Hearing your doctor say you have cancer can be frightening. But treatments for testicular cancer work extremely well. Most men make a complete recovery. However, it's pretty much certain that you'll need an operation to remove the affected testicle. But it's perfectly possible to have sex and father children with just one testicle.

You're more likely to recover from testicular cancer than almost any other kind of cancer. The cyclist Lance Armstrong recovered from testicular cancer and went on to win the Tour de France a record seven times.

When doctors talk about people who've had treatment for cancer, they don't usually say people are cured. This is because, in theory, there's always a chance the cancer could come back. So, doctors tend to talk about five-year survival instead. This means that someone is alive and free from cancer five years after being diagnosed.

In practice, if you've been treated for testicular cancer and you're alive after five years, it's pretty much the same as being cured.

With treatment, nearly all men recover from testicular cancer and are alive five years after being diagnosed. If you'd like to read the statistics, see Survival rates for testicular cancer.

Yes. If you have testicular cancer, you'll need an operation to remove the affected testicle.

 

 

 

 

 

Source:
Dearnaley DP, Huddart RA, Horwich A.
Managing testicular cancer.
BMJ. 2001; 322: 1583-1588.

 

 

 

 

 

¹

It's rare for men to get cancer in both testicles at once.

 

 

 

 

 

Source:
Colls BM, Harvey VJ, Skelton L.
Bilateral germ cell testicular tumors in New Zealand: experience in Auckland and Christchurch 1978-1994.
Journal of Clinical Oncology. 1996; 14: 2061-2065.

 

 

 

 

 

²

 

 

 

 

 

Source:
Osterlind A, Berthelsen JG, Abildgaard N et al.
Risk of bilateral testicular germ cell cancer in Denmark: 1960-1984.
Journal of the National Cancer Institute. 1991; 83: 1391-1395.

 

 

 

 

 

³ There's a barrier in your scrotum between your testicles, which usually stops cancer from spreading from one to the other.

 

 

 

 

 

Source:
Osterlind A, Berthelsen JG, Abildgaard N et al.
Risk of bilateral testicular germ cell cancer in Denmark: 1960-1984.
Journal of the National Cancer Institute. 1991; 83: 1391-1395.

 

 

 

 

 

³ So, most men only need one of their testicles removed. The other testicle can take over the job of the missing testicle, so most men will be able to have sex and father children without any problems.

A very small number of men get cancer in both testicles at once. In one study, only about 1 in 500 men with cancer in one testicle turned out to have cancer in their other testicle at the same time.

 

 

 

 

 

Source:
Osterlind A, Berthelsen JG, Abildgaard N et al.
Risk of bilateral testicular germ cell cancer in Denmark: 1960-1984.
Journal of the National Cancer Institute. 1991; 83: 1391-1395.

 

 

 

 

 

³ If this happens, you'll need to have both testicles removed.

About 2 in 100 men go on to get cancer in their remaining testicle in the years after treatment.

 

 

 

 

 

Source:
Osterlind A, Berthelsen JG, Abildgaard N et al.
Risk of bilateral testicular germ cell cancer in Denmark: 1960-1984.
Journal of the National Cancer Institute. 1991; 83: 1391-1395.

 

 

 

 

 

³ This can mean you need a second operation to remove your other testicle.

If you have both testicles removed, you'll need to take hormone treatments to keep your sex drive. And you'll need to have your sperm frozen before the operation if you want to have children.

You might be concerned about how your body will look if you have a testicle removed. It's possible to have an implant in your scrotum to make your testicles look the same as before the operation. For more information, see Surgery to remove the affected testicle.

You can have a perfectly normal sex life after treatment for testicular cancer. One study found that about 70 in 100 men had no problems having sex.

 

 

 

 

 

Source:
Jonker-Pool G, Hoekstra HJ, van Imhoff GW et al.
Male sexuality after cancer treatment - needs for information and support: testicular cancer compared to malignant lymphoma.
Patient Education and Counselling. 2004; 52: 143-50.

 

 

 

 

 

⁴ Although you'll have had the affected testicle removed, your remaining testicle can make all the sperm and testosterone you need.

However, testicular cancer is a serious illness. You'll probably be worried about the future. You might need several types of medical treatment. Treatment can be tiring and may continue for several weeks. All these things can affect your attitude to life, including how you feel about sex. But there's no need to rush. You'll probably feel more optimistic about the future once you start having treatment.

