 11 20 and ask for a free copy of Fertility and Cancer.

    Sexuality and intimacy

    A common question asked by men with testicular cancer is whether their sex life will be affected by treatment. Having cancer can affect your sexuality in both physical and emotional ways. The impact of these changes depends on many factors such as treatment and side effects, your self-confidence, the way you see your changed body and whether you have a partner. The changes can be temporary or permanent.

    Knowing the potential challenges and addressing them will help you adjust to these changes. Different cancer treatments have different effects on sexuality:

    • Surgery (orchidectomy) – the removal of one testicle will not affect your ability to have an erection or an orgasm.
    • Chemotherapy – this may cause your erections or orgasms to decrease for a few weeks because the drugs can lower your testosterone levels. It can also affect fertility.
    • Radiotherapy – treatment to the abdomen is unlikely to affect semen production but treatment to the pelvis may temporarily stop semen production. This means that you will still feel the sensations of an orgasm but little or no semen will be ejaculated. This is called a dry orgasm. Some men say that a dry orgasm does not feel as strong or long-lasting as an orgasm with semen, while others say it is more intense. Semen production usually returns to normal after a few months.
    • Retroperitoneal lymph node dissection (RPLND) – this may damage the nerves that control ejaculation causing sperm to travel backwards into the bladder instead of forwards into the penis (retrograde ejaculation). You will still feel like you are having an orgasm, but it will permanently affect your fertility.
    • All treatments – tiredness, anxiety and worry are common during all types of cancer treatment. These effects can lower your interest in sex but sex drive usually returns when treatment ends.

    For more information, call Cancer Council 13 11 20 and ask for a free copy of Sexuality, Intimacy and Cancer.

    Changing body image

    Cancer treatment can change the way you feel about yourself (your self-esteem). You may feel less confident about who you are and what you can do particularly if your body has changed physically.

    Give yourself time to adapt to the changes. Try to see yourself as a whole person (body, mind and personality) instead of focusing on the parts of you that have changed.

    If you have lost a testicle it will probably not affect your ability to have sex but it may influence how you feel about yourself as a man. You may have less confidence and feel less sexually desirable. Getting used to having one testicle will take time. If you have a partner explain how you are feeling.

    If you continue to be concerned about your appearance you may wish to speak to your medical team about getting a prosthesis (artificial testicle).

    Follow-up after treatment

    Treatment for testicular cancer usually has a good outcome. Only about 2–3% of men who have had cancer in one testicle develop cancer in the other testicle. However some men have a recurrence of cancer in another part of the body, such as the lymph nodes.

    After treatment you will need regular check-ups to confirm that the cancer hasn’t come back. A physical examination, blood tests, chest x-rays and/or CT scans may be done. Check-ups will become less frequent if you have no further problems. If you have health concerns between follow-up appointments let your doctor know immediately.

    It’s important to make surveillance a priority as the tests can detect cancer recurrence early when it is most likely to be cured.

    What if testicular cancer returns?

    For some men testicular cancer does come back after treatment. This is known as a recurrence. This is why it is important to have regular check-ups.

    Treatment will depend on whether the cancer is in the other testicle, whether it has spread and what type of testicular cancer it is. Men with advanced cancer may have surgery and/or high-dose chemotherapy. Your doctor will discuss your treatment options with you.

    Unlike many other cancers there is still a good chance that a recurrence of testicular cancer may be cured.

    This website page was last reviewed and updated January 2017.

    Information last reviewed September 2016 by: A/Prof Declan Murphy, Urologist, Director of Genitourinary Oncology, Peter MacCallum Cancer Centre, VIC; Gregory Bock, Urology Cancer Nurse Coordinator, WA Cancer & Palliative Care Network, WA; A/Prof Martin Borg, Radiation Oncologist, Adelaide Radiotherapy Centre, SA; A/Prof Joseph McKendrick, Medical Oncologist, Eastern Oncology, Eastern Health and Monash University, VIC; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council Western Australia, WA; Ben Peacock, Consumer; and Deb Roffe, Cancer Council Nurse, Cancer Council SA.

     

     

     

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