 

 

 

 

 

Source:
Trask PC, Paterson AG, Fardig J et al.
Course of distress and quality of life in testicular cancer patients before, during, and after chemotherapy: results of a pilot study.
Psychooncology. 2003; 12: 814-820.

 

 

 

 

 

⁵

Some men do encounter problems having sex after being treated for testicular cancer. The problems men got were:

 

 

 

 

 

Source:
Jonker-Pool G, Van de Wiel HB, Hoekstra HJ.
Sexual functioning after treatment for testicular cancer: review and meta-analysis of 36 empirical studies between 1975-2000.
Archives of Sexual Behavior. 2001; 30: 55-74.

 

 

 

 

 

⁶

But the doctors who found these figures said there were some problems with the research. Men were asked to fill in a questionnaire about their sex lives. Researchers think that men who had problems were more likely to reply. So, sexual problems might be less common than these numbers suggest. Any problems you get will also depend on the particular treatments you have.

Some types of testicular cancer can affect the levels of

 

 

 

 

 

hormones
Hormones are chemicals that are made in certain parts of the body. They travel through the bloodstream and have an effect on other parts of the body. For example, the female sex hormone estrogen is made in a woman's ovaries. Estrogen has many different effects on a woman's body. It makes the breasts grow at puberty and helps control periods. It is also needed to get pregnant.

 

 

 

 

 

hormones in your body. Hormones control all sorts of things, including your sex drive. The levels of hormones in your body get back to normal between three and six months after treatment for testicular cancer.

 

 

 

 

 

Source:
Nazareth I, Lewin J, King M.
Sexual dysfunction after treatment for testicular cancer: a systematic review.
Journal of Psychosomatic Research. 2001; 51: 735-743.

 

 

 

 

 

⁷ So, if there have been changes in your sex life, they might get back to normal after this time. When men do get sexual problems after being treated for testicular cancer, they don't usually last longer than two years.

 

 

 

 

 

Source:
Nazareth I, Lewin J, King M.
Sexual dysfunction after treatment for testicular cancer: a systematic review.
Journal of Psychosomatic Research. 2001; 51: 735-743.

 

 

 

 

 

⁷

Some men find they can't ejaculate after being treated for testicular cancer. You may hear your doctor call this dry climax or retrograde ejaculation. It doesn't mean you can't have an orgasm. It means that when you do orgasm, no semen (or much less semen than before) comes out of your penis.

You're most likely to get this problem if you have an operation to remove some of the

 

 

 

 

 

lymph nodes
Lymph nodes (also called glands) are small, bean-shaped lumps that you cannot usually see or easily feel. They are located in various parts of the body, such as the neck, armpit and groin. Lymph nodes filter the lymph fluid and remove unusual things, such as bacteria and cancer cells.

 

 

 

 

 

lymph nodes in your abdomen.

 

 

 

 

 

Source:
Jonker-Pool G, Van de Wiel HB, Hoekstra HJ.
Sexual functioning after treatment for testicular cancer: review and meta-analysis of 36 empirical studies between 1975-2000.
Archives of Sexual Behavior. 2001; 30: 55-74.

 

 

 

 

 

⁶

 

 

 

 

 

Source:
Kao J, Mantz C, Garofalo MC, et al.
Treatment-related sexual dysfunction in male nonprostate pelvic malignancies.
Sexuality and Disability. 2003; 21: 3-20.

 

 

 

 

 

⁸ But surgical techniques are getting better all the time. It used to be that nearly 9 in 10 men had dry climax after an operation to remove some of their lymph nodes.

 

 

 

 

 

Source:
Kao J, Mantz C, Garofalo MC, et al.
Treatment-related sexual dysfunction in male nonprostate pelvic malignancies.
Sexuality and Disability. 2003; 21: 3-20.

 

 

 

 

 

⁸ But more modern types of surgery mean that fewer men get this problem.

 

 

 

 

 

Source:
Nazareth I, Lewin J, King M.
Sexual dysfunction after treatment for testicular cancer: a systematic review.
Journal of Psychosomatic Research. 2001; 51: 735-743.

 

 

 

 

 

⁷

 

 

 

 

 

Source:
Kao J, Mantz C, Garofalo MC, et al.
Treatment-related sexual dysfunction in male nonprostate pelvic malignancies.
Sexuality and Disability. 2003; 21: 3-20.

 

 

 

 

 

⁸ With keyhole surgery (laparoscopic surgery), the risk may be lower than 2 in 100.

 

 

 

 

 

Source:
National Institute for Health and Clinical Excellence.
Laparoscopic retroperitoneal lymph node dissection for testicular cancer.
March 2006. Available at http://www.nice.org.uk/download.aspx?o=IPG158guidance (accessed on 23 April 2008).

 

 

 

 

 

⁹ To read more about the different types of operation, see Surgery to remove lymph nodes for testicular cancer.

If you have dry climax, you'll still get erections and you'll still have the feeling of ejaculation during sex. So, you should be able to enjoy sex. But you'll be unlikely to have children naturally if you have dry climaxes.

If you want to have children, you should tell your doctor before you have treatment for testicular cancer. You can consider having your sperm samples frozen and stored in a sperm bank.

 

 

 

 

 

Source:
National Institute for Health and Clinical Excellence.
Guidance on cancer services: improving outcomes in urological cancers, the manual.
September 2002. Cancer service guidance. Available at http://www.nice.org.uk (accessed on 18 April 2008).

 

 

 

 

 

¹⁰

If you have dry climax, even though you don't ejaculate when you have sex, your testicle will still make sperm. You can have a small operation where a doctor takes sperm directly from your testicle using a needle. You may be able to have children this way. For more information, see ICSI and IVF in our section on Fertility problems.

If you have chemotherapy, you'll be advised to use condoms during sex while you're being treated.

 

 

 

 

 

Source:
British National Formulary.
Anthracyclines and other cytotoxic antibiotics.
BNF 55. March 2008. Section 8.1.2. Available at http://bnf.org (accessed on 23 April 2008).

 

 

 

 

 

¹¹ This is because the drugs used in chemotherapy could harm the baby if your partner got pregnant. There's also a small chance that traces of the drugs could get into your partner's body in your semen. Chemotherapy drugs can be poisonous, so it makes sense to use condoms to protect your partner, just in case.

Many men go on to father children after being treated for testicular cancer. One study looked at men who'd had one testicle removed and an operation to remove some of their lymph nodes.

 

 

 

 

 

Source:
Kao J, Mantz C, Garofalo MC, et al.
Treatment-related sexual dysfunction in male nonprostate pelvic malignancies.
Sexuality and Disability. 2003; 21: 3-20.

 

 

 

 

 

⁸ Three-quarters of the men were able to have children after they'd had their cancer treated.

Testicular cancer itself can make it harder to have children. Roughly half of men with testicular cancer have lower-quality sperm.

 

 

 

 

 

Source:
Kao J, Mantz C, Garofalo MC, et al.
Treatment-related sexual dysfunction in male nonprostate pelvic malignancies.
Sexuality and Disability. 2003; 21: 3-20.

 

 

 

 

 

⁸ So, having treatment may make it more likely that you'll be able to have children.

However, some treatments for testicular cancer can reduce your chances of being able to father children.

 

 

 

 

 

Source:
Kao J, Mantz C, Garofalo MC, et al.
Treatment-related sexual dysfunction in male nonprostate pelvic malignancies.
Sexuality and Disability. 2003; 21: 3-20.

 

 

 

 

 

⁸

Before you have treatment for testicular cancer, your doctor should offer you the chance to have your sperm frozen.

 

 

 

 

 

Source:
National Institute for Health and Clinical Excellence.
Guidance on cancer services: improving outcomes in urological cancers, the manual.
September 2002. Cancer service guidance. Available at http://www.nice.org.uk (accessed on 18 April 2008).

 

 

 

 

 

¹⁰ If your doctor doesn't mention this, be sure to ask about it. However, having sperm frozen may not help if your cancer has damaged the quality of your sperm.

If you've had chemotherapy or radiation therapy and intend to have children, your doctor will also probably advise you not to get your partner pregnant for some time after your treatment finishes. You may be asked to wait six months or a year. That's because there could be a risk of birth defects in the baby if your sperm have been damaged. Waiting for a while gives your sperm time to get back to normal.

If you're having problems getting your partner pregnant after being treated for testicular cancer, fertility treatments may help. For more information, see Fertility problems.

